Dental Cleaning, Community Water Fluoridation and Preterm Birth, Massachusetts: 2009–2016.

Abstract

Objectives: Data on the potential effect of dental cleaning and community water fluoridation (CWF) on pregnancy outcomes are scarce. While numerous studies confirm the cost-effectiveness of fluoride in preventing dental caries, the benefit of CWF during pregnancy has not been well established.

Methods: This cross-sectional study used data from 2009 to 2016 Massachusetts Pregnancy Risk Assessment Monitoring System and restricted to singleton live births (n = 9234, weighted response rate = 64.3%). Our exposures were: (1) dental cleaning alone during pregnancy; (2) CWF alone; and (3) dental cleaning and CWF combined (DC–CWF). Women without dental cleaning during pregnancy and CWF comprised our reference group. The outcome was preterm birth, (birth <37 weeks gestation). This study used multivariate logistic regression modeling, controlling for maternal sociodemographic characteristics, previous medical risk and behavioral factors, and calculated adjusted risk ratios (aRRs) and 95% confidence intervals (CIs).

Results: During 2009–2016, the prevalence of preterm birth among women with a singleton live birth was 8.5% in Massachusetts. Overall, 58.7% of women had dental cleaning during pregnancy, and 63.6% lived in CWF. After adjusting for potential confounders, the associations between dental cleaning alone and preterm birth (aRR = 0.74 [95% CI 0.55–0.98]), and DC–CWF and preterm birth (aRR = 0.74 [95% CI 0.57–0.95]) were significant, while the association between CWF alone and preterm birth was not significant (aRR = 0.81 [95% CI 0.63–1.05]), compared to women without dental cleaning and CWF.

Conclusions for Practice: This study shows that the prevalence of preterm birth was lower among women with DC only and DC–CWF.

Appendix

MA PRAMS questions on Dental Cleaning

https://www.mass.gov/files/documents/2016/07/vj/prams-09-11-survey.pdf

Years 2009-2011, Q78

https://www.mass.gov/files/documents/2016/07/pr/prams-12-15-survey.pdf

Years 2012-2015, Q31c

https://www.mass.gov/files/documents/2017/11/30/prams-survey-2016-2019.pdf

Year 2016, Q27