(717) Effect of dental treatments on reduction of preterm birth: A systematic review and meta-analysis

We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). We searched EMBASE, MEDLINE, PubMed, and Cochrane Central Register of Controlled Trials from inception to December 2023 with no language restrictions for RCTs enrolling pregnant persons with any dental disease who were randomized to receiving dental treatment versus a control. Pairs of independent reviewers screened studies, and abstracted and assessed the risk of bias of the studies using the Cochrane Risk of Bias tool, RoB 2. We conducted meta-analysis using a random effects model with the Mantel-Haenszel variance estimate. We assessed the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

Results:

We included 19 RCTs, enrolling 8526 participants. The risk of bias for most of the RCTs ranged from some concerns to high risk. The most frequent interventions addressed were scaling and root planing (SRP) with oral hygiene instructions (OHI, 10 RCTs), and SRP with OHI and chlorhexidine mouthwash (6 RCTs). Meta-analysis found low-quality evidence suggesting that dental treatment results in a 22% relative risk reduction of preterm birth (RR 0.78; 95% CI 0.63-0.95) when compared to placebo or control, which was usually minimal dental treatment or oral examination only (absolute difference 29 fewer preterm births per 1000 individuals; 95% CI from 48 fewer to 6 fewer).

Conclusion:

This systematic review suggests that treating dental disease during pregnancy reduces the risk of preterm birth. The main limitations of the evidence are risk of bias and inconsistency. Additional well-powered RCTs at low risk of bias are necessary to increase the certainty about the effect of dental disease treatments during pregnancy on reduction of preterm births.