Effect of being overweight and obese on periodontal treatment costs.

BACKGROUND: Obesity can increase a person's risk of developing periodontal disease, and patients with obesity have greater health care costs. However, the effect of obesity on periodontal treatment costs has not been examined. METHODS: This retrospective cohort study used data from the electronic dental records of adult patients examined from July 1, 2010, through July 31, 2019 at a US dental school. Primary exposure was body mass index, which was categorized as obese, overweight, or normal. Periodontal disease was categorized using clinical probing measures. Fee schedules and procedure codes were used to compute the primary outcome, which was total periodontal treatment costs. A generalized linear model with gamma distribution was used to examine the relationship between body mass index and periodontal costs after controlling for initial periodontal disease severity and other confounding variables. Parameter coefficients and mean ratios with 95% CIs were estimated. RESULTS: The study sample included 3,443 adults, of whom 39% were normal weight, 37% were overweight, and 24% were obese. Mean (SD) total periodontal treatment costs for patients who were obese were considerably higher ($420 [$719]) than those for patients who were overweight ($402 [$761]) and patients who were normal weight ($268 [$601]). After controlling for covariates and disease severity, patients who were obese had 27% higher periodontal treatment costs than patients who were normal weight. The additional periodontal treatment costs attributable to obesity were greater than those attributable to either diabetes or smoking. CONCLUSIONS: The study results suggest that among patients at a dental school, those who were obese incurred substantially higher periodontal treatment costs than patients who were normal weight, independent of initial periodontal disease severity. PRACTICAL IMPLICATIONS: The study findings have important implications for clinical guidelines and dental benefit design and coverage policies.

Periodontal treatment associated with decreased diabetes mellitus-related treatment costs: An analysis of dental and medical claims data.

BACKGROUND: Diabetes mellitus (DM) and periodontal disease have a suggested bidirectional relationship. Researchers have reported decreases in DM-related health care costs after periodontal treatment. The authors examined the relationship between periodontal disease treatment and DM health care costs in commercial insurance and Medicaid claims data. METHODS: This study of IBM MarketScan commercial insurance and Medicaid databases included overall outpatient, inpatient, and drug costs for patients with DM. The authors examined associations between overall health care costs per patient in 2019 according to use of periodontal services from 2017 through 2018 using generalized linear modeling. The average treatment effect on treated was calculated by means of propensity score matching using a logistic model for periodontal treatment on covariates. RESULTS: For commercial insurance enrollees, periodontal treatment was associated with reduced overall health care costs of 12% compared with no treatment ($13,915 vs $15,739; average treatment effect on treated, -$2,498.20; 95% CI, -$3,057.21 to -$1,939.19; P < .001). In the Medicaid cohort, periodontal treatment was associated with a 14% decrease in costs compared with patients with DM without treatment ($14,796 vs $17,181; average treatment effect on treated, -$2,917.84; 95% CI, -$3,354.48 to -$2,480.76; P < .001). There were no significant differences in inpatient costs (commercial insurance) or drug costs (Medicaid). CONCLUSIONS: Undergoing periodontal treatment is associated with reduced overall and outpatient health care costs for patients with DM in Medicaid and commercial insurance claims data. There were no significant differences in inpatient costs for commercial insurance enrollees or in drug costs for Medicaid beneficiaries. PRACTICAL IMPLICATIONS: A healthy mouth can play a key role in DM management. Expanding Medicaid benefits to include comprehensive periodontal treatment has the potential to reduce health care costs for patients with DM.

Assessment of Periodontal Status in Patients with Depression: A Cross-Sectional Study.

OBJECTIVE: Depression leads to behavioral and systemic changes making individuals more susceptible to inflammatory diseases. This study was conducted to assess the periodontal status of patients with clinically diagnosed mild and moderate depression. SUBJECTS AND METHODS: This cross-sectional study included 135 participants. Test group 1 (n = 45) consisted of patients clinically diagnosed with mild depression, test group 2 (n = 45) included patients with moderate depression and the control group (n = 45) included non-depressive participants. Sociodemographic characteristics and periodontal parameters were recorded. RESULTS: Plaque levels and gingival inflammation were significantly (p < 0.05) higher in mild and moderate depression patients than in controls. Significant greater number of sites with bleeding on probing, increasing probing pocket depth (PPD), sites with PPD 4-5 mm, ≥6 mm, attachment loss 3-4 mm, and high prevalence with grade C periodontitis were observed in moderate depression patients, compared to patients with mild depression and healthy controls. On applying partial correlation, periodontal parameters were positively correlated with depression, while a negative correlation was found with income status. On regression analysis, bleeding on probing as a dependent variable was also associated with depression. CONCLUSIONS: Patients with moderate depression showed high periodontal destruction and inflammation as compared to those with mild depression. Further, deep pockets were associated with depressive patients. Periodontal care is required in such patients so that the progression of periodontal diseases can be prevented at the earliest.

Assessment of the association between periodontal disease and total cancer incidence and mortality: a meta-analysis.

Background: Periodontal disease (PD) is a chronic inflammatory disease that leads to alveolar bone resorption and tooth loss. Many studies have reported the association between periodontal disease and various cancers including oral cancer, lung cancer, breast cancer and so on. However, there is still no specialized meta-analysis that assesses the association between periodontal disease and cancer incidence and mortality in-deepth. Thus, we conducted this meta-analysis. Methods: This meta-analysis was registered with PROSPERO: CRD42020183497. We searched five online databases for observational studies about the association between periodontal disease and breast, prostate, lung and bronchial, colorectal, and total cancers by July 2020. Then we evaluated quality of the included studies by the Newcastle-Ottawa scale. Risk ratios (HRs) and their 95% confidence intervals (CIs) were pooled to evaluate the strength of the association between periodontal disease and four cancers, total cancer incidence and mortality. In addition, we analyzed heterogeneity by subgroup analysis and sensitivity analysis. Finally, we inspected publication bias by Begg's and Egger's tests. Results: None of the studies included in this meta-analysis were of poor quality. PD is not only related to breast cancer incidence (HR = 1.26,95%CI [1.11-1.43], I 2 = 75.8%, P = 0.000), but also connected with total cancer mortality (HR = 1.40,95%CI [1.24-1.58], I 2 = 0.0%, P = 0.718). Subgroup analyses showed that study population, study design, dental status, follow-up period, adjustment for smoking partially explained the heterogeneity between studies. The results of Begg's test and Egger's test were consistent and indicated that there is no publication bias in this study. Conclusion: In conclusion, this meta-analysis revealed a positive relationship between periodontal disease and breast cancer incidence and total cancer mortality. Further well-designed studies with specific inclusion and exclusion criteria are required to strengthen the conclusion of this meta-analysis. However, longer follow-up period, multi-center trials and even multinational studies are required to corroborate the results.

Assessment of clinical depression in abdominally obese subjects with periodontal disease.

Background: Depression is a commonly prevailing condition that goes undetected in clinical settings. Both abdominal obesity and periodontal disease have a bearing on mental health and have an impact on the quality of life. Objective: To assess the level of clinical depression in abdominally obese subjects with periodontal disease. Methods: Two hundred and ten subjects with a mean age of 37.45 ± 9.59 years (males = 117; females = 93) were grouped as per their abdominal obesity and periodontal status and assessed for their clinical depression levels (mental health) using the Centre for Epidemiologic Studies-Depression Scale (CES-D). Collected data were analysed. Results: The clinical depression score significantly varied in subjects with different periodontal status in both non-obese (F (2,102) = 113.66, P < 0.0001) and abdominally obese subjects (F (2,102) = 132.04, P < 0.001). Significantly higher depression score was demonstrated in healthy (P < 0.001), gingivitis (P < 0.001), and periodontitis (P < 0.001) groups in abdominally obese subjects. Conclusion: Clinical depression is significantly associated with abdominal obesity and periodontal disease in subjects with abdominal obesity and severe periodontal disease demonstrating higher depression scores.

COVID-19 Pandemic and Periodontal Practice: The Immunological, Clinical, and Economic Points of View.

The recent global health problem, COVID-19, has had far-reaching impacts on lifestyles. Although many effective WHO-approved vaccines have been produced that have reduced the spread and severity of the disease, it appears to persist in humans for a long time and possibly forever as everyday it turns out to have new mutations. COVID-19 involves the lungs and other organs primarily through cytokine storms, which have been implicated in many other inflammatory disorders, including periodontal diseases. COVID-19 is in a close association with dental and periodontal practice from two respects: first, repeated mandatory lockdowns have reduced patient referrals to dentists and limited the dental and periodontal procedures to emergency treatments, whereas it is important to recognize the oral manifestations of COVID-19 as well as the influence of oral and periodontal disease on the severity of COVID-19. Second, dentistry is one of the high-risk professions in terms of close contact with unmasked individuals, necessitating redefining the principles of infection control. The pressures of the economic recession on patients as well as dentists add to the difficulty of resuming elective dental services. Therefore, this study is divided into two parts corresponding to what mentioned above: the first part examines the clinical and immunological associations between COVID-19 and periodontal and oral diseases, and the second part delineates the measures needed to control the disease transmission in dental clinics as well as the economic impact of the pandemic era on dental services.

Assessment of Cardiovascular Risk in Women with Periodontal Diseases According to C-reactive Protein Levels.

Cardiovascular diseases (CVD) are highly prevalent non-communicable diseases worldwide. Periodontitis may act as a non-traditional cardiovascular risk (CVR) factor, linked by a low-grade systemic inflammation mediated by C-reactive protein (CRP). Patients with periodontitis reported higher serum CRP levels; however, a CRP systemic and periodontal correlation in gingival crevicular fluid (GCF) and its CVR impact have been barely studied. We aimed to assess the association between periodontal diseases and CVR in a group of adult women, based on serum high-sensitivity CRP (hs-CRP) levels; and secondly, to determine the association between serum and GCF CRP levels. Gingival crevicular fluid and blood samples were obtained from women with periodontitis, gingivitis, and healthy controls. Serum and GCF CRP were determined by turbidimetric method and Luminex technology, respectively. Data were analyzed and adjusted by CVR factors. All women presented moderate CVR, without an evident association between serum hs-CRP levels and periodontal diseases. While serum hs-CRP concentrations did not significantly differ between groups, patients with gingivitis and periodontitis showed higher CRP levels in GCF, which positively correlated to CRP detection in serum.

Assessment of Peri-Implant Soft Tissues Conditions around Short and Ultra-Short Implant-Supported Single Crowns: A 3-Year Retrospective Study on Periodontally Healthy Patients and Patients with a History of Periodontal Disease.

The aim of this retrospective study was to evaluate implant survival, marginal bone loss and peri-implant complications in 326 short and ultra-short implants. Implants were placed in the maxillary and mandibular posterior regions of 140 patients with (PP) and without (NPP) a history of periodontal disease. Clinical and radiographic examinations were performed at 3-year recall appointments. The 8.0, 6.0 and 5.0 mm-length implants placed in PP and NPP were respectively 43.75% and 38.46%, 35.10% and 34.19%, 21.15% and 27.35%; 325 implants (one early failure) were rehabilitated with single crowns in 139 patients. Overall implant survival after 3 years of follow-up was 97.55%, 98.08% and 96.61% for PP and NPP (p = 0.46). Crestal bone level variations were not statistically different among PP and NPP; 15.41% of implants presented signs of mucositis, 14.71% and 16.67% in PP and NPP (p = 0.64). Setting the threshold for bone loss at 2 mm after 36 months, peri-implantitis prevalence was 2.2%, 1.96% and 2.63% in PP and NPP (p = 0.7). Overall implant success was 82.39%, 83.33% and 80.7% for PP and NPP (p = 0.55). Short-term outcomes suggest that short and ultra-short locking-taper implants can successfully be restored with single crowns in the posterior jaws both in PP and NPP.

Effect of interprofessional education on oral assessment performance of nursing students.

OBJECTIVES: The purpose of this study was to investigate the effect of interprofessional educational programmes on the improvement of nursing students' oral assessment performances by comparing their attitudes, confidence, abilities, and self-performance before and after the education. MATERIALS AND METHODS: The subjects included 112 first-year nursing students in a Japanese nursing school. They participated in the oral assessment educational programmes, which were supported by dentists and introduced into the 1-year curriculum. The first programme was a 1.5-hr lecture with a self-oral assessment training in May 2018, and the second was a 1-hr oral assessment training in October 2018. The questionnaire surveys investigating nursing students' attitudes, confidence, and self-performance regarding oral assessment and the tests measuring their oral assessment abilities were conducted before and after the programmes. The total scores on the tests were 0-9 points. RESULTS: A total of 101 (90.2%) nursing students responded to all the questionnaires and tests. Their attitudes and confidence regarding oral assessment were significantly improved after the programmes. The total average scores on the tests were significantly increased from 6.8 points at baseline to 7.9 points after the programmes. The percentage of their performance of self-oral assessment every day significantly increased from 15.8% at baseline to 32.7% after the programmes. CONCLUSIONS: These results suggested that the educational programme might be effective in improving not only the students' attitudes and confidence regarding oral assessment but also their oral assessment abilities and self-oral assessment performance. Therefore, future programmes must focus on training them to improve oral health care referrals.

MICROBIOLOGICAL AND IMMUNOLOGICAL ASSESSMENT OF A COMPLEX OF THERAPEUTIC-PREVENTIVE MEASURES FOR CHRONIC CATARRHAL GINGIVITIS IN CHILDREN WITH DIABETES MELLITUS.

Dysbacteriosis of the oral cavity is known to complicate the course of chronic catarrhal gingivitis resulting from functional disorders of the macroorganism ecosystem, decreased amount of probiotic and increased amount of opportunistic and pathogenic microflora. And natural immune response is activated first in this case. It differentiates pathogens by TLR. The aim - to enhance the efficacy of treatment of chronic catarrhal gingivitis in children suffering from type 1 diabetes mellitus by means of improving the methods of pharmacological correction on the basis of investigation of the indices of local natural immune response and microbiological properties of the disease. We formed 2 group of the study. Children received basic insulin therapy. The treatment of chronic catarrhal gingivitis in children from the main group were suggested the antiseptic solution "Decasan"; pill of a probiotic action "BioGaia ProDentis" and the immune modulator "Imupret". Children from the comparative group were treated according to the common scheme. Oral microflora of children after treatment was decreased by 69,42% of general microbial number in children from the main group. Natural immunity state was also indicative of the improved protective mechanisms of the oral cavity in children from the main subgroup in the dynamics of treatment: twice as less level of mRNA TLR-2 expression was found in the main subgroup and mRNA TLR-4 - 45,44%. Therefore, the initiated course of treatment concerning chronic catarrhal gingivitis promoted a considerable improvement of the periodontal tissue state in children.

Assessment of the risk and characterization of non-melanoma skin cancer in Kindler syndrome: study of a series of 91 patients.

BACKGROUND: Kindler Syndrome (KS) is a rare genodermatosis characterized by skin fragility, skin atrophy, premature aging and poikiloderma. It is caused by mutations in the FERMT1 gene, which encodes kindlin-1, a protein involved in integrin signalling and the formation of focal adhesions. Several reports have shown the presence of non-melanoma skin cancers in KS patients but a systematic study evaluating the risk of these tumors at different ages and their potential outcome has not yet been published. We have here addressed this condition in a retrospective study of 91 adult KS patients, characterizing frequency, metastatic potential and body distribution of squamous cell carcinoma (SCC) in these patients. SCC developed in 13 of the 91 patients. RESULTS: The youngest case arose in a 29-year-old patient; however, the cumulative risk of SCC increased to 66.7% in patients over 60 years of age. The highly aggressive nature of SCCs in KS was confirmed showing that 53.8% of the patients bearing SCCs develop metastatic disease. Our data also showed there are no specific mutations that correlate directly with the development of SCC; however, the mutational distribution along the gene appears to be different in patients bearing SCC from SCC-free patients. The body distribution of the tumor appearance was also unique and different from other bullous diseases, being concentrated in the hands and around the oral cavity, which are areas of high inflammation in this disease. CONCLUSIONS: This study characterizes SCCs in the largest series of KS patients reported so far, showing the high frequency and aggressiveness of these tumors. It also describes their particular body distribution and their relationship with mutations in the FERMT-1 gene. These data reinforce the need for close monitoring of premalignant or malignant lesions in KS patients.

Correlations between periodontal disease, mandibular inferior cortex index and the osteoporotic fracture probability assessed by means of the fracture risk assessment body mass index tool.

BACKGROUND: The aim was to examine correlations between radiological signs of chronic periodontitis, Mandibular Inferior Cortex (MIC) index and osteoporotic fracture probability based on the FRAX BMI tool. METHODS: The material comprised 422 panoramic radiographs taken in patients aged 40-89, 270 females and 152 males. The severity of chronic periodontitis and resorption of mandibular inferior cortex based on MIC index were assessed. A diagnostic survey was conducted to estimate 10-year major and hip osteoporotic fracture probability (MOFP, HOFP) by means of the FRAX BMI tool - an algorithm that allows to calculate osteoporotic fracture probability based on assessing bone fracture risk factors knowing only BMI value. RESULTS: The conducted analysis based on U Mann-Whitney test revealed that mean 10-year MOFP was significantly higher (p = 0.00) in women than in men. Mean 10-year MOFP in females was 4.8% (SD = 3.95%) and in males 3.21% (SD = 2.35%). Mean 10-year HOFP in women was 1.35% (SD = 2.07%) and was significantly higher (p = 0.03) than in men - 0.79% (SD = 1.18%).MOFP is significantly higher in patients with moderate and severe periodontitis than in those with mild periodontitis. Significant difference between MIC values and MOFP (p = 0.00) and HOFP (p = 0.00) was found. Osteoporotic fracture probability was significantly higher in patients with MIC stages C2 and C3 than C1. CONCLUSIONS: The FRAX BMI tool with radiological evaluation of periodontal disease severity and MIC index may be used in dental practice in determining individual risk of osteoporotic fracture in females and provide new opportunities of selecting those potentially more prone to such fractures. TRIAL REGISTRATION: The approval of the local bioethics committee was obtained (KE-0254/107/2017).

Natural history of periodontitis: Disease progression and tooth loss over 40 years.

OBJECTIVES: To assess long-term attachment and periodontitis-related tooth loss (PTL) in untreated periodontal disease over 40 years. MATERIAL AND METHODS: Data originated from the natural history of periodontitis study in Sri Lankan tea labourers first examined in 1970. In 2010, 75 subjects (15.6%) of the original cohort were re-examined. RESULTS: PTL over 40 years varied between 0 and 28 teeth (mean 13.1). Four subjects presented with no PTL, while 12 were edentulous. Logistic regression revealed attachment loss as a statistically significant covariate for PTL (p < .004). Markov chain analysis showed that smoking and calculus were associated with disease initiation and that calculus, plaque, and gingivitis were associated with loss of attachment and progression to advanced disease. Mean attachment loss <1.81 mm at the age of 30 yielded highest sensitivity and specificity (0.71) to allocate subjects into a cohort with a dentition of at least 20 teeth at 60 years of age. CONCLUSIONS: These results highlight the importance of treating early periodontitis along with smoking cessation, in those under 30 years of age. They further show that calculus removal, plaque control, and the control of gingivitis are essential in preventing disease progression, further loss of attachment and ultimately tooth loss.

Periodontal Disease and Body Weight Assessment in Children.

PURPOSE: The purpose of this study was to assess body weight and periodontal disease development in obese and normal weight children. METHODS: Eighty-eight 5- to 10-year-old children participated in this study. Periodontal measurements included the visible plaque index (VPI), community periodontal index (CPI), and bleeding on probing (BOP). Complete periodontal examinations were performed in some children with CPI codes three and four. Anthropometric examination consisted of body mass index (BMI, kg/m2), which was adjusted by age according to percentiles. The groups were divided into children of normal weight (N=43, BMI less than 85 per age) and obese children (N=45, BMI greater than 97 per age). RESULTS: The results showed that the obesity group showed significant proportions of CPI codes one (44.2%) and three (7.4%), when compared with normal weight subjects (P<0.05). VPI was similar between both groups (P>0.05). BOP was higher in obese patients than in children with normal weight (P<0.05). CPI zero was more prevalent in normal weight subjects (62.6%, P<0.05). CONCLUSION: Obese children seem to be more susceptible to periodontal disease.

Bayesian semiparametric variable selection with applications to periodontal data.

A normality assumption is typically adopted for the random effects in a clustered or longitudinal data analysis using a linear mixed model. However, such an assumption is not always realistic, and it may lead to potential biases of the estimates, especially when variable selection is taken into account. Furthermore, flexibility of nonparametric assumptions (e.g., Dirichlet process) on these random effects may potentially cause centering problems, leading to difficulty of interpretation of fixed effects and variable selection. Motivated by these problems, we proposed a Bayesian method for fixed and random effects selection in nonparametric random effects models. We modeled the regression coefficients via centered latent variables which are distributed as probit stick-breaking scale mixtures. By using the mixture priors for centered latent variables along with covariance decomposition, we could avoid the aforementioned problems and allow efficient selection of fixed and random effects from the model. We demonstrated the advantages of our proposed approach over other competing alternatives through a simulated example and also via an illustrative application to a data set from a periodontal disease study. Copyright © 2017 John Wiley & Sons, Ltd.

Systematic review and assessment of systematic reviews examining the effect of periodontal treatment on glycemic control in patients with diabetes.

OBJECTIVES: There have been several systematic reviews(SRs) on whether periodontal treatment for an individual with both periodontal disease and diabetes can improve diabetes outcomes. The purpose of this investigation was to conduct a systematic review (SR) of previous meta-analyses, and to assess the methodological quality of the SRs examining the effects of periodontal treatment and diabetes. (PROSPERO Registration # CRD 42015023470). STUDY DESIGN: We searched five electronic databases and identified previous meta-analyses of randomized controlled trials published through July 2015. In cases where the meta-analysis did not meet our criteria, the meta-analyses were recalculated. General characteristics of each included trial were abstracted, analyzed, and compared. The mean difference, 95% confidence intervals (CIs) and the I2 statistic were abstracted or recalculated. The Assessment of Multiple Systematic Reviews Instrument (AMSTAR) was used to assess methodological quality. RESULTS: Of the 475 citations screened, nine systematic reviews were included. In total, 13 meta-analyses included in nine SRs were examined. In comparability analyses, meta-analyses in four SRs did not meet our criteria, and were recalcuated. Of these 13 meta-analyses, 10 suggested significant effects of periodontal treatment on HbA1c improvement. Mean differences found in the 13 meta-analyses ranged from -0.93 to 0.13. AMSTAR assessment revealed six SRs with moderate and three with high overall quality. CONCLUSIONS: We can conclude that there is a significant effect of periodontal treatment on improvement of HbA1c in diabetes patients, although the effect size is extremely small. In addition to the small effect size, not all SRs could be considered of high quality.

[Inpatients days in patients with respiratory diseases and periodontal disease]. / Días de estancia hospitalaria (DEH) en pacientes con enfermedades respiratorias (ER) y enfermedad periodontal (EP).

INTRODUCTION: Periodontal disease is a chronic inflammatory gingival process that has been associated with the severity of respiratory diseases. In Mexico a prevalence of 78% was found in population with social security and > 60 years old. The aim of this study is to establish the association between periodontal disease and respiratory diseases according to the inpatient days. MATERIAL AND METHODS: A cross-sectional study was conducted from January to December 2011. We included hospitalized patients, ≥ 18 years of age, without sedation or intubated. A dentist classified patients into two groups according to the severity of the periodontal disease: mild-to-moderate and severe. We estimated medians of inpatient days by disease and severity. Negative binomial models were adjusted to estimate incidence rate ratios and predicted inpatient days. RESULTS: 3,059 patients were enrolled. The median of observed and predicted inpatient days was higher in the group of severe periodontal disease (p < 0.05). Patients with chronic obstructive pulmonary disease, tuberculosis, and influenza had the highest incidence rates ratios of periodontal disease (p < 0.05). CONCLUSIONS: The severity of periodontal disease is positively -associated with inpatient days of patients with respiratory diseases.

The Relationship between Periodontal Interventions and Healthcare Costs and Utilization. Evidence from an Integrated Dental, Medical, and Pharmacy Commercial Claims Database.

Periodontal disease has been linked to poor glycemic control among individuals with type 2 diabetes. Using integrated dental, medical, and pharmacy commercial claims from Truven MarketScan® Research Databases, we implement inverse probability weighting and doubly robust methods to estimate a relationship between a periodontal intervention and healthcare costs and utilization. Among individuals newly diagnosed with type 2 diabetes, we find that a periodontal intervention is associated with lower total healthcare costs (-$1799), lower total medical costs excluding pharmacy costs (-$1577), and lower total type 2 diabetes-related healthcare costs (-$408). © 2016 The Authors. Health Economics Published by John Wiley & Sons Ltd.

Obstetric knowledge, attitude, and behavior concerning periodontal diseases and treatment needs in pregnancy: influencing factors in France.

BACKGROUND: Many studies have shown that periodontal diseases are risk factors for adverse pregnancy outcomes. The aim of this study is to assess the knowledge and clinical attitude of French obstetricians and/or gynecologists regarding periodontal diseases. METHODS: A cross-sectional study was performed on randomly selected French obstetricians and/or gynecologists using a self-administered, structured questionnaire during an annual French professional congress. RESULTS: The questionnaire was completed by 190 French obstetricians and/or gynecologists. Among respondents, 88% were aware of the inflammatory and infectious nature of periodontal diseases. Furthermore, 74.7% of respondents were conscious of its negative impact on pregnancy outcomes. Few obstetricians and/or gynecologists (26.3%) interviewed patients about oral health. Information on oral health was systematically provided to patients by 10.5% of the practitioners. However, 55.6% addressed this issue if they considered the patient at risk for pregnancy. Only 33.2% of practitioners systematically referred the patient to a dentist. Periodontal disease knowledge and consideration levels increased in more experienced practitioners with a private practice and a personal history of periodontal disease. CONCLUSIONS: Periodontal knowledge of the French obstetricians and/or gynecologists surveyed seemed satisfyingly apparent and influenced by levels of professional experience and personal history. However, clinical behavior did not adequately correlate with this knowledge.