Prenatal dental care: Difference between revisions
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Periodontal maintenance procedures such as [[Scaling and root planing|scaling and root-planning]] can positively improve the quality of life in pregnant women; by decreasing the microbial activity by removing [[Dental plaque|plaque]] and [[Calculus (dental)|calculus]], and other irritants.<ref>{{cite journal |doi=10.1590/1807-3107bor-2018.vol32.0002 |pmid=29364329 |title=Oral health related quality of life among pregnant women: A randomized controlled trial |journal=Brazilian Oral Research |volume=32 |pages=e002 |year=2018 |last1=Musskopf |first1=Marta Liliana |last2=Milanesi |first2=Fernanda Carpes |last3=Rocha |first3=José Mariano da |last4=Fiorini |first4=Tiago |last5=Moreira |first5=Carlos Heitor Cunha |last6=Susin |first6=Cristiano |last7=Rösing |first7=Cassiano Kuchenbecker |last8=Weidlich |first8=Patricia |last9=Oppermann |first9=Rui Vicente }}</ref> [[Pyogenic granuloma]]s or “pregnancy tumors,” are commonly seen on the labial surface of the papilla in pregnant women. Lesions can be treated by local debridement or deep incision depending on their size, and by following adequate [[oral hygiene]] measures.<ref>{{cite journal |pmid=17220613 |year=2006 |author1=Jafarzadeh |first1=H |title=Oral pyogenic granuloma: A review |journal=Journal of Oral Science |volume=48 |issue=4 |pages=167–75 |last2=Sanatkhani |first2=M |last3=Mohtasham |first3=N |doi=10.2334/josnusd.48.167}}</ref> |
Periodontal maintenance procedures such as [[Scaling and root planing|scaling and root-planning]] can positively improve the quality of life in pregnant women; by decreasing the microbial activity by removing [[Dental plaque|plaque]] and [[Calculus (dental)|calculus]], and other irritants.<ref>{{cite journal |doi=10.1590/1807-3107bor-2018.vol32.0002 |pmid=29364329 |title=Oral health related quality of life among pregnant women: A randomized controlled trial |journal=Brazilian Oral Research |volume=32 |pages=e002 |year=2018 |last1=Musskopf |first1=Marta Liliana |last2=Milanesi |first2=Fernanda Carpes |last3=Rocha |first3=José Mariano da |last4=Fiorini |first4=Tiago |last5=Moreira |first5=Carlos Heitor Cunha |last6=Susin |first6=Cristiano |last7=Rösing |first7=Cassiano Kuchenbecker |last8=Weidlich |first8=Patricia |last9=Oppermann |first9=Rui Vicente }}</ref> [[Pyogenic granuloma]]s or “pregnancy tumors,” are commonly seen on the labial surface of the papilla in pregnant women. Lesions can be treated by local debridement or deep incision depending on their size, and by following adequate [[oral hygiene]] measures.<ref>{{cite journal |pmid=17220613 |year=2006 |author1=Jafarzadeh |first1=H |title=Oral pyogenic granuloma: A review |journal=Journal of Oral Science |volume=48 |issue=4 |pages=167–75 |last2=Sanatkhani |first2=M |last3=Mohtasham |first3=N |doi=10.2334/josnusd.48.167}}</ref> |
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== Endocrine effects on oral health during pregnancy == |
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Hormonal changes during pregnancy have an effect on women's oral health during pregnancy. Good oral hygiene and seeking dental care during pregnancy is extremely important because an increase level of estrogen and progesterone can cause a variety of physiological changes in oral cavity.<ref name=":0">19. Silk, D., Douglass, A., Silk, L. (2008) Oral health during pregnancy. American Family Physician Vol.77.8 Retrieved Sep 22,2019.</ref> |
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An increase in hormone levels makes pregnant women are more likely to develop pregnancy gingivitis. Pregnancy [[gingivitis]]<nowiki/>is an inflammation of gum tissue due to an increase of blood flow to gums. It is often characterized with soreness, sensitivity and bleeding of gums. Pregnant women are often required more often cleanings and prescription mouth rinses.<ref name=":0" /> |
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If gingivitis is not treated pregnant individuals can develop [[Periodontal disease|periodontitis.]]Periodontitis or periodontal disease is a progressed infection of gum tissue and supporting structures. Periodontal disease is a chronic condition that can cause loosening of teeth, bad breath and irreversible bone loss. Periodontal disease has been linked to premature births and low birth weights.<ref name=":0" /> |
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Increase levels of progesterone and bacteria might cause some women to experience pyogenic granuloma or commonly known pregnancy tumors. These are lumps of overgrown gum very close to the gum line or in between teeth. Tumors are non cancerous and disappear after pregnancy.<ref name=":0" /> |
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Hormonal changes increase blood flow to gum tissue often resulting in [[Gingival enlargement|gingival hyperplasia]]<nowiki/>and gum bleeding while brushing and flossing. <ref name=":0" /> |
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Although teeth erosion and an increase of oral caries is not hormonal related, it is often experienced during pregnancy due to in increase intake of food and negative side effects vomiting due to morning sickness. <ref name=":0" /> |
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== Radiographic exposure == |
== Radiographic exposure == |
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Revision as of 02:00, 28 October 2019
Prenatal dental care is the care of the oral cavity during the time when the fetus develops inside a woman. The woman’s body is subject to several changes during pregnancy. Some of these changes occur in the oral cavity; which may cause tooth decay and periodontal tissue loss, that is why dental care is recommended to maintain oral health, hygiene and well being.[1]
Psychological changes during pregnancy
The increased levels of progesterone and estrogen induce changes in the gum tissue and oral cavity; the gum tissues become more prone to irritants.[2] The flow of blood and permeability of vessels increase in the periodontium, in addition to changes occurring in the collagen production. Decreased calcium and phosphate reduces the saliva pH values, altering the composition of saliva, and the medium of the oral cavity.[3]
Dental interventions during pregnancy
There have been suggestions that pregnant women should seek dental visits after child birth to avoid any adverse effects on the mother and fetus during the period of pregnancy, but there is no evidence to support this avoidance.[4][5] Dental procedures are most preferred during the second trimester of pregnancy, however emergency treatment should be performed regardless of the gestational period. Practitioners should keep the dental visit short, and minimally invasive.[6] It is also safe to use dental local anesthetics during pregnancy; however, the type of vasoconstrictor, amount of anesthesia should be well regulated by the dentist. The safety of local anesthesia with a vasoconstrictor is questioned in patients having systemic conditions such as heart disease, untreated diabetes, hypertension, or hyperthyroidism.[7]
Blood pressure and cardiac output decrease in pregnant women,[8][9] to overcome potential hypotensive syndrome resulting from the supine position on the dental chair,[10] it is recommended that the patient should have the right hip elevated 10 to 12 cm by placing a cushion; meaning the patient's hip position should be higher than the foot level in the second and third trimesters to relieve the pressure on the inferior vena cava, and if necessary, the patient should be tilted 5% to 15% on her left side. If patient experiences fatigue, weakness and hypotension, a full left lateral position may be needed.[11]
Periodontal maintenance procedures such as scaling and root-planning can positively improve the quality of life in pregnant women; by decreasing the microbial activity by removing plaque and calculus, and other irritants.[12] Pyogenic granulomas or “pregnancy tumors,” are commonly seen on the labial surface of the papilla in pregnant women. Lesions can be treated by local debridement or deep incision depending on their size, and by following adequate oral hygiene measures.[13]
Endocrine effects on oral health during pregnancy
Hormonal changes during pregnancy have an effect on women's oral health during pregnancy. Good oral hygiene and seeking dental care during pregnancy is extremely important because an increase level of estrogen and progesterone can cause a variety of physiological changes in oral cavity.[14]
An increase in hormone levels makes pregnant women are more likely to develop pregnancy gingivitis. Pregnancy gingivitisis an inflammation of gum tissue due to an increase of blood flow to gums. It is often characterized with soreness, sensitivity and bleeding of gums. Pregnant women are often required more often cleanings and prescription mouth rinses.[14]
If gingivitis is not treated pregnant individuals can develop periodontitis.Periodontitis or periodontal disease is a progressed infection of gum tissue and supporting structures. Periodontal disease is a chronic condition that can cause loosening of teeth, bad breath and irreversible bone loss. Periodontal disease has been linked to premature births and low birth weights.[14]
Increase levels of progesterone and bacteria might cause some women to experience pyogenic granuloma or commonly known pregnancy tumors. These are lumps of overgrown gum very close to the gum line or in between teeth. Tumors are non cancerous and disappear after pregnancy.[14]
Hormonal changes increase blood flow to gum tissue often resulting in gingival hyperplasiaand gum bleeding while brushing and flossing. [14]
Although teeth erosion and an increase of oral caries is not hormonal related, it is often experienced during pregnancy due to in increase intake of food and negative side effects vomiting due to morning sickness. [14]
Radiographic exposure
Undergoing radiographic xray images with the use of a lead apron and a collar do not impose problems to the mother or fetus.[15]
Medications & teratogenic potentials
The FDA categorized drugs according to their safety with respect to their effects on pregnant populations into 5 categories, from category A to category X.[16][17]
A - The drug has not shown an increased risk of fetal abnormalities when tested on pregnant women.
B - The drug was used in animal studies but revealed no evidence of harm to the fetus, but there are no adequate studies to prove this conclusion in pregnant women, or studies have shown an actual adverse effect on animals, but studies in pregnant women have failed to demonstrate a risk to the fetus.
C - studies have shown an adverse effect but no studies to determine these effects in pregnant women.
D - The drug causes a risk to the fetus, but the benefits of therapy may outweigh the potential risk.
X - the product is contraindicated because fetal abnormalities were seen.
Research & evidence
There have been suggestions that severe periodontitis and tooth caries may increase the risk of having preterm birth and low birth weight, however, systemic reviews found insufficient evidence to determine if periodontitis or tooth decay can develop adverse birth outcomes.[18][19]
References
- ^ Mills, L. W; Moses, D. T (2002). "Oral health during pregnancy". MCN: The American Journal of Maternal/Child Nursing. 27 (5): 275–80, quiz 281. PMID 12209058.
- ^ Straka, M (2011). "Pregnancy and periodontal tissues". Neuro Endocrinology Letters. 32 (1): 34–8. PMID 21407157.
- ^ Laine, M. A (2002). "Effect of pregnancy on periodontal and dental health". Acta Odontologica Scandinavica. 60 (5): 257–64. doi:10.1080/00016350260248210. PMID 12418714.
- ^ Shagana, J. A.; Kumar, R. Pradeep (2018). "Oral health care during pregnancy: A strategies and considerations" (PDF). Journal of Pharmacy Research. 12 (5): 684–8.
- ^ Rabinerson, D; Krispin, E; Gabbay-Benziv, R (2018). "Dental Care During Pregnancy". Harefuah. 157 (5): 330–334. PMID 29804341.
- ^ Minozzi, F; Chipaila, N; Unfer, V; Minozzi, M (2008). "Odontostomatological approach to the pregnant patient". European Review for Medical and Pharmacological Sciences. 12 (6): 397–409. PMID 19146202.
- ^ Wrzosek, T; Einarson, A (2009). "Dental care during pregnancy". Canadian Family Physician. 55 (6): 598–9. PMC 2694079. PMID 19509200.
- ^ Duvekot, J. J; Peeters, L. L (1994). "Maternal cardiovascular hemodynamic adaptation to pregnancy". Obstetrical & Gynecological Survey. 49 (12 Suppl): S1–14. PMID 7877788.
- ^ Clapp, JF; Capeless, E (1997). "Cardiovascular function before, during, and after the first and subsequent pregnancies". The American Journal of Cardiology. 80 (11): 1469–73. doi:10.1016/s0002-9149(97)00738-8. PMID 9399724.
- ^ Stergiopoulos, Kathleen; Brown, David L (2013-11-01). Evidence-Based Cardiology Consult. ISBN 9781447144410.
- ^ Kurien, S; Kattimani, V. S; Sriram, R. R; Sriram, S. K; Rao V k, P; Bhupathi, A; Bodduru, R. R; n Patil, N (2013). "Management of pregnant patient in dentistry". Journal of International Oral Health. 5 (1): 88–97. PMC 3768073. PMID 24155583.
- ^ Musskopf, Marta Liliana; Milanesi, Fernanda Carpes; Rocha, José Mariano da; Fiorini, Tiago; Moreira, Carlos Heitor Cunha; Susin, Cristiano; Rösing, Cassiano Kuchenbecker; Weidlich, Patricia; Oppermann, Rui Vicente (2018). "Oral health related quality of life among pregnant women: A randomized controlled trial". Brazilian Oral Research. 32: e002. doi:10.1590/1807-3107bor-2018.vol32.0002. PMID 29364329.
- ^ Jafarzadeh, H; Sanatkhani, M; Mohtasham, N (2006). "Oral pyogenic granuloma: A review". Journal of Oral Science. 48 (4): 167–75. doi:10.2334/josnusd.48.167. PMID 17220613.
- ^ a b c d e f 19. Silk, D., Douglass, A., Silk, L. (2008) Oral health during pregnancy. American Family Physician Vol.77.8 Retrieved Sep 22,2019.
- ^ Amini, H; Casimassimo, P. S (2010). "Prenatal dental care: A review". General Dentistry. 58 (3): 176–80. PMID 20478796.
- ^ Research, Center for Drug Evaluation and. "Labeling - Pregnancy and Lactation Labeling (Drugs) Final Rule". www.fda.gov. Retrieved 2018-06-09.
- ^ Kurien, Sophia; sk, Drvivekanand; Rani Sriram, Roopa; Krishna Sriram, Sanjay; Rao V K, Prabhakara; Bhupathi, Anitha; Rani Bodduru, Rupa; N Patil, Namrata (2013-02-01). Management of Pregnant Patient in Dentistry. Vol. 5.
- ^ Crowther, Caroline A; Thomas, Natalie; Middleton, Philippa; Chua, Mei-Chien; Esposito, Marco (2005). "Treating periodontal disease for preventing preterm birth in pregnant women". Cochrane Database of Systematic Reviews. doi:10.1002/14651858.cd005297.
- ^ Wagle, Madhu; d'Antonio, Francesco; Reierth, Eirik; Basnet, Purusotam; Trovik, Tordis A; Orsini, Giovanna; Manzoli, Lamberto; Acharya, Ganesh (2018). "Dental caries and preterm birth: A systematic review and meta-analysis". BMJ Open. 8 (3): e018556. doi:10.1136/bmjopen-2017-018556. PMC 5855295. PMID 29500202.