1. Pregnancy & Breast Feeding
Dr. Suresh. C. S. BDS; MDS; MDSc ( UK )
Oral Diagnosis I
Pregnant patients are not considered medically
Pregnant patients poses a unique set of
management considerations for the dentist.
Dental care must be rendered to the mother
without adversely affecting the developing
3. Overview (Cont.)
Providing routine dental care to pregnant patients
is generally safe. However, the potentially harmful
4. Physiology & Complications
During pregnancy, several cardiovascular changes
Blood volume increases 40%.
Cardiac output increases 30-40%.
RBC volume increases only about 15-20%.
Blood pressure falls (100/70 mm Hg).
Heart murmur (90% of cases).
5. Physiology & Complications
During late pregnancy a supine hypotension
syndrome may occur:
Abrupt fall in blood pressure
Air hunger when the patient is in supine
6. Physiology & Complications
Normal pregnancy lasts about 40 weeks:
During the first trimester, formation of organs
and systems occurs (fetus most susceptible to
After the first trimester, the majority of
formation is complete (growth & maturation).
7. Physiology & Complications
Complications of pregnancy
More common in expectant mothers who
Might results in perinatal abnormalities and
8. Dental Management
Dentist should determine the general health of the
Proper medical history
9. Dental Management
Establish a healthy oral environment and an
optimum level of oral hygiene
Minimize the exaggerated inflammatory response
Studies have shown that maternal periodontal
disease increases the infant risk for low birth
Uses of prenatal fluoride and oral hygiene
measures benefits the mother & the newborn
10. Dental Management
Elective dental care is best avoided during the
The second trimester is the safest period which
to provide routine dental care
After the middle of third trimester, elective
dental care is best postponed
Prolonged time should be avoided
11. Dental Management
Irradiation should be avoided especially in
the first trimester of pregnancy
If radiographs becomes necessary, the
dentist must be aware of how to proceed
12. Dental Management
Ideally, no drug should be administered
during pregnancy, especially the first
Counseling should be provided to make
sure that pregnant women clearly
understand the magnitude of risk associated
13. Dental Management
The dentist should be familiar with FDA
A: controlled studies in humans have failed to
demonstrate a risk to the fetus.
B: animal studies have not indicated fetal risk.
C: animal studies have shown a risk.
D: positive evidence of human fetal risk exists.
E: evidence of fetal abnormalities and fetal risk
14. Dental Management
Careful drug selection for the nursing
mother should be made.
Authorities suggest that she takes the drug
just after breast feeding and avoid nursing
for 4 hours or more if possible.
15. Oral Complications &
Exaggerated inflammatory response to local
The most common location of pyogenic
granuloma is the labial aspect of the interdental
A relationship between dental caries and
physiologic process of pregnancy has not been