DENTAL HEALTH CONSIDERATION IN

PREGNANCY

UIN : 1504022002

DEPARTMENT OF ORAL MEDICINE AND RADIOLOGY

 CONTENTS
Are dental
medications
safe????
 Introduction
Can I receive
Dental
treatment???  Stages of Pregnancy

 Pregnancy Related Oral Health Problems

 Dental Management Guidelines During Pregnancy

Are dental
 Risks of Dental X-Rays
X rays
safe????
 Pharmacotherapy in pregnancy

 TAKE HOME MESSAGE

INTRODUCTION

☛ Pregnancy is a dynamic physiological

state which is evidenced by several
transient changes.

☛ important to educate - about the

common problems noticed during
pregnancy.
Stages of Pregnancy
 Pregnancy Related Oral Health Problems

Pregnancy Gingivitis Xerostomia

Pregnancy granuloma Dental Caries

Erosion Candidiasis
 Dental Management Guidelines During Pregnancy

1st Trimester 2nd Trimester 3rd Trimester

Miscarriage

Dental treatment

Emergency

Oral Prophylaxis

Restoration &RCT

Epinephrine

Radiographs
Pregnancy Related Oral Health Consideration

Hypertension

Gestational
Diabetes

Water Fluoridation
Supine Hypotensive syndrome
 Risks of Dental X-Rays
Deterministic Effects Of Whole-Body Irradiation:
On Embryos And Fetuses
PREGANACY IS A RELATIVE CONTRAINDICATION TO RADIATION

1. 1st trimester – Absolute contraindication - most sensitive time

2. The medical scans (CT) are avoided- MRI is opted

3. 2nd and 3rd trimester – relative contraindication – Risk benefit

analysis .

1 rad of utero radiation exposure has been A dental periapical

estimated to be approximately 0.1% film  0.00001 RAD
malignant disease (0.1 mrad)
 Deterministic Effects Of Whole-Body Irradiation:
On Embryos And Fetuses

1. 18th week- abnormalities like small birth size, cataracts,

microcephaly, genital and skeletal malformations, and

microphthalmia.

2. The period of maximal sensitivity of the brain is 8 to 15

weeks after conception.

3. 1Gy in 8-15th week- 4% chance of Mental retardation.

Exposure can be limited by:

Lead apron shielding

Use long cone

Use proper collimation &

shielding

Modern fast film

Avoid retakes
Pharmacotherapy in pregnancy:
 TERATOGENESIS:

A teratogen is any agent, that when exposed to the

foetus, causes permanent alterations in the function or
form of the offspring .

Eg: Thalidomide disaster (1558-1961) resulting in thousand

of babies born with PHOCOMELIA.
 (F.D.A) classification system
Pregnancy Risk Categories for Pharmacologic Agents.

Category Drug

A Controlled studies showed no risk to the patient

B Either animal studies have shown no risk

C Potential benefit must be greater than the risk to the fetus

D Evidence of fetal risk proven

X Proven fetal risk clearly outweighs any potential benefit

Pharmacotherapy in pregnancy
 TAKE HOME MESSAGE

Timing of Dental Treatment During Pregnancy - From Little and Fallace

First trimester Second trimester Third trimester

Plaque control Plaque control Plaque control
Oral hygiene Oral hygiene Oral hygiene
instruction instruction instruction
Scaling, polishing, Scaling, polishing, Scaling, polishing,
curettage curettage curettage

Avoid elective After middle of third

treatment; urgent care Routine dental care trimester, elective care
only should be avoided
 I referred ….......

I. Burket, Greenberg, M. and Glick, M. (2003). Burket's oral medicine. New York: BC Decker Inc.
II. White S, Pharaoh M. Oral radiology principles and interpretation. 6th Edn; Philadelphia Mosby.
2004.Ch.02
III. Scully, C. (2016). Scully's Handbook of Medical Problems in Dentistry E-Book. London: Elsevier Health
Sciences.
IV. Offenbacher S, Lieff S, Boggess KA, Murtha AP, Madianos PN, Champagne CM, McKaig RG, Jared HL,
Mauriello SM, Auten RL Jr, Herbert WN and Beck JD. Maternal periodontitis and prematurity. Part I:
Obstetric outcome of prematurity and growth restriction. Ann Periodontol. 2001;6(1):164-174.

Further reading....
I. Oral Health Care During Pregnancy Expert Workgroup. Oral health care during pregnancy: a national
consensus statement—summary of an expert workgroup meeting. Washington, DC: National Maternal
and Child Oral Health Resource Center; 2012.