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Oral health in pregnancy

txdentalsurgery — Wed, 05 Dec 2018 02:01:43 +0000

Thanks for the information!!

Oral health in pregnancy

northstapleydental — Thu, 29 Nov 2018 00:48:15 +0000

Informative Post!!

Oral health in pregnancy

Tue, 20 Nov 2018 02:12:02 +0000

Thanks.

Female Dentists Open to Accepting Support and Guidance

Thu, 04 Jul 2013 00:07:04 +0000

This is a very difficult economic climate and I must commend the female dentists for being the ones who step up most often and accept the guidance of a dental consultant.

Women are not afraid to ask for directions and today they are asking for direction with taking their dental practice to the next level.

KUDOS to The Women of Today’s World!

Just sayn’.

Health grant for Hawaiian mothers and kids for oral care

drsnehamaheshwari — Tue, 11 Jun 2013 20:39:24 +0000

The Illinois State Dental Society (ISDS) Foundation is accepting community grant applications from Illinois community health organizations for oral health projects.

The group plans to make grants from a pool of $50,000 to organizations that promote and encourage improved oral health and oral health education in Illinois, according to the organization.

Applicants must live in Illinois and be endorsed by an ISDS local dental society, and projects must benefit Illinois residents.

The application deadline is June 14. Grant applications and information are available at the ISDS Foundation website.

Oral health in pregnancy

drsnehamaheshwari — Sat, 04 May 2013 10:30:59 +0000

The following are guidelines suggested by the American Academy of Pediatrics (AAP), in response to the increased concern about oral health during pregnancy:

1) Oral Health Education – DO have consultations with your dentist before, during and after your pregnancy. Early intervention is key, but ongoing care is just as important!

2) Oral Hygiene – DO brush and floss regularly – and properly. It is especially important to try and always brush after meals and snacks, especially sugary ones. Also, have more frequent dental cleanings than you normally would (2-3 during your pregnancy is about right). This will greatly increase the amount of plaque that is removed from the teeth and gums, thereby lowering your risk.

3) Nutrition – DON’T eat junk. This is good advice in general during your pregnancy, but just know that proper diet and nutrition during pregnancy will limit sugar intake which, in turn, will minimize plaque build up.

4) Treat Tooth Decay – DO try and have all urgent dental work completed prior to becoming pregnant. Although, it is safe to perform certain emergency dental procedures during your pregnancy, it is best to have it done prior to becoming pregnant, and especially prior to it becoming an emergency dental treatment!

5) Transmission of Bacteria – DON’T share food and utensils, so as not to potentially transmit bacteria known to cause tooth decay.

6) Use of Xylitol Gum – DO chew gum. Expectant mothers, and everyone, are encouraged to chew xylitol gum (around 4x/day), since research suggests that it may decrease the rate of tooth decay. Chewing sugarless gum increases saliva and thus increases the production of salivary enzymes that help equalize the Ph in the mouth and thus reduce cavity growth.

Oral health in pregnancy

drsnehamaheshwari — Mon, 29 Apr 2013 12:38:44 +0000

Tooth surface loss

Tooth surface loss, primarily through acid-induced erosion, may be seen if there has been nausea and associated repeated vomiting during pregnancy. The palatal surfaces of the upper incisors and canines are often the most affected. The woman commonly presents complaining of sensitivity, which is a consequence of the resulting dentine exposure. Management is essentially preventative and includes the regular use of a fluoride mouth rinse, especially in those women who vomit frequently. In addition, these women should be advised to avoid tooth brushing directly after vomiting as the effect of erosion can be exacerbated by brushing an already demineralised tooth surface. Consumption of acidic fruits and juices as well as carbonated drinks should be restricted to avoid the potential for contact between additional acids and the tooth tissues. The use of drinking straws is recommended for the same reason, as is breaking the habit of holding such acidic drinks in the mouth for a longer time than is necessary.

Tooth mobility

Increased tooth mobility has been detected in pregnancy even in periodontally healthy women. The upper incisors are most mobile during the last month of pregnancy. Development of such mobility is possibly due to mineral shifts in the lamina dura and not to modification of the alveolar bone. The degree of periodontal disease present and disturbance of the supporting attachment tissues are also thought to contribute to this mobility, which usually resolves post delivery.

Oral health in pregnancy

drsnehamaheshwari — Sun, 28 Apr 2013 10:25:40 +0000

The effects of pregnancy on host response and oral flora

The effects of pregnancy on the host response and oral flora Although the damaging processes accompanying periodontal disease (such as bone and periodontal ligament destruction) are associated with plaque bacteria they are, in fact, mainly a result of the host response to this microbial assault.

For bacteria to colonise subgingival sites and ultimately infiltrate the underlying connective tissue,many aspects of the host response must be evaded. It would appear that many facets of the immune response with regard to the periodontium are affected by pregnancy,with the overall effect being one of decreased activity and efficiency. The key developments are a decrease in the number of neutrophils, decreased chemotaxis and phagocytosis, and depressed antibody responses and cell-mediated immunity. Given that estrogen and progesterone receptors are found in the periodontal tissues, the progressive increase in levels of these hormones in pregnancy also affects the response of the tissues. The extracellular matrix, gingival vessels and fibroblasts are all affected.4 Although estrogen,which may be involved in the regulation of cellular proliferation, differentiation and keratinisation, seems to stimulate matrix synthesis, along with progesterone it also enhances the localised production of inflammatory mediators, especially prostaglandin E 2 (PGE 2), a potent inducer of osteoclastic activity.

Progesterone also compromises tissue homeostasis by reducing fibroblast proliferation, altering the pattern of collagen production and reducing the level of plasminogen activator inhibitor type 2 (PAI-2) which is an important inhibitor of tissue proteolysis. With regards to periodontal disease,Gram-negative anaerobic bacteria are the main culprits. They include: Prevotella intermedia (P. intermedia), Tannerella forsythensis, Porphyromonas gingivalis (P. gingivalis),Treponema denticola and Actinobacillus actinomycetemcomitans. Although the causal role of specific bacteria in pregnancy associated gingivitis has been difficult to establish, gingival bleeding and inflammation appears to be associated with a rise in the numbers of Gramnegative rods present. However, an increase in the selective growth of P. intermedia, P. gingivalis and Tannerella species (formerly Bacteroides) has been demonstrated in subgingival plaque during the onset of pregnancy gingivitis. This is likely to be a result of these species being able to use the pregnancy hormones, particularly progesterone, as a source of nutrition. This increase in selective growth may also be favoured by the changes that occur in the immune system during pregnancy alongside those that develop locally in the gingival crevice, such as blood from bleeding gingiva providing further nutrients and increased pocketdepths creating a more favourable environment for anaerobes.

Dental caries is a chronic endogenous infection which is multifactorial in nature and caused by the bacterial fermentation of dietary carbohydrates resulting in the localised destruction of the tooth. It appears that the important organisms in the initiation and subsequent progression of dental caries are the Mutans streptococci (a group name for seven different Streptococcus species), Lactobacilli and Actinomyces species. It is not thought that these are in any way affected by pregnancy directly in terms of their cariogenicity or that the structure of the tooth is changed resulting in the teeth becoming more susceptible to caries. Interestingly, increased levels of Mutans streptococci and

Lactobacilli are found in late pregnancy and during lactation. The dietary changes that may occur, especially in early pregnancy, such as regular consumption of sugary snacks and drinks to satisfy cravings or to prevent nausea and sickness will result in an increased risk of dental caries unless extra attention is paid to oral hygiene. This can be further complicated if the pregnant woman is unable to tolerate tooth brushing because of nausea and sickness to the extent that tooth brushing is significantly compromised.

In addition, the risk of caries may be further increased in pregnancy as a result of the estrogen enhanced proliferation and desquamation of the oral mucosa. It is suggested that the desquamating cells enhance the microenvironment by providing nutrition and a suitable environment for bacterial growth, therefore potentially predisposing to caries. Alterations in saliva flow, composition, pH and buffering capacity further compound this.

Oral health in pregnancy

drsnehamaheshwari — Wed, 24 Apr 2013 08:20:58 +0000

Periodontal disease and pregnancy outcome

Current evidence suggests an association between periodontal disease and increased risk of systemic diseases such as atherosclerosis, myocardial infarction, stroke, diabetes mellitus, and adverse pregnancy outcomes. Since the first report on the association between periodontal disease and preterm low birth in 1996 there has been an established link between periodontal disease and adverse pregnancy outcomes including preterm birth, low birth weight, miscarriage, and preeclampsia. Additionally, in 2003 a randomized controlled trial indicated that periodontal treatment consisting of scaling root planning to pregnant women with periodontitis may reduce the risk of preterm birth before 37 weeks of gestation and very preterm birth before 35 weeks of gestation.

Chronic periodontal infections can produce both local and systemic inflammatory response. The activation of the maternal inflammatory cell response and cytokine release plays an important role in the pathophysiological process of preterm birth, low birth weight and preeclampsia.

However, the limited number of randomized controlled trials prevents us from drawing a solid and clear conclusion. There is definite need for additional well-designed epidemiological studies that will test the hypothesis that periodontal treatment can significantly reduce the rates of certain adverse pregnancy outcomes.

Oral health in pregnancy

drsnehamaheshwari — Sun, 21 Apr 2013 12:57:02 +0000

Dental treatment in pregnancy

Normal pregnancy does not necessarily contraindicate dental treatment if the stage of gestation and the extent of dental procedures are taken into account. The first trimester is the period of organogenesis. In addition, approximately 75–80% of spontaneous abortions occur before the 16th week of gestation. T he fetus is thus very sensitive to environmental influences at this time. In the last half of the third trimester, premature delivery becomes a hazard. Prolonged chair time should be avoided because supine hypotensive syndrome may occur. Whether a pregnant woman is in a semireclining or a supine position, the great vessels, particularly the inferior vena cava, are compressed by the uterus. By interfering with venous return, this compression causes hypotension, decreased cardiac output, and eventual loss of consciousness. Supine hypotensive syndrome can usually be reversed byturning the patient on her left side, thereby relieving the pressure on the vena cava and allowing blood to return to the lower extremities and pelvic areas. Because of these hazards, however, no elective procedures, such as definitive periodontal surgery, should be performed during the first and third trimesters.

The second trimester is the safest period during which routine dental care can be provided. Even so, it is advisable to limit care to minimal treatment. Based on numerous studies that emphasize the role of local irritants in the initiation of periodontal disease during pregnancy, it is prudent to educate pregnant women about effective plaque control techniques early in pregnancy. All local irritants should be removed as soon as possible, before the effects of pregnancy are manifested in the gingival tissues.

If emergency treatment is indicated, it should be performed anytime during gestation to eliminate any associated physical or emotional stress. The pain and anxiety precipitated by a dental emergency may be more detrimental to a fetus than the treatment itself. One controversial area in the treatment of pregnant patients involves taking dental radiographs. Only serious dental emergencies require radiographic evaluation, especially in the first trimester, when a developing fetus is particularly susceptible to the effects of radiation. Routine radiographs should be avoided and taken only when necessary. If radiographs are taken, patients should wear a protective lead apron to reduce the amount of radiation to which the abdominal area is exposed.

Another area of concern involves drug therapy, because any drug given to a pregnant patient can affect her fetus by diffusion across the placental barrier. In most cases, it is safe practice to use a local anesthetic with a vasoconstrictor (1:100,000). Analgesics, including acetaminophen and aspirin (except during the third trimester, when bleeding problems can occur during or after delivery) are also safe.

Certain drugs occasionally prescribed by dentists are known to cause complications during pregnancy and therefore should be avoided. These include diazepam (Valium), chlordiazepoxide (Librium), flurazepam (Dalmane), meprobamate (Miltown), streptomycin, and tetracycline. Nitrous oxide should not be administered during organogenesis (first trimester), and neither general anesthesia nor intravenous sedation should be used at all during pregnancy.