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Pregnancy > Dental Care in Pregnancy > Flashcards

Dental Care in Pregnancy Flashcards

1
Q

What are the names given for each trimester and how many weeks. are they (out of 40)

A

1st TRI:
- 0-12 weeks ORGANOGENESIS

2nd TRI:
- 13-28 weeks MATURATION AND GROWTH

3rd TR:
28-42 weeks GROWTH AND MATURATION

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2
Q

Why are there Physiological changes in pregnancy

A
  • Oestrogenic & Progestognenic effects
  • Metabloc demands of foetus
  • Nutritional demands of foetus
  • Mass effect of uterus
  • All effects magnified in multiple pregnancy
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3
Q

What are the Respiratory system changes that occur during pregnancy

A
  • Tidal volume increases
  • RR unchanged
  • PO2 rises
  • PCO2 falls
  • External dyspnoea normal (difficulty breathing)
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4
Q

What are the Cardiovascular system changes that occur during pregnancy

A
  • HR increase (by 10bpm)
  • CO increases 30-50%
  • Dilutiona anaemia
  • Vasodilation
  • Aortocaval compression - compression of abdominal aorta and inferior vena cava when pregnant women lie on their back
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5
Q

What are the changes in the Gastrointestinal system during pregnancy

A
  • Decreased tone in lower oesophagus
  • Delayed gastric emptying and bowel transit
  • Increased intra-abdominal pressure
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6
Q

What are the changes in the Haematological System during pregnancy

A
  • Iron deficiency anaemia
  • Increased clotting factors
  • Increased risk of DVT
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7
Q

What are the changes in Oral health during pregnancy

A
  • Hyper salivation
  • Increased vascularity
  • Gingival tissue growth
  • Altered immune response to bacteria
  • Tooth mobility
  • Effects of excess vomiting
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8
Q

What is “Pregnancy Gingivitis”

A
  • Aggravated pre-existing disease
  • Plaque induced inflammation
  • Histologically similar to non-pregnant disease
  • Worsens through pregnancy
  • Usually resolves after
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9
Q

What is “Pregnancy Epulis”

A
  • Granulomatous/Fibrous hormonal response at pre-existing sit of gingivitis
  • Often at labial interdental papillary gingiva upper jaw
  • Usually pedunculated
  • 5% incidence
  • Associated with plaque
  • Inflammatory cells, new capillaries & fibroblasts microscopically
  • Bone involvement rare
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10
Q

Relationship between periodontal disease and adverse perinatal outcome

A
  • Low birth weight
  • Pre-eclampsia (high blood pressure and protein in urine)
  • Prematurity & pregnancy loss
  • Unclear if treatment improve outcome
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11
Q

Significance of imaging in pregnant women (x-rays)

A

X-rays are teratogenic (disturb development of foetus)

  • Foetal exposure from 18 oral views
  • Document pregnancy status prior to x-ray
  • Strategies:
  • Shielding
  • Restrict
  • Number of views
  • Avoid
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12
Q

Prescribing in pregnancy

A
  • Almost all drugs cross placenta & enter breast milk
  • Highest risk during organogenesis
  • Dependence & Neonatal withdrawal > 28/40
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13
Q

Antimicrobials in pregnancy

A
  • Penicillins, Cephalosporins, Erythromycin, Nystatin ok
  • AVOID TETRACYCLINES
  • AVOID AUGMENTIN
  • AVOID METRONIDAZOLE BEOFRE 24/40 (in some patients)
  • AVOID KETOCONAZOLE, MICONAZOLE, AMPHOTERICIN
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14
Q

Analgesics in pregnancy

A
  • AVOID NSAIDs especially >34/40

* Use minimum dose of opioids for shortest time

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15
Q

Anaesthesia in pregnancy

A

• Avoid sedatives and hypnotics.
Entenox ok for 20-30 mins

  • Lignocaine/Prilocaine +/- adrenaline ok
  • Avoid vasopressin (uterine stimulant)
  • Avoid GA, risks lowest in 2nd trimester
  • Specialist anaesthetic input advised
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16
Q

Amalgam in pregnancy

A
  • Exposure during pregnancy associated with low birth weight

* DOH advises mercury amalgam fillings should not be inserted or removed during pregnancy

17
Q

Breast feeding mothers advice

A
  • Drug levels lower in breast milk compared to blood
  • Advise taking after breast feeding
  • Avoid tetracyclines, Aspirin
18
Q

Prevention Key Messages

A
  • Good oral hygiene & plaque control
  • Dietary advice
  • Routine dental checkup, S&P in 2nd trimester ideally
  • Persistant vomiting: see obstetrician, avoid brushing more than bd
  • Give advice about infant dental care and diet
19
Q

General Key messages

A
  • Care is free
  • Document pregnancy status of all women 13-50 yrs prior to x-rays and any treatment
  • Treat infection and pain
20
Q

Key messages about Procedures

A
  • Treatment is safe and generally the same with specific exceptions
  • Limit procedures to 20-30min until 3/13 postnatal
  • Avoid supine position >20/40
  • Defer procedures in 1st & 3rd trimester
  • If unavoidable: 15 degrees left lateral tilt, oxygen, thromboprophylaxis

Pregnancy (1 decks)

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