Xylitol and the Prevention of Periodontal Disease and Preterm Birth Trial

Inclusion Criteria

• •Able to provide informed consent. For those under 18 years of age, an approval will additionally be sought from the parent or guardian
• •Less than 20 weeks' gestation (by best obstetric estimate)
• •At least 20 natural teeth
• •Planning to deliver at one of the health facilities within the XaPPP trial
• •Receiving antenatal obstetric care at one of the 8 health districts
• •Willing to chew two pieces of gum thrice daily for 5 minutes after the morning, day and evening meals throughout pregnancy
• •Willing to attend all study visits
• •Willing to provide biospecimens (oral, vaginal, placental, breast milk)
• •Willing to undergo at least two dental exams including oral microbiota sampling at study enrolment \<20 weeks of pregnancy, 28-30 weeks of pregnancy, and 6-8 weeks after giving birth
• •Willing to have their child undergo follow up through at least 12 months after birth including neurodevelopmental examination(s)
• •Speaks Chichewa or English