Preterm birth is often associated with infection or inflammation as the immune response triggers prostaglandin production, which is associated with an increase I uterine contraction leading to preterm delivery. This is one of the mechanisms suggested to explain the impact of periodontal disease on preterm delivery.
Three prominent periodontal pathogens Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola all contain the enzyme benzoyl-DL-arginine-naphthylamide (BANA). Dr. Walter Loesche developed a test to measure this enzyme in a plaque sample, indentifying one of more of these pathogens.
The BANA test is done chair side using a wooden toothpick between the first and second molars in each quadrant to collect a plaque sample. It is then placed on a reagent card, moistened, closed and incubated at 55 degrees Celsius for five minutes. A color change indicates a weak or strong presence of the enzyme associated with the perio pathogens.
In Conclusion those who test positive in the BANA test in two or more than 4 quadrants are six times more likely to deliver preterm than those with negative tests.