| When I was pregnant, it never occurred to me that keeping up with my semi-annual dental checks could help ensure I had a healthy baby.
But it's true. During pregnancy, periodontal disease is linked with a two- to three-fold increase in the risk of both preterm deliveries (at fewer than 37 weeks) and low-birthweight babies. In many parts of the developing world, avoiding these outcomes is a continual battle that if lost can have lifelong health consequences. Prematurity is the world's leading cause of death in children younger than five years old. One simple, inexpensive way to attack the problem doesn't require dentist visits or even access to clean running water, according to a study in the journal Med: offering prospective mothers chewing gum that contains the sugar substitute xylitol as a sweetening agent.
The research was conducted in Malawi, the African country where up to 20% of births are preterm or weighing less than 2.5 kilograms — one of the highest global rates. The randomized trial involving 10,069 women found that chewing xylitol-based gum twice a day "significantly reduced the occurrence" of these risky conditions. The study also showed that regularly using the gum cut not only the risk of death in babies, but also in mothers. Imagine the relief available to families — especially in low- and middle-income countries — in avoiding such an enormous emotional and financial burden. Periodontal disease is a threat because it causes inflammation and the spread of nasty germs. In humans, 1 cubic millimeter of dental plaque contains about 100 million bacteria, the researchers say. When bacteria that causes gum disease, dental plaque and cavities gets into the bloodstream, it can cross through the placenta and affect the fetus, leading to premature labor and low birth weights. Even for pregnant women with access to a dentist, procedures such as dental scaling and root planing may cause the bacteria to spread further. While sugarless chewing gum can help, it can't be just any brand. Xylitol, a naturally occurring sweetener, has prebiotic properties in gum that help crowd out bad bacteria and slow its growth. These benefits differ from sorbitol versions and also from xylitol candies: participants who chewed xylitol had significantly less bleeding of the gums on their second visit to a dentist. Providing xylitol gum has been shown to be effective and inexpensive. To prevent one premature birth, as few as 26 pregnant women are needed to use it regularly, according to the study. At full retail cost this comes to $23.96–$113.86 per person over the course of a full-term pregnancy. The researchers point out that providing this gum to 26 people for 37 weeks costs far less than a single day in intensive care for one newborn. Orbit, Trident and Dentyne are among the brands that use xylitol, though formulations can vary so check the ingredients. An added bonus to using gum? This intervention doesn't add to the growing global problem of antimicrobial resistance that happens when bacteria no longer respond to antibiotics. — Janice Kew | 
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