Oral prophylaxis for the reduction of interdental dysbiosis-associated red complex pathogens during pregnancy: a randomized clinical trial
Résumé
Periodontal disease during pregnancy is associated with adverse outcomes such as preterm birth, low birth weight, and preeclampsia. Socransky’s red complex pathogens including Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, are key risk factors for these complications. This study aims to evaluate whether daily use of calibrated interdental brushes, in addition to conventional tooth brushing, reduces the bacterial load these pathogens in pregnant women. Methods A randomized controlled trial was conducted in six obstetric clinics in Senegal between March 2022 and January 2023. One hundred pregnant women, aged 18–40 and in their third month of pregnancy, were randomized into a test group using interdental brushes plus tooth brushing and a control group using tooth brushing alone. The outcome was the change in bacterial load from the third to eighth month of pregnancy, quantified using real-time polymerase chain reaction techniques. Results By the eighth month, the test group demonstrated a statistically significant reduction in total bacterial load compared to the control group, with a mean reduction of 36.6% (95% CI: 31.2–41.1%, p < 0.001). Notably, T. denticola load decreased by 92.1% (95% CI: 87.1–95.6%, p < 0.001) in the test group, while it increased in the control group. Reductions were also observed for P. gingivalis and T. forsythia , although these differences were not statistically significant ( p = 0.061 and p = 0.148, respectively). Discussion These findings suggest that adding calibrated interdental brushes to a conventional tooth brushing routine is more effective in lowering the bacterial load of harmful red complex pathogens in pregnant women. Conclusion The results support the inclusion of interdental cleaning in prenatal oral health care guidelines as a strategy for managing periodontal risk during pregnancy.
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