Choosing the left fork: Steven Offenbacher and understanding maternal periodontal disease and adverse pregnancy outcomes.

Steven Offenbacher was one of the first researchers to identify periodontal disease as a risk factor for various adverse pregnancy outcomes. Cohort and case-controlled studies of pregnant women have demonstrated periodontal disease as a risk factor for preterm birth, preeclampsia, and fetal growth restriction. Periodontal therapy during the second trimester improves maternal oral health but fails to reduce the risk of preterm birth. A possible association between periodontal disease and gestational diabetes has also been reported. In one model, periodontal bacteria gain access to the systemic circulation, and thereby the placenta, resulting in local inflammation, placental dysfunction, and, consequently, adverse pregnancy outcomes. It is crucial to increase awareness of the links between maternal periodontal and adverse pregnancy outcomes and to promote oral health prophylaxis during pregnancy.