Periodontology L1 - Pregnancy I class 16/03/20

Question 1

What can hormonal changes do in pregnant women in relation to their oral health?

Answer 1

Hormonal changes can lower disease threshold, which may result in pregnant patients picking up oral disease.

Question 2

Is it beneficial to complete any periodontal work pre-conception?

Answer 2

Guidelines suggest that we should treat periodontal disease and not leave it until after birth, to allow the best outcomes for mother and baby.

Question 3

Why is it important to limit root surface debridement during pregnancy?

Answer 3

Minimise bacteraemia.

Question 4

Why is it important to minimise bacteraemia in pregnant patients?

Answer 4

Reduces the risk of bacteria crossing the placenta and entering the foetal blood.

Question 5

Can you place in amalgam restorations on pregnant women?

Answer 5

No

Question 6

If you must absolutely remove a amalgam restoration on a pregnant patient, what method must you use to prevent the absorption of amalgam?

Answer 6

Rubber dam

Question 7

A pregnant has caries under her amalgam restoration, without removing the amalgam restoration how would you treat the caries?

Answer 7

Glass ionomer.

Question 8

What dental condition may arise from prolonged morning sickness especially if in the future multiple pregnancies?

Answer 8

Dental erosion

Question 9

During the 1^st trimester, women exhibit and increase in gingival bleeding why?

Answer 9

Increased levels of progesterone cause increased levels of vascular permeability and vessel dilation, which results in increased gingival exudate and swelling.

Question 10

Progesterone and oestrogen reduce the thickness of the keratin in the gingival epithelium, what does this mean for bacteria?

Answer 10

The gingivae is less effective barrier to bacteria.

Question 11

Why would you wait after parturition to remove a pregnancy epulis?

Answer 11

Pregnancy epulis is driven by the increase in hormones, after birth the hormonal drive drops.

Question 12

The patient has been anaemic post birth, what may you notice orally?

Answer 12

Recurrent oral ulceration.

Question 13

Why has the patient become anaemic postpartum?

Answer 13

Blood loss/decreased blood volume

Question 14

What type of anaemia would result in postpartum?

Answer 14

Normocytic anaemia

Question 15

What position should you not treat patients during their 3^rd trimester?

Answer 15

Supine.

Question 16

When is the greatest risk to a foetus?

Answer 16

During organogenesis that takes place in first trimester.

Question 17

Use of dental amalgam no longer allowed for?

Answer 17

Children under 15 years old

Pregnant women

Breastfeeding women

Question 18

Are there any known restrictions on the use of resin composites during pregnancy?

Answer 18

No restrictions on use of resin composites during pregnancy/breast feeding.

Question 19

Pregnancy is associated with an increased sensitivity of the periodontal tissues to the presence of plaque, clinical name for this is?

Answer 19

Pregnancy gingivitis.

Question 20

When would you expect to see the recession in red swollen gingivae with increased pocket depths and bleeding on probing?

Answer 20

Usually recedes after the 8^th month of pregnancy

Question 21

Endocrine/metabolic risk factors usually lead to the formation of a localised fibrogranulomatus growth leading to the formation of what?

Answer 21

Pregnancy epulis or granuloma

Question 22

what is this

Answer 22

pregnancy epulis

Question 23

During puberty, the significant increase in steroid hormone levels during puberty causes a temporary increase in gingival inflammation, to which gender?

Answer 23

Both male and female

Question 24

Oral bacteria when present in the blood have the ability to trigger various reactions, what reactions do they trigger with platelets?

Answer 24

They could trigger inappropriate

Question 25

Maternal high blood pressures clinical term is?

Answer 25

Pre-eclampsia

Question 26

Can you use lidocaine with epinephrine on pregnant women?

Answer 26

Yes

Question 27

Gestational diabetes affects what percentage of pregnant women and how likely are they to develop perio disease?

Answer 27

4% of pregnant women are likely to develop gestational diabetes and are 9x more likely to devlop perio disease.

Question 28

Pre term birth, low birth weight and pre-eclampsia is associated with which oral disease?

Answer 28

Periodontitis

Question 29

Best practice is to avoid prescribing in pregnancy unless benefit clearly outweighs risk to foetus, all drugs should be avoided if possible, during which trimester?

Answer 29

1^st