Ch 46 Patients With Special Needs Flashcards
All organs are formed (organogenesis) during the ___ trimester
By week __ the fetus moves
Swallows at approx week ___ to __
First
8th
10 to 12
Tooth buds develop between the __ and __ weeks
Initial mineralization occurs from the __ to __ month
5th and 6th
4th to 5th month
What forms during the 4th-7th week ? Bw 8th and 12th?
Cleft lip is apparent by the __ week
Cleft palate by the __ week
Lips
Palate forms
8th
12th
What trimester is the ideal time for treatment.
Baby’s organs are completed and growth and maturation continue
Second
T/F
There is a strong relationship between periodontal disease and adverse pregnancy outcomes (not confer causality)
True
What 2 meds to never use during pregnancy
Ciprofloxacin
Tetracycline
When does tetracycline effect fetus
During mineralization of primary teeth beginning at about 4 months of gestation
And permanent teeth near and after birth
Is antiretroviral therapy (cART) considers face and effective for HIVinfected pregnant women
-maternal viral suppression and decrease mother to child transmission and infant mortality
Yes
Used for upper respiratory infections. Associated with numerous infant complications including cleft lip, heart conditions, hydronephrosis, and trisomy 18
Echinacea
Increased proportions of which oral microbiota have been found during pregnancy
Also increases biofilm formation
AA
P gingivalis
Prevotella
Campylobacter recuts
Isolated discrete soft round enlargement near GM usually with interdental margin
Mushroom shaped, smooth, glistening
Pressure of lip or cheek tends to flatten
Colors depends on what?
Pyogenic granuloma
Color depends on age of lesion
Newer is increase vascularity-purple, red, deep blue
Older is pinker color
Symptoms of Pyogenic granuloma
Bleeds easily with slight trauma
Painless unless interferes with occlusion and mastication
Is periodontal treatment safe during pregnancy
Yes. Pregnant women should undergo routine perio exams
PMT and perio therapeutic services if needed
Where does erosion from vomiting primarily occur ?
Max anterior lingual
Max and mand occlusal
Posterior region of mand buccal surfaces
What can be used for erosion prevention
Sodium bicarbonate rinse after vomiting (1 cup water to 1 tsp sodbicarb)
Consult during pregnancy is only needed if the women has
Not required for other routine dental care
Hypertension.
An abnormal blood pressure or underlying health condition
Factors for radiology
As low as reasonably acheivable (ALARA)
Safe throughout pregnancy, cover with apron and thyroid collar
What is contraindicated during pregnancy and first 6 months of breastfeeding
Potassium iodide
Restorative materials (amalgam and composite) are recommended when
elective esthetic tx?
Anytime during the pregnancy
Should be postponed until after delivery
What position should pregnant women be placed
On left side, or supine or trendelenburg
Monthly or appt three times during the 9 Month period may be required
Appt frequency depends on pts needs as well as
True
Ability and motivation to maintain good oral self care
Hyperemesis gravidarum
Morning sickness
- What happens is pt placed in supine position
- The venous return is decreased and causes
- Weight of fetus is placed directly on major vessels (aorta and inferior vena cava)
Pressed bw spinal column and uterus
- Circulatory insufficiency
Lying in supine
Fall in BP
Bradycardia sweat nausea weak air hunger
Reduced cardiac output and loss of consciousness
Supine hypotensive syndrome emergency
Pressure of uterus with baby on inferior vena cava
What to do in case of supine hypotensive syndrome emergency
Roll pt over to left side to relieve pressure
BP should return promptly
Or elevate right hip to displace uterus to left (pillow or blanket)
Pt lies on left side in semi supine
Is the use of ultrasonic scaler contraindicated for reasons relate to pregnancy ?
No
Local anesthetic containing _______ is allowed during pregnancy
Consult with pt PCP for use of ___ ___ (in moderation )
How long can N.O. be used in 2nd or 3rd semester
Epinephrine
Nitrous oxide
30 min with oxygen at 50%!
Particular needs for mother’s diet include
Proteins
tissue construction
Minerals
calcium and phosphorus- bone and tooth, iron - RBCs
Vitamins
D- calcium metabolism, folate- prevent neural tube defects and low birth weight
400mg
1300mg, 1000mg for all 19-50 yrs
Per day
Folate
Calcium
Is the relationship bw dental caries and pregnancy direct?
No, caries do not increase just bc of pregnancy ( food intake and bad habits like at other times in any individual)
Factor that can contribute to increase dental caries
Previous neglect
Diet (cravings, frequency)
Salivary changes
-lower pH
Neglect of oral self care
-smell of toothpaste or lack of interest
Low socioeconomic status
-low income, less education
Prenatal Fluoride supplements and relation to early childhood caries ?
No evidence that intake influences rate in offspring
Sadness
Insomnia or excessive sleep
Loss of appetite or excessive eating
Anxiety, panic attacks
Feelings of worthlessness and suicidal thoughts
Signs of depression
How does perinatal depression impact the fetus
Higher tendency for preeclampsia
Growth restriction
Low birth weight
Preterm delivery
Infant oral health should be discussed during ____ ____ to improve preparedness
Prenatal visits
Should children under 2 receive OTC benzocaine
What can result if so
No
Can cause potentially fatal methemoglobinemia
When should infant receive a dental exam
Eruption of first primary and no late than 12 months
Kissing
Sharing food, drink, utensil
Cleaning pacifier via moth
Vs
Saliva containing S Mutans exchanged Between siblings and children at daycare
Vertical transmission
Horizontal transmission
Exam sequence
Head and neck and legs and arms (evidence of abuse)
With teeth present, lift lips away from GM to examine
-biofilm, discoloration
Malformations, caries, white spots
Aptypical Frenal attachment
-can limit to bud mobility
Show parent , refer to DDS
Educating expectant mother about importance of infant oral health to improve preparedness
Anticipatory guidance
