Pregnancy and Your Pregnancy and Your Oral HealthOral Health

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

You could hurt yourself or your baby by You could hurt yourself or your baby by NOT going to the dentistNOT 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 third best Second trimester or first half of third best for procedures that require:for procedures that require: AnesthesiaAnesthesia MedicationMedication Time in the chairTime in the chair

Safe Dental TreatmentSafe Dental Treatment

Most treatments considered safeMost treatments considered safe Acceptable drugsAcceptable drugs

Dental anesthetics Dental anesthetics Chlorhexidine rinseChlorhexidine rinse

Give dentist your obstetrician’s contact Give 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 tooth Disruptions of tooth development development Teeth Can decay more Teeth Can decay more

easilyeasily Occurs in utero or early in life Occurs 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 the When is it safe to go to the

dentist during pregnancy?dentist during pregnancy?

A.A. When you need a check-up or a When you need a check-up or a cleaningcleaning

B.B. Only during the second trimesterOnly during the second trimester

C.C. When something hurtsWhen something hurts

D.D. A and CA and C

Changes During Pregnancy Changes 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 trimesterDecreasing flow first and last trimester

Increased flow second trimesterIncreased 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 sugarMorning sickness/low blood sugar Between-meal snacksBetween-meal snacks

Increase in amount and frequency of Increase in amount and frequency of starches/carbohydrates starches/carbohydrates Crackers are commonly recommendedCrackers are commonly recommended Promotes decay-causing bacteriaPromotes decay-causing bacteria

Courtesy Proctor & GambleCourtesy Proctor & Gamble

Increased Bacteria - Dental Increased Bacteria - Dental DecayDecay

Courtesy Diann Bomkamp, RDH, BSDH, MissouriCourtesy Diann Bomkamp, RDH, BSDH, Missouri

Courtesy Proctor & GambleCourtesy Proctor & Gamble

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

A. A large hole in the head A. A large hole in the head

B. A diseaseB. A disease

C. A hole in the toothC. A hole in the tooth

D. Both B and CD. Both B and C

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, and Cause gums to swell, bleed easily, and

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

and multiplyand multiply Decreased immune response limits Decreased immune response limits

ability to fight bacteria ability to fight bacteria

Gum ProblemsGum Problems

Pregnancy GingivitisPregnancy Gingivitis

Red edgesRed edges

Swollen or puffySwollen or puffy

TenderTender

Bleed easily Bleed easily during brushingduring brushing

Courtesy of Phoenix CollegeCourtesy of Phoenix College

Gum Problems - Pregnancy Gum Problems - Pregnancy GranulomaGranuloma

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

Gum Problems - Pregnancy Gum Problems - Pregnancy GranulomaGranuloma

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

Gum Changes - Pregnancy Gum Changes - Pregnancy GranulomaGranuloma

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

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

A. Red, scaly patches A. Red, scaly patches

B. Black, hairy patchesB. Black, hairy patches

C. Bleeding, swelling or tendernessC. Bleeding, swelling or tenderness

D. None of the aboveD. None of the above

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

Changes During Pregnancy Changes 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 vomitingDo NOT brush immediately after vomiting

Rinse Rinse Water with baking sodaWater with baking soda

AntacidAntacid

Plain waterPlain water

Eat some cheeseEat some cheese

Ask about fluorideAsk about fluoride

Oral Diseases Can Effect Oral Diseases Can Effect PregnancyPregnancy

Preterm, low birth weight (LBW) linked Preterm, low birth weight (LBW) linked to periodontal diseaseto periodontal disease

Thorough calculus (tartar) removal in Thorough calculus (tartar) removal in pregnant women with periodontitis pregnant women with periodontitis may reduce pre-term birthsmay reduce pre-term births

Spontaneous preterm birth in Spontaneous 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 a Jeffcoat et al. (2003) Periodontal disease and preterm birth: results of a pilot intervention study. pilot intervention study.

Spon

tane

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Pret

erm

Bir

ths

Prevention: Oral HygienePrevention: Oral Hygiene

Reduce the amount of bacteria in Reduce 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 carbohydrate Avoid starchy or high carbohydrate

snackssnacks Raw fruits and vegetablesRaw fruits and vegetables Dairy productsDairy products

Who Wants a Who 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 foods

D.D. A and BA and B

E.E. All of the aboveAll of the above

AcknowledgementsAcknowledgements

MAJ Georgia dela CruzMAJ Georgia dela CruzDental Staff OfficerDental 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 the Additional 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

Dr. Luke Shwart, Calgary Health RegionDr. Luke Shwart, Calgary Health Region