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Use of alcohol-free antimicrobial mouth rinse is associated with decreased incidence of preterm birth in a high-risk population

      Objective

      We sought to determine if treatment of periodontal disease during pregnancy with an alcohol-free antimicrobial mouth rinse containing cetylpyridinium chloride impacts the incidence of preterm birth (PTB) in a high-risk population.

      Study Design

      This single-blind clinical trial studied pregnant women (6-20 weeks' gestation) with periodontal disease who refused dental care. Subjects receiving mouth rinse were compared to designated controls who did not receive rinse (1 rinse:2 controls), balanced on prior PTB and smoking. Primary outcome was PTB <35 weeks.

      Results

      In all, 226 women were included in the analysis (71 mouth rinse subjects, 155 controls). Incidence of PTB <35 weeks was lower in the rinse group compared to controls (5.6% and 21.9% respectively, P < .01); relative risk was 0.26 (95% confidence interval, 0.096–0.70). Gestational age and birthweight were significantly higher in the rinse group (P < .01).

      Conclusion

      A nonalcohol antimicrobial mouth rinse containing cetylpyridinium chloride was associated with decreased incidence of PTB <35 weeks.

      Key words

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      References

        • Offenbacher S.
        • Katz V.
        • Fertik G.
        • et al.
        Periodontal infection as a possible risk factor for preterm low birth weight.
        J Periodontol. 1996; 67: 1103-1113
        • Jeffcoat M.K.
        • Geurs N.C.
        • Reddy M.S.
        • Cliver S.P.
        • Goldenberg R.L.
        • Hauth J.C.
        Periodontal infection and preterm birth: results of a prospective study.
        J Am Dent Assoc. 2001; 132: 875-880
        • Jeffcoat M.K.
        • Geurs N.C.
        • Reddy M.S.
        • Goldenberg R.L.
        • Hauth J.C.
        Current evidence regarding periodontal disease as a risk factor in preterm birth.
        Ann Periodontol. 2001; 6: 183-188
        • Clothier B.
        • Stringer M.
        • Jeffcoat M.K.
        Periodontal disease and pregnancy outcomes: exposure, risk and intervention.
        Best Pract Res Clin Obstet Gynaecol. 2007; 21: 451-466
        • Lopez N.J.
        • Da Silva I.
        • Ipinza J.
        • Gutierrez J.
        Periodontal therapy reduces the rate of preterm low birth weight in women with pregnancy-associated gingivitis.
        J Periodontol. 2005; 76: 2144-2153
        • Lopez N.J.
        • Smith P.C.
        • Gutierrez J.
        Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomized controlled trial.
        J Periodontol. 2002; 73: 911-924
        • Lopez R.
        Periodontal treatment during pregnancy did not reduce the occurrence of poor pregnancy outcomes.
        Evid Based Dent. 2009; 10: 105
        • Jeffcoat M.
        • Parry S.
        • Samuel M.
        • Clothier B.
        • Catlin A.
        • Macones G.
        Periodontal infection and preterm birth: successful periodontal therapy reduces the risk of preterm birth.
        BJOG. 2011; 118: 250-256
        • Jeffcoat M.K.
        • Hauth J.C.
        • Geurs N.C.
        • et al.
        Periodontal disease and preterm birth: results of a pilot intervention study.
        J Periodontol. 2003; 74: 1214-1218
        • Macones G.A.
        • Parry S.
        • Nelson D.B.
        • et al.
        Treatment of localized periodontal disease in pregnancy does not reduce the occurrence of preterm birth: results from the Periodontal Infections and Prematurity Study (PIPS).
        Am J Obstet Gynecol. 2010; 202: 147-148
        • Michalowicz B.S.
        • Hodges J.S.
        • DiAngelis A.J.
        • et al.
        Treatment of periodontal disease and the risk of preterm birth.
        N Engl J Med. 2006; 355: 1885-1894
        • Fogacci M.F.
        • Leao A.
        • Vettore M.V.
        • et al.
        Periodontal treatment completed before the 35th week of pregnancy appeared to have a beneficial effect on birthweight and time of delivery.
        J Dent Res. 2010; 89: 101-102
        • Novak T.
        • Radnai M.
        • Gorzo I.
        • et al.
        Prevention of preterm delivery with periodontal treatment.
        Fetal Diagn Ther. 2009; 25: 230-233
        • Tarannum F.
        • Faizuddin M.
        Effect of periodontal therapy on pregnancy outcome in women affected by periodontitis.
        J Periodontol. 2007; 78: 2095-2103
        • Radnai M.
        • Pal A.
        • Novak T.
        • Urban E.
        • Eller J.
        • Gorzo I.
        Benefits of periodontal therapy when preterm birth threatens.
        J Dent Res. 2009; 88: 280-284
        • Newnham J.P.
        • Newnham I.A.
        • Ball C.M.
        • et al.
        Treatment of periodontal disease during pregnancy: a randomized controlled trial.
        Obstet Gynecol. 2009; 114: 1239-1248
        • Offenbacher S.
        • Beck J.D.
        • Jared H.L.
        • et al.
        Effects of periodontal therapy on rate of preterm delivery: a randomized controlled trial.
        Obstet Gynecol. 2009; 114: 551-559
        • Wilson W.
        • Taubert K.A.
        • Gewitz M.
        • et al.
        • American Heart Association
        Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Groupx.
        J Am Dent Assoc. 2008; 139: 3S-24S
        • Hunter-Rinderle S.J.
        • Bacca L.A.
        • McLaughlin K.T.
        • Macksood D.
        • Lanzalaco A.C.
        • Doyle M.J.
        Evaluation of cetylpyridinium chloride containing mouthwash using in vitro disk retention and ex vivo plaque glycolysis methods.
        J Clin Dent. 1997; 8: 107-110
        • Kozak K.M.
        • Gibb R.
        • Dunavent J.
        • White D.J.
        Efficacy of a high bioavailable cetylpyridinium chloride mouthrinse over a 24-hour period: a plaque imaging study.
        Am J Dent. 2005; 18: 18-32A
        • P&G
        MSDS Prohealth Rinse; 2008. 1: Material data safety sheet.
        (Accessed Oct. 11, 2010)
        • NIDCR
        Periodontal (gum) disease: causes, symptoms, and treatments.
        (Accessed Feb. 26, 2011)
        • Witt J.J.
        • Walters P.
        • Bsoul S.
        • Gibb R.
        • Dunavent J.
        • Putt M.
        Comparative clinical trial of two antigingivitis mouthrinses.
        Am J Dent. 2005; 18 (Spec No:15A-A)
        • Michalowicz B.S.
        • DiAngelis A.J.
        • Novak M.J.
        • et al.
        Examining the safety of dental treatment in pregnant women.
        J Am Dent Assoc. 2008; 139: 685-695