Management of Pregnant Patients

Bunyi, Bien Racquel Cathleen

Torres, Kathleen

DMD3-A

First trimester (conception to 14th week) most critical and rapid cell division and active organogenesis

occur between the second and the eighth week of post-conception

greater risk of susceptibility to stress and teratogens

educate the patient about maternal oral changes during pregnancy

emphasize strict oral hygiene instructions limit dental treatment to periodontal prophylaxis

and emergency treatment avoid routine radiographs

Recommendation

Second trimester (14th to 28th week) safest period for providing dental care during

pregnancy organogenesis is completed

oral hygiene, instruction, and plaque control scaling, polishing, and curettage may be

performed if necessary control of active oral diseases, if any elective dental care is safe avoid routine radiographs

Recommendation

Third trimester (29th week until childbirth) although there is no risk to the fetus during this trimester,

the pregnant mother may experience an increasing level of discomfort

it is safe to perform routine dental treatment in the early part of the third trimester, but from the middle of the third trimester routine dental treatment should be avoided

oral hygiene, instruction, and plaque control scaling, polishing curettage may be performed if use routine radiographs selectively and when needed short dental appointments with appropriate positioning to

prevent supine hypotension

Recommendation

Radiography

Procedure in making radiographs safer for pregnant patients

make only the film absolutely essential for diagnosing the conditions (i.e. root canal therapy, trauma)

use lead apron shielding use long cone use proper collimation & shielding limited to affected tooth care should be used while taking essential films to eliminate the need for repeated

exposure

Causes of dental health problems gum problems vomiting cravings for sugary foods retching while brushing teeth

Gum Problem during pregnancy, the gum problems that occur are not

due to increased plaque, but a worse response to plaque as a result of increased hormone levels

switch to a softer toothbrush brush your teeth regularly, at least twice every day use toothpaste that contains fluoride to help strengthen your teeth against decay

Recommendation

Vomiting can damage teeth

gastric reflux (regurgitating food or drink) or the vomiting associated with morning sickness can coat your teeth with strong stomach acids

repeated reflux and vomiting can damage tooth enamel and increase the risk of decay

Recommendation don’t brush your teeth immediately after

vomiting rinse your mouth thoroughly with plain tap

water follow up with a fluoridated mouthwash if you don’t have a fluoridated mouthwash,

put a dab of fluoridated toothpaste on your finger and smear it over your teeth

Food cravings while pregnant a regular desire for sugary snacks may

increase your risk of tooth decay

try to snack on low-sugar foods instead rinse your mouth with water or milk, or brush your teeth after havingsugary snacks

Recommendation

Retching while brushing some pregnant women find that brushing their teeth,

particularly the molars, provokes retching

use a brush with a small head, such as a brush made for toddlers

slow down your brushing action It may help to close your eyes and concentrate on your

breathing. try other distractions, such as listening to music if the taste of the toothpaste seems to provoke your gag

reflex, switch to another brand

Recommendation

Medication