TREATMENT OF PERIODONTAL DISEASE
It has been known for many years that periodontal disease is associated
with preterm birth (121). Inflamed and infected periodontal
tissues could stimulate preterm labor either by translocation of
periodontopathic organisms, or by stimulation and release of
inflammatory mediators and prostaglandins into the maternal
circulation (122). Disappointingly, randomized controlled trials
of treating periodontal disease during pregnancy have failed to
lower the rate of preterm birth (123–125). It seems likely that the
alterations in maternal immune responses that cause periodontal
disease also predispose women to preterm birth, but that treating
periodontal disease during pregnancy will neither cause nor prevent
this major complication of pregnancy. Nevertheless, further
research is required to investigate if there is any benefit in reducing
rates of preterm birth by treatment of periodontal disease before