Perio - Pregnant and Nursing Flashcards
what is the first line antibiotic for spreading infection in non-pregnant patient?
Penicillin V, metronidazole
what is the first line antibiotic for spreading infection in non-pregnant patient?
Penicillin V, metronidazole
What are the benefits of managing periodontal disease before patient gets pregnant?
do not want to have bacteria and their exotoxins constantly leaking into bloodstream, triggering inflammatory responses –> LOW LEVEL CHRONIC INFLAMMATION
when is first trimester?
1-12
when is second trimester
13-27
when is third trimester?
28-40
what are some feelings patient may have 1st trimester?
- morning sickness
- tiredness
- potential for anemia
why do we get pregnancy gingivitis
increase in OESTROGEN AND PROGESTERONE.
- cause INCREASED VASCULAR PERMEABILITY, INCREASED SENSITIVITY TO PLAQUE, VESSELS BECOME DILATED AND MORE LEAKY.
- increase in oestrogen changes FOLLATE METABOLISM
- reduced keratin thickness
- more bacterial ingress
- 30-100% of pregnancies will experience PREGNANCY GINGIVITIS
- gets worse from month 2 to 8.
- drain of energy in first trimester due to PLACENTAL GROWTH.
what should you avoid in pregnancy?
- amalgam
- articaine
- felypressin
what are the reccomendations about doing periodontal care in first trimester pregnancy?
- avoid periodontal care completely
- provide PREVENTION (fluoride, OH etc).
what medications are patients put in to help them support and sustain pregnancy? what is the clinical implication?
fragmin and aspirin. both ANTICOAGULANTS, BLOOD THINNERS, INCREASED RISK OF BLEEDING
What antibiotics should you avoid in pregannt patients? what can you provide instead?
metronidazole and tetracyclines. give AMOXICILLIN
what is a pregancy epulis? why do we get it?
gingival swelling. readily bleeds/ulcerates but not associated with pain. red-purple swelling. usually regresses after birth.
due to INCREASED PROGESTERONE which INCREASES VASCULAR PERMEABILITY AND DILATION.
what is the safest trimester to treat a pregnant patient for caries?
second trimester
How would you remove an amalgam in a pregnant patient to keep fetus safe?
- use RUBBER DAM
- GOOD ASPIRATION
can you do subgingival debridement in second trimester?
- can provide it in SMALL NUMBER OF SITES/ TEETH (3-4 teeth per visit).
- can use ultrasonic and LA normally.
- SHOULD TREAT PERIO BECAUSE CHILD IS LEARNING IMMUNE RESPONSE, PERIO PATHOGENS CROSSING PLACENTA AND WILL RECOGNIZE THEM AS NORMAL -> MORE LIKELY TO GET PERIO LATER ON.
what are some considerations for 3rd trimester patients?
- uncomfortable for longer appointments
- uncomfy if too supine
- ELEVATE THE RIGHT HIP
- AVOID FELYPRESSIN
- joints become loose (due to relaxin increase)
- MAXIMUM INCREASE IN VASCULARITY AND THUS BOP.
What are adverse outcomes associated with periodontal disease?
- stimulate prostaglandings
- PREMATURE BIRTH
- LOW BIRTH WEIGHT
what systemic conditions may patient present with in 3rd trimester?
- pregnancy induced diabetes
- anemia
