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Pregnancy and Your Pregnancy and Your
Oral HealthOral Health[insert presenter info][insert presenter info]
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When should I see the dentist?When should I see the dentist?
You could hurt yourself or your baby You could hurt yourself or your baby
by NOT going to the dentistby NOT going to the dentist
Any timeAny time Check-ups and cleaningsCheck-ups and cleanings Emergency care (including x-rays)Emergency care (including x-rays)
Second trimester or first half of thirdSecond trimester or first half of third
best for procedures that require:best for procedures that require: AnesthesiaAnesthesia MedicationMedication Time in the chair Time in the chair
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Safe Dental TreatmentSafe Dental Treatment
Most treatments considered safeMost treatments considered safe
Acceptable drugsAcceptable drugs
Dental anestheticsDental anesthetics Chlorhexidine rinseChlorhexidine rinse
Give dentist your obstetrician’s contactGive dentist your obstetrician’s contact
informationinformation AvoidAvoid
Aspirin or ibuprofenAspirin or ibuprofen
Tetracyclines, chloramphenicolTetracyclines, chloramphenicol
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Fetal Growth and DevelopmentFetal Growth and Development
Development of infant’s mouthDevelopment of infant’s mouth
4-5 weeks – primary tooth buds4-5 weeks – primary tooth buds
4-7 weeks – lips4-7 weeks – lips 8-12 weeks – roof of mouth8-12 weeks – roof of mouth
12 weeks – primary teeth start to harden12 weeks – primary teeth start to harden
6 months - permanent tooth buds6 months - permanent tooth buds
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Childhood Enamel HypoplasiaChildhood Enamel Hypoplasia
What is it?What is it? Deformed, weak enamelDeformed, weak enamel Disruptions of toothDisruptions of tooth
developmentdevelopment Teeth Can decay moreTeeth Can decay more
easilyeasily
Occurs in utero or early in lifeOccurs in utero or early in life Causes:Causes:
Fever in the pregnant mother or infantFever in the pregnant mother or infant Low birth weightLow birth weight Diann Bomkamp, RDH, BSDH, Missouri
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Who Wants a $1,000,000 $mile?Who Wants a $1,000,000 $mile?
When is it safe to go to theWhen is it safe to go to the
dentist during pregnancy?dentist during pregnancy?
A.A. When you need a check-up or aWhen you need a check-up or acleaningcleaning
B.B.
Only during the second trimester Only during the second trimester
C.C. When something hurtsWhen something hurts
D.D. A and CA and C
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Changes During PregnancyChanges During Pregnancy
that Affect Oral Healththat Affect Oral Health
Hormonal AffectsHormonal Affects
Increased tooth mobilityIncreased tooth mobility
Saliva changesSaliva changes
Increased bacteriaIncreased bacteria
Gum problemsGum problems
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Saliva changesSaliva changes
Decreased buffersDecreased buffers
Decreased mineralsDecreased minerals
Decreasing flow first and last trimester Decreasing flow first and last trimester
Increased flow second trimester Increased flow second trimester
More acidicMore acidic
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Increased BacteriaIncreased Bacteria
Increased acidityIncreased acidity Increase in decay-causing bacteriaIncrease in decay-causing bacteria
Increased SnackingIncreased Snacking Morning sickness/low blood sugar Morning sickness/low blood sugar
Between-meal snacksBetween-meal snacks
Increase in amount and frequency of Increase in amount and frequency of starches/carbohydratesstarches/carbohydrates Crackers are commonly recommendedCrackers are commonly recommended
Promotes decay-causing bacteriaPromotes decay-causing bacteria
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Increased Bacteria - DentalIncreased Bacteria - Dental
DecayDecay
Courtes Diann Bomkam RDH BSDH MissouriCourtes Diann Bomkam , RDH, BSDH, Missouri
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Who Wants a
$1,000,000$mile?What is a cavity?What is a cavity?
D. Both B and C
C. A hole in the tooth
B. A disease
A. A large hole in the head
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Increased BacteriaIncreased Bacteria
Increased food supplyIncreased food supply
Increased hormonesIncreased hormones
Gingival fluid and saliva contain hormonesGingival fluid and saliva contain hormones Cause gums to swell, bleed easily, andCause gums to swell, bleed easily, and
secrete more fluidsecrete more fluid Bacteria use hormones for energy to growBacteria use hormones for energy to grow
and multiplyand multiply Decreased immune response limitsDecreased immune response limits
ability to fight bacteriaability to fight bacteria
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Gum ProblemsGum Problems
Pregnancy GingivitisPregnancy Gingivitis
Red edgesRed edges
Swollen or puffySwollen or puffy
Tender Tender
Bleed easilyBleed easilyduring brushingduring brushing
Courtesy of Phoenix CollegeCourtesy of Phoenix College
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Gum Problems - PregnancyGum Problems - Pregnancy
GranulomaGranuloma
Courtesy of Univ. of Southern CaliforniaCourtesy of Univ. of Southern California
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Gum Problems - PregnancyGum Problems - Pregnancy
GranulomaGranuloma
Courtesy of Univ. of Southern CaliforniaCourtesy of Univ. of Southern California
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Gum Changes - PregnancyGum Changes - Pregnancy
GranulomaGranuloma
Courtesy of Univ. of Southern CaliforniaCourtesy of Univ. of Southern California
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Who Wants aWho Wants a
$1,000,000$1,000,000
$mile?$mile?
D. None of the above
C. Bleeding, swelling or tenderness
B. Black, hairy patches
A. Red, scaly patches
Some signs of gum disease are…Some signs of gum disease are…
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Changes During PregnancyChanges During Pregnancy
that Affect Oral Healththat Affect Oral Health Morning sicknessMorning sickness
Difficulty with hygieneDifficulty with hygiene Gum diseaseGum disease
Tooth decayTooth decay
VomitingVomiting
Esophogeal Reflux (heartburn)Esophogeal Reflux (heartburn)
Acid exposureAcid exposure Irritation of the gumsIrritation of the gums Weakening of tooth enamelWeakening of tooth enamel Dental erosionDental erosion
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Treatment for Acid ExposureTreatment for Acid Exposure
Do NOT brush immediately after Do NOT brush immediately after
vomitingvomiting
RinseRinse Water with baking sodaWater with baking soda
AntacidAntacid
Plain water Plain water
Eat some cheeseEat some cheese
Ask about fluorideAsk about fluoride
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Oral Diseases Can EffectOral Diseases Can Effect
PregnancyPregnancy
Preterm, low birth weight (LBW) linkedPreterm, low birth weight (LBW) linked
to periodontal diseaseto periodontal disease
Thorough calculus (tartar) removal inThorough calculus (tartar) removal in
pregnant women with periodontitispregnant women with periodontitis
may reduce pre-term birthsmay reduce pre-term births
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Spontaneous preterm birth inSpontaneous preterm birth in
pregnant women with gum diseasepregnant women with gum disease
0.0%
1.0%2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
8.0%
9.0%
10.0%
No treatment Polish Cleaning
Jeffcoat et al. (2003) Periodontal disease and preterm birth: results of aJeffcoat et al. (2003) Periodontal disease and preterm birth: results of a
pilot intervention study.pilot intervention study.
S
p o n t a n e o u s P r e t e
r m B
i r t h s
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Prevention: Oral HygienePrevention: Oral Hygiene
Reduce the amount of bacteria inReduce the amount of bacteria in
your mouthyour mouth
Brushing and flossingBrushing and flossing
Antibacterial mouth rinsesAntibacterial mouth rinses
Xylitol gum or mintsXylitol gum or mints
Keep routine dental visitsKeep routine dental visits
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Prevention:Prevention:
Nutrition for Oral HealthNutrition for Oral Health Eat well-balanced mealsEat well-balanced meals
B vitamins, especially folate (folic acid)B vitamins, especially folate (folic acid)
Vitamin CVitamin C CalciumCalcium
Snack smartSnack smart
Avoid starchy or high carbohydrateAvoid starchy or high carbohydratesnackssnacks Raw fruits and vegetablesRaw fruits and vegetables Dairy productsDairy products
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Who Wants aWho Wants a
$1,000,000$1,000,000
$mile?$mile?Oral diseases can be prevented by…Oral diseases can be prevented by…
A.A. Using fluoride rinseUsing fluoride rinse
B.B. Brushing 2-3 times a dayBrushing 2-3 times a day
C.C. Eating nutritious foodsEating nutritious foodsD.D. A and BA and B
E.E. All of the aboveAll of the above
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AcknowledgementsAcknowledgements
MAJ Georgia dela CruzMAJ Georgia dela CruzDental Staff Officer Dental Staff Officer
Directorate of Health Promotion & WellnessDirectorate of Health Promotion & Wellness
US Army Center for Health Promotion & Preventive MedicineUS Army Center for Health Promotion & Preventive Medicine
Additional graphics or information provided by theAdditional graphics or information provided by the
following:following:
Diann Bomkamp, RDH, BSDH, MissouriDiann Bomkamp, RDH, BSDH, Missouri
WI Dept. of Health and Family ServicesWI Dept. of Health and Family Services
University of Southern CaliforniaUniversity of Southern California
Phoenix CollegePhoenix College
Proctor & GambleProctor & Gamble
D L ke Sh a t Calga Health RegionDr Luke Shwart Calgary Health Region