Apparently, oral health care
during pregnancy is often misunderstood by treating physicians, dentists, and their
patients. Every pregnant woman should be screened for oral risks, educated
about proper oral hygiene, and referred to a dentist where treatment may be
necessary.[1]
Dental procedures such as periodontal treatment, restorations, and extractions
are safe and are best performed during the second trimester. We are hesitant to
perform diagnostic radiography regardless of the accepted practice that its
safe. Xylitol and chlorhexidine[2]
may be used as adjuvant therapy for high-risk mothers in the early postpartum
period to reduce transmission of cariogenic bacteria to their infants.[3]
Appropriate dental care and prevention during pregnancy may reduce poor
prenatal outcomes and decrease infant caries.[4]
Every pregnant woman should be
assessed by a dentist for dental hygiene habits, access to fluoridated water,
oral problems (e.g., caries, gingivitis), and continued access to dental care.[5]
Patients should be counseled to perform
routine brushing and flossing, to avoid excessive amounts of sugary snacks and
drinks, and to consult a dentist.[6] Many dentists are reported to be reluctant to
treat pregnant women.[7]
Optimally, physicians and dentists can overcome this situation through
education, clear communication, and the development of ongoing collaborative
relationships. Physicians can share information on the safety of dental
treatment in pregnancy with dental colleagues and provide clear referral
recommendations.
Novy Scheinfeld, DDS, PC
290 Carpenter Drive, 200A
Atlanta (Sandy Springs), GA 30328
404-256-3620
Related articles
- Dentist Dunwoody: Oral Health,
Women and Pregnancy (therightsmile.wordpress.com)
- Dentist Dunwoody: Women and Oral
Health Issues (therightsmile.wordpress.com)
[2]
Teratogenic Effects Pregnancy Category B. Reproduction studies
have been performed in rats and rabbits at Chlorhexidine gluconate doses up to
300 mg/kg/day and 40 mg/kg/day, respectively, and have not revealed evidence of
harm to fetus. However, adequate and well-controlled studies in pregnant women
have not been done. Because animal reproduction studies are not always
predictive of human response, this drug should be used during pregnancy only if
clearly needed. http://www.drugs.com/pro/chlorhexidine.html
[3]
http://www.mchaccess.org/pdfs/alerts/oral%20health%20during%20pregnancy.pdf.
HUGH SILK, MD, University of Massachusetts Medical School and Family
Medicine Residency Program, Worcester, Massachusetts. ALAN B. DOUGLASS, MD,
Family Medicine Residency Program, Middlesex Hospital, Middletown,
Connecticut. JOANNA M. DOUGLASS, BDS,
DDS, University of Connecticut School of Dental Medicine, Farmington,
Connecticut. LAURA SILK, MD, Health
Alliance, Leominster, Massachusetts.
[4]
Am Fam Physician. 2008;77(8):1139-1144. Copyright © 2008 American Academy of
Family Physicians.
[5]
Oral examination should include the teeth, gums, tongue, palate, and mucosa.
[7]
Livingston HM, Dellinger TM, Holder R. Considerations in the management of the
pregnant patient. Spec Care Dentist. 1998;18(5):183-188
