Each year, an estimated 15 million babies are born prematurely or preterm (defined as delivery before the 37th week of pregnancy), and this number is rising, according to the World Health Organization. Preterm babies are at greater risk of experiencing serious health problems. Over the last several decades, multiple studies have shown a link between poor oral health and the increased occurrence of preterm birth. Researchers have looked at various ways to improve dental health during pregnancy, including doing a “deep-teeth cleaning,” (also called ‘scaling and planing’) which involves removing plaque and tartar on the teeth and below the gum line. However, despite improving periodontitis, deep teeth cleaning approaches have not proven to be effective in the prevention of preterm birth. But now researchers have discovered an easy and inexpensive way to improve oral health and reduce preterm births.
The study, the largest of its kind, was conducted over 10 years and included 10,069 women in the South-Central African country of Malawi, which has the highest number of preterm births in the world. Most Malawians live in rural locations, making it especially difficult to conduct a study of this magnitude. Participants enrolled voluntarily and consented to participation before they became pregnant or within 20 weeks of becoming pregnant. All of the eight health centers provided health care messages promoting oral health care and preterm birth prevention and care, while half of the eight centers were randomized to also provide xylitol chewing gum to enrolled research participants.
In the four health centers that served as the control group, 5,520 participants received basic perinatal and oral health education, including things they could do to help lower the chance of delivering a baby prematurely. In the other four centers, the 4,549 enrolled participants also received this same health education. In addition, they were given xylitol chewing gum and instructed to chew the gum for 10 minutes once a day, ideally twice a day, throughout pregnancy. Out of the 9,670 participants who were available for contact during the up to six years of follow-up, results showed a significant reduction in preterm birth among those who chewed the xylitol-containing gum (12.6 percent vs. 16.5 percent) and fewer low birth weight babies, those weighing 5.5 pounds or less (8.9 percent vs. 12.9 percent). Participants also saw an improvement in their oral health.
“Using xylitol chewing gum as an intervention prior to 20 weeks of pregnancy reduced preterm births, and specifically late preterm births between 34 to 37 weeks,” says the study’s lead author Kjersti Aagaard, MD, PhD, a Professor in Maternal-Fetal Medicine and Vice-Chair of Obstetrics & Gynecology at Texas Children’s and Baylor College of Medicine in Houston.
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