Dental Materials and Pregnancy

Question 1

How can pregnancy affect a patients oral health/disease?

Answer 1

• increased caries risk and erosion risk: sugary diet and acid reflux
• increased periodontal disease risk
• increased tooth mobility due to disturbances in the PDL attachment

Question 2

What should we consider when treating patients in 1st trimester?

3rd trimester?

Answer 2

1st trimester: fetus most prone to teratogenic effects (drugs taken by mother)

3rd trimester - do not treat patient supine - prevent hypotensive syndrome

• correct positioning avoids maternal vena cava and aorta compression
• recommended right hip elevated 10-12cm, or 5-15% tilt to left hand side aided by positioned blanket

Question 3

What is the purpose of the placental barrier?

Answer 3

• acts as an interface between mother and fetus
• gas exchange and transfer of nutrients and waste products
• mother to fetus transfer of immunity
• secretion of hormones for foetal growth and development

Greatest risk to fetus is during organogenesis that takes place in the 1st trimester

Question 4

What are the potential mechanisms of transfer across the placental barrier?

Answer 4

Simple diffusion:

• molecular weight
• lipid solubility
• degree of ionisation
• protein binding

Question 5

What group of patients has dental amalgam been no longer allowed for use?

Why is this?

Answer 5

• children under 15
• pregnant women
• breastfeeding women
• except when deemed strictly necessary by the dental practitioner based on the specific medical needs of the patient

Restrictions of use of dental amalgam aim to help reduce environmental mercury pillution and are not as a result of any safety concerns about amalgam fillings for dental patients (SDCEP)

Question 6

What is the concern of resin composite?

Answer 6

Concerns regarding elution of bisphenol A (BPA)

• endocrine disrupter
• mimics oestrogen
• available from impirity in production process of BIS GMA, possible monomer degradation

Newly placed resin composites associated with increased short term BPA concentration in saliva and urine

• BPA may cross placental barrier
• No restrictions on use of resin composites during pregnancy/breastfeeding