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8/14/2019 US Army: PregnancyAndYourOralHealth

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Pregnancy and Your Pregnancy and Your

Oral HealthOral Health[insert presenter info][insert presenter info]



When should I see the dentist?When should I see the dentist?

You could hurt yourself or your baby You could hurt yourself or your baby

by NOT going to the dentistby NOT going to the dentist

Any timeAny time Check-ups and cleaningsCheck-ups and cleanings Emergency care (including x-rays)Emergency care (including x-rays)

Second trimester or first half of thirdSecond trimester or first half of third

best for procedures that require:best for procedures that require: AnesthesiaAnesthesia MedicationMedication Time in the chair Time in the chair



Safe Dental TreatmentSafe Dental Treatment

Most treatments considered safeMost treatments considered safe

Acceptable drugsAcceptable drugs

Dental anestheticsDental anesthetics Chlorhexidine rinseChlorhexidine rinse

Give dentist your obstetrician’s contactGive dentist your obstetrician’s contact

informationinformation AvoidAvoid

Aspirin or ibuprofenAspirin or ibuprofen

Tetracyclines, chloramphenicolTetracyclines, chloramphenicol



Fetal Growth and DevelopmentFetal Growth and Development

Development of infant’s mouthDevelopment of infant’s mouth

4-5 weeks – primary tooth buds4-5 weeks – primary tooth buds

4-7 weeks – lips4-7 weeks – lips 8-12 weeks – roof of mouth8-12 weeks – roof of mouth

12 weeks – primary teeth start to harden12 weeks – primary teeth start to harden

6 months - permanent tooth buds6 months - permanent tooth buds



Childhood Enamel HypoplasiaChildhood Enamel Hypoplasia

What is it?What is it? Deformed, weak enamelDeformed, weak enamel Disruptions of toothDisruptions of tooth

developmentdevelopment Teeth Can decay moreTeeth Can decay more

easilyeasily

Occurs in utero or early in lifeOccurs in utero or early in life Causes:Causes:

Fever in the pregnant mother or infantFever in the pregnant mother or infant Low birth weightLow birth weight Diann Bomkamp, RDH, BSDH, Missouri



Who Wants a $1,000,000 $mile?Who Wants a $1,000,000 $mile?

When is it safe to go to theWhen is it safe to go to the

dentist during pregnancy?dentist during pregnancy?

A.A. When you need a check-up or aWhen you need a check-up or acleaningcleaning

B.B.

Only during the second trimester Only during the second trimester

C.C. When something hurtsWhen something hurts

D.D. A and CA and C



Changes During PregnancyChanges During Pregnancy

that Affect Oral Healththat Affect Oral Health

Hormonal AffectsHormonal Affects

Increased tooth mobilityIncreased tooth mobility

Saliva changesSaliva changes

Increased bacteriaIncreased bacteria

Gum problemsGum problems



Saliva changesSaliva changes

Decreased buffersDecreased buffers

Decreased mineralsDecreased minerals

Decreasing flow first and last trimester Decreasing flow first and last trimester

Increased flow second trimester Increased flow second trimester

More acidicMore acidic



Increased BacteriaIncreased Bacteria

Increased acidityIncreased acidity Increase in decay-causing bacteriaIncrease in decay-causing bacteria

Increased SnackingIncreased Snacking Morning sickness/low blood sugar Morning sickness/low blood sugar

Between-meal snacksBetween-meal snacks

Increase in amount and frequency of Increase in amount and frequency of starches/carbohydratesstarches/carbohydrates Crackers are commonly recommendedCrackers are commonly recommended

Promotes decay-causing bacteriaPromotes decay-causing bacteria


http://slidepdf.com/reader/full/us-army-pregnancyandyouroralhealth 10/27Courtesy Proctor & GambleCourtesy Proctor & Gamble



Increased Bacteria - DentalIncreased Bacteria - Dental

DecayDecay

Courtes Diann Bomkam RDH BSDH MissouriCourtes Diann Bomkam , RDH, BSDH, Missouri


http://slidepdf.com/reader/full/us-army-pregnancyandyouroralhealth 12/27Courtesy Proctor & GambleCourtesy Proctor & Gamble



Who Wants a

$1,000,000$mile?What is a cavity?What is a cavity?

D. Both B and C

C. A hole in the tooth

B. A disease

A. A large hole in the head



Increased BacteriaIncreased Bacteria

Increased food supplyIncreased food supply

Increased hormonesIncreased hormones

Gingival fluid and saliva contain hormonesGingival fluid and saliva contain hormones Cause gums to swell, bleed easily, andCause gums to swell, bleed easily, and

secrete more fluidsecrete more fluid Bacteria use hormones for energy to growBacteria use hormones for energy to grow

and multiplyand multiply Decreased immune response limitsDecreased immune response limits

ability to fight bacteriaability to fight bacteria



Gum ProblemsGum Problems

Pregnancy GingivitisPregnancy Gingivitis

Red edgesRed edges

Swollen or puffySwollen or puffy

Tender Tender

Bleed easilyBleed easilyduring brushingduring brushing

Courtesy of Phoenix CollegeCourtesy of Phoenix College



Gum Problems - PregnancyGum Problems - Pregnancy

GranulomaGranuloma

Courtesy of Univ. of Southern CaliforniaCourtesy of Univ. of Southern California



Gum Problems - PregnancyGum Problems - Pregnancy

GranulomaGranuloma




Gum Changes - PregnancyGum Changes - Pregnancy

GranulomaGranuloma




Who Wants aWho Wants a

$1,000,000$1,000,000

$mile?$mile?

D. None of the above

C. Bleeding, swelling or tenderness

B. Black, hairy patches

A. Red, scaly patches

Some signs of gum disease are…Some signs of gum disease are…



Changes During PregnancyChanges During Pregnancy

that Affect Oral Healththat Affect Oral Health Morning sicknessMorning sickness

Difficulty with hygieneDifficulty with hygiene Gum diseaseGum disease

Tooth decayTooth decay

VomitingVomiting

Esophogeal Reflux (heartburn)Esophogeal Reflux (heartburn)

Acid exposureAcid exposure Irritation of the gumsIrritation of the gums Weakening of tooth enamelWeakening of tooth enamel Dental erosionDental erosion



Treatment for Acid ExposureTreatment for Acid Exposure

Do NOT brush immediately after Do NOT brush immediately after

vomitingvomiting

RinseRinse Water with baking sodaWater with baking soda

AntacidAntacid

Plain water Plain water

Eat some cheeseEat some cheese

Ask about fluorideAsk about fluoride



Oral Diseases Can EffectOral Diseases Can Effect

PregnancyPregnancy

Preterm, low birth weight (LBW) linkedPreterm, low birth weight (LBW) linked

to periodontal diseaseto periodontal disease

Thorough calculus (tartar) removal inThorough calculus (tartar) removal in

pregnant women with periodontitispregnant women with periodontitis

may reduce pre-term birthsmay reduce pre-term births



Spontaneous preterm birth inSpontaneous preterm birth in

pregnant women with gum diseasepregnant women with gum disease

0.0%

1.0%2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

9.0%

10.0%

No treatment Polish Cleaning

Jeffcoat et al. (2003) Periodontal disease and preterm birth: results of aJeffcoat et al. (2003) Periodontal disease and preterm birth: results of a

pilot intervention study.pilot intervention study.

S

p o n t a n e o u s P r e t e

r m B

i r t h s



Prevention: Oral HygienePrevention: Oral Hygiene

Reduce the amount of bacteria inReduce the amount of bacteria in

your mouthyour mouth

Brushing and flossingBrushing and flossing

Antibacterial mouth rinsesAntibacterial mouth rinses

Xylitol gum or mintsXylitol gum or mints

Keep routine dental visitsKeep routine dental visits



Prevention:Prevention:

Nutrition for Oral HealthNutrition for Oral Health Eat well-balanced mealsEat well-balanced meals

B vitamins, especially folate (folic acid)B vitamins, especially folate (folic acid)

Vitamin CVitamin C CalciumCalcium

Snack smartSnack smart

Avoid starchy or high carbohydrateAvoid starchy or high carbohydratesnackssnacks Raw fruits and vegetablesRaw fruits and vegetables Dairy productsDairy products



Who Wants aWho Wants a

$1,000,000$1,000,000

$mile?$mile?Oral diseases can be prevented by…Oral diseases can be prevented by…

A.A. Using fluoride rinseUsing fluoride rinse

B.B. Brushing 2-3 times a dayBrushing 2-3 times a day

C.C. Eating nutritious foodsEating nutritious foodsD.D. A and BA and B

E.E. All of the aboveAll of the above



AcknowledgementsAcknowledgements

MAJ Georgia dela CruzMAJ Georgia dela CruzDental Staff Officer Dental Staff Officer

Directorate of Health Promotion & WellnessDirectorate of Health Promotion & Wellness

US Army Center for Health Promotion & Preventive MedicineUS Army Center for Health Promotion & Preventive Medicine

Additional graphics or information provided by theAdditional graphics or information provided by the

following:following:

Diann Bomkamp, RDH, BSDH, MissouriDiann Bomkamp, RDH, BSDH, Missouri

WI Dept. of Health and Family ServicesWI Dept. of Health and Family Services

University of Southern CaliforniaUniversity of Southern California

Phoenix CollegePhoenix College

Proctor & GambleProctor & Gamble

D L ke Sh a t Calga Health RegionDr Luke Shwart Calgary Health Region