Although causality cannot be demonstrated between GDM and T. forsythia infection, methods to reduce bacterial reservoirs of this and other associated “red complex” Gram-negative anaerobic bacteria in women may be of benefit in better managing oral colonization of these biofilm and tissue-associated pathogens. The results of this study underscore the associations of oral infection and total body health.

Oral health professionals must establish a prevention and treatment protocol for women with GDM that focuses on meticulous oral hygiene measures, including twice-a-day brushing and daily flossing. It is important to adopt a “zero tolerance” policy for biofilm accumulation and periodontal problems, particularly for these patients. Practitioners should recommend the use of antibacterial products, such as a triclosan-containing dentifrice that demonstrates both antimicrobial and anti-inflammatory properties, to help achieve a healthy periodontal status. These women should also be advised that periodic evaluation during pregnancy, with debridement provided as needed, will help to maximize both oral and general health of the mother and the fetus.

One of the key treatment implications based on this study is the need to continue to partner with obstetricians, midwives, endocrinologists, nurses, and family care providers to ensure that the optimal overall health of a pregnant woman includes oral health care. Referral to a dentist or dental hygienist for further education and treatment will help the patient understand the link between GDM, periodontal health, and adverse pregnancy outcomes. The education of patients on the implications of poor oral health and systemic influences of chronic inflammation and bacterial infections may improve lifestyle choices, prenatal guidance, and more consistent pre-conceptual dental care.