Dental Material Considerations

Question 1

What dental related problems are pregnant patients more at risk of?

Answer 1

• increased caries and erosion risk (due to sugary diet and acid reflux)
• increased periodontal disease risk
• increased mobility due to disturbances in PDL attachment

Question 2

What trimester is the foetus most prone to teratogenic effects?

Answer 2

1st trimester

Question 3

What is important to consider when treating a patient in their third trimester?

Answer 3

Their positioning - do not treat them in a supine position
- this reduces risk of hypotensive syndrome

Question 4

What is supine hypotensive syndrome?

Answer 4

when the gravid uterus compresses the inferior vena cava when a pregnant woman is in a supine position, leading to decreased venous return centrally.

Question 5

What position do some dentists recommend positioning a pregnant women (in their third trimester) in the dental chair?

Answer 5

Right hip elevated 10-12cm
- reduces risk of hypotensive syndrome
OR
Tilt to left hand side 5-15% aided by positioning a blanket

Question 6

At what stage is the foetus at greatest risk to developmental defects?

Answer 6

during organogenesis which takes place in the first trimester

Question 7

What acts as an interface between the mother and foetus

Answer 7

the placental barrier

Question 8

What is the function of the placental barrier?

Answer 8

Provides gas exchange and transfer of nutrients and waste products
transfer of immunity from mother to foetus
secretion of hormones for foetal growth and development

Question 9

In what form can mercury transfer by passive diffusion?

Answer 9

mercury vapour

Question 10

what form can mercury pass by active transport by amino acid carriers?

Answer 10

methyl mercury

Question 11

What patients is dental amalgam no longer allowed for unless deemed strictly necessary by the dental practitioner?

Answer 11

children under 15
pregnant women
breat feeding women

Question 12

The SDCEPT guidance in implementation stated “the restrictions on the use of dental amalgam aim to reduce environmental mercury pollution and are not as a result of any safety concerns)

Answer 12

True

Question 13

There are no restrictions on use of resin composities during pregnancy/breast feeding but some concerns been raised regarding resin composites, what are these?

Answer 13

concerns raised regarding elution of bisphenol A (BPA)
- endocrine disruptor
- mimics oestrogen

Question 14

True or false: Newly placed resin composites are associated with a short term increase in [BPA] in saliva and urine

Answer 14

True

Question 15

What did the norwegian mother and child cohort study find regarding getting white fillings during pregnancy?

Answer 15

No statistically significant association between having white fillings in pregnancy and still births, malformations, pre term births and low/high birth weights