The document discusses dental management considerations for pregnant women. It notes that dental treatment may be modified during pregnancy if risk is properly assessed for the patient and fetus. Key changes include increased blood volume, heart rate and the potential for supine hypotensive syndrome in later stages. Treatment timing, dental radiation exposure, medications and nitrous oxide use all require special precautions. Periodontal disease is associated with preterm birth and low birth weight so maintenance is important. With proper risk assessment and positioning, dental care can be provided safely during pregnancy.
An overview on the principle managements and considerations for treating a pregnant patient in the dental chamber. This presentation includes the possible diseases, complications, drug therapies and treatment plans proposed by various authors in treating dental diseases during pregnancy.
One of the most painful but easy-to-treat dental emergencies is a dry socket.
• Dry socket symptoms are experienced after a tooth extraction.
• This condition requires follow-up care by the doctor who performed the surgery, an oral surgeon or a dentist who is familiar with how to treat it.
For more information, contact :-
Dr Sachdeva's Dental Aesthetic And Implant Institute,
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
• Phone : +919818894041,01142464041
• Our Websites:
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
#drysocket #management #thirdmolarextraction #extractioncomplications
This lecture, which oriented to the level of mind of undergraduate students, discuss the topic of pulpectomy, its indications, contraindications, and procedural steps.
Visit us on Facebook:
https://www.facebook.com/iraqi.Dental.Academy
An overview on the principle managements and considerations for treating a pregnant patient in the dental chamber. This presentation includes the possible diseases, complications, drug therapies and treatment plans proposed by various authors in treating dental diseases during pregnancy.
One of the most painful but easy-to-treat dental emergencies is a dry socket.
• Dry socket symptoms are experienced after a tooth extraction.
• This condition requires follow-up care by the doctor who performed the surgery, an oral surgeon or a dentist who is familiar with how to treat it.
For more information, contact :-
Dr Sachdeva's Dental Aesthetic And Implant Institute,
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
• Phone : +919818894041,01142464041
• Our Websites:
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
#drysocket #management #thirdmolarextraction #extractioncomplications
This lecture, which oriented to the level of mind of undergraduate students, discuss the topic of pulpectomy, its indications, contraindications, and procedural steps.
Visit us on Facebook:
https://www.facebook.com/iraqi.Dental.Academy
self correcting anomalies in the development of occlusion. this ppt includes the anomalies of a child's developing occlusion which get corrected by itself in some time as the development continues. This includes Retrognathic mandible,infantile swallow,anterior open and deep bite,etc. these topics are important in BDS final examination
This presentation specifically deals with the maxillary and mandibular Major connectors used in a cast partial denture. it also mentions the uses, advantages and disadvantages of each,
self correcting anomalies in the development of occlusion. this ppt includes the anomalies of a child's developing occlusion which get corrected by itself in some time as the development continues. This includes Retrognathic mandible,infantile swallow,anterior open and deep bite,etc. these topics are important in BDS final examination
This presentation specifically deals with the maxillary and mandibular Major connectors used in a cast partial denture. it also mentions the uses, advantages and disadvantages of each,
Oral Healthcare for Pregnant Women | Maneesh GuptaManeesh Gupta
It's essential for you to take excellent care of your tooth and gums while pregnant.Listed below are some guidelines to support you manage good oral health before, throughout, and after pregnancy.
Many mothers to be often wonder, “What does pregnancy have to do with my oral health?”
Well, the answer is quite simple: quite a lot! In fact, dental health problems during pregnancy can be a sign of other health problems. Your oral health routine is of utmost importance during pregnancy, and should be seen as equally important as a healthy diet and regular check-ups with your dentist.
An academic presentation on Dental considerations, interventions and precautions to ensure a safe pregnancy. The presentation deals with physiology, complications and dental considerations for treating a pregnant patient.
During pregnancy, women undergo certain hormonal and physiological changes that can affect their mouths.
EFFECT OF PREGNANCY ON PERIODONTAL TISSUES
PREGNANCY GINGIVITIS
EFFECT OF PERIODONTITIS ON PREGNANCY
PRETERM LOW BIRTH WEIGHT (PLBW) INFANTS
PREECLAMPSIA
Hormonal changes in female patients and periodontal diseasesPerio Files
Hormonal fluctuations and gingival changes in female patient occurs during Puberty, Menstruation, Pregnancy, Menopause,
Oral Contraceptives, Osteoporosis.
NEED FOR ASSESSMENT: To identify high-risk stages of female patients in prior so that preventive and treatment procedures can be tailored
Oral surgery during pregnancy
Dr. Ahmed M. Adawy
Professor Emeritus, Dep. Oral & Maxillofacial Surg.
Former Dean, Faculty of Dental Medicine
Al-Azhar University
Pregnancy, also known as gestation, is the time during which a fetus develops inside a woman's uterus. Pregnancy is typically divided into three trimesters. The common belief has been that, if an oral surgery procedure is recommended, but it’s not an emergency, the second trimester is the ideal time. Pregnancy however, is not a disease and pregnant woman should not be treated differently than the general population. In short, it could be concluded that:
• Dental care is safe and essential during pregnancy
• Pregnancy is not a reason to defer routine dental care or treatment
• Diagnostic measures, including needed dental x-rays, can be undertaken safely
• Emergency care should be provided at any time during pregnancy
Abortion Including Recurrent Abortion And Septic Abortion.pptxDeepekaTS
Abortion is defined as the spontaneous or induced termination of pregnancy
before fetal viability. Many prefer miscarriage for spontaneous loss.
abortion as
loss or termination of a pregnancy with a fetus aged younger than 20 weeks’
gestation or weighing <500 g.
Of all miscarriages, approximately half are euploid abortions, that is, carrying a normal chromosomal complement.
Most common abnormalities are
trisomy, found in 50 to 60 percent;
monosomy X, in 9 to 13 percent; and
triploidy, in 11 to 12 percent
A prominent miscarriage risk is associated with poorly
controlled diabetes mellitus, obesity, thyroid disease, and systemic lupus
erythematosus. In these, inflammatory mediators may be an underlying theme
to pregnancy loss.
For women undergoing cancer treatment, direct therapeutic radiation can
cause miscarriage.
This article gives a spot on one of the most controversial neoplasms of the face, which is Ameloblastoma and discusses its histopathological classification, clinical subtypes and ways of treatment
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
2. The pregnant woman who presents for
dental care requires special
considerations to accommodate the
physiologic changes associated with
pregnancy.
During pregnancy, dental treatment may
be modified but need not be withheld
provided that the risk assessment is made
properly for both the patient and the fetus.
3. PHYSIOLOGIC CHANGES:
Complex hormonal interactions profound
physiologic changes
Increase estrogen by 10 folds & progestron by 30
folds
Cardiovascular system:
Increase in blood volume by an average of 30% -
40%.
Dilutional anemia “ physiologic anemia of
pregnancy”.
Cardiac output increases 30% - 50%.
Heart rate increases 20% - 30%.
Increased all coagulation factors except factors XI
& XIII decreased ( hypercoagulable state
4. SUPINE HYPOTENSIVE SYNDROME
During second & third trimesters, a decrease
in blood pressure & cardiac output can
occur while patient is in a supine position
due to decreased venous return to heart
due to compression of inferior vena cava
by the gravid uterus.
8. DENTAL CONSIDERATIONS
1. Timing of treatment
2. Dental radiation exposure
3. Use of local anesthesia
4. Prescription of drugs
5. Nitrous oxide gas administration
6. Prenatal fluoride
7. Amalgam restorations
9. TIMING OF TREATMENT
First trimester:
unless emergency treatment is required it is advisable to defer elective
treatment because of potential vulnerability of fetus.
The baby’s organs develop during this time and are most sensitive to radiation and
chemicals.
Second trimester: of pregnancy is the safest period for dental therapy because:
- absence of nausea & vomiting
- stable fetus
- low incidence of obstetrical complications
Periodontal maintenance and preventive care and simple restorative procedures that
will eliminate potential problems and control active disease may be performed..
Third trimester:
- scaling and prophylaxis may be repeated to minimize hormonal gingival
changes
- elective treatment should be avoided
- short visits
- position is more upright rather than supine, and slightly rolled to left side or
place small pillow under right hip.
For pregnant patient with excessive ,uncontrolled vomiting morning appointments
10. DENTAL RADIATION EXPOSURE
Fetus is most susceptible to radiation between 2nd
& 6th week of gestation.
Single dental x-ray exposes patient to 0.01
millirads ( 40 times less than daily dose acquired
from cosmic radiation).
Doses less than 5-10 rads not teratogenic.
Therefore diagnostic dental x-ray should not be
withheld during pregnancy.
Exposure can be limited by :
- lead apron shielding
- modern fast film
- avoiding retakes
11. PRESCRIPTION OF DRUGS
FDA drug classification for pregnancy
Controlled studies in women fail to demonstrate a risk to the fetus
in 1st trimester & the possibility of fetal harm appears remote
(safe for use)
A
Animal studies show no risk or if risk shown in animals controlled trials
in women showed no risk
(safe for use)
B
Studies in animals with adverse effects & no human studies or no
animal or human studies but benefits of use may out weight potential
harms
(used only if benefits out weight the risks)
C
There is evidence of human fetal risk but benefits may out weight risks
(avoided with some exceptional circumstances)D
Studies in animal or human demonstrate fetal abnormalities or there is
evidence of fetal risk or both & risk out weight any benefits
(Strictly avoided during pregnancy)
X
12. Common analgesics:
- Paracetamol (B)
- Ibuprofen (B/D)
- Aspirin (C/D) {despite being non teratogenic , it may cause maternal
& fetal hemorrhage as well as prolonged labor thus its use should be
avoided specially during 2nd & 3rd trimesters.}
Common antibiotics:
- Penicillin (B)
- Amoxicillin (B)
- Cephaloxin (B)
- Erythromycine base (B) {not estate, as it cause cholestatic
hepatitis}
- Clindamycine (B)
- Tetracycline (D) {accumulates in bones & chelates calcium , inhibits
bone growth, discolors teeth}
- Nystatin (B)
- Chlorhexidine rinse (B)
- Metronidazole (B).
Sedatives:
- Diazepam (D)
13. USE OF LOCAL ANAESTHETICS
LA are in no way contraindicated for pregnant
women , however it should be remembered that all
LA agents cross the placental barrier & inter the
circulation of the fetus , so excessive amount of
LA should not be used & LA without
vasoconstrictor are more suitable.
Lidocaine(xylocaine)
Etidocaine (B)
Prilocaine
Procaine
Bupivicaine (C)
mepivicaine
14. NITROUS OXIDE GAS
Safety is being debated.
Short term exposure do not cause birth
defects or spontaneous abortion .
Chronic exposure may result in fetal loss
& infertility.
Literature suggests that nitrous oxide
should be avoided until more conclusive
research is available.
15. USE OF FLUORIDE
Fluoride:
- inhibits demineralization & promotes
remineralization of early caries
- decreases acid production in plaque by
inhibiting glycolysis in cariogenic bacteria
- inhibits synthesis of extracellular
polysaccharides
- safely tolerated dose (STD) 1 mg/kg
Topical fluoride :
has no increased risk during pregnancy.
Pre-natal fluoride :
the placenta only allows small amount of fluoride to
cross, thus pre-natal fluoride is relatively
16. AMALGAM RESTORATIONS
Amount of mercury vapor released from
amalgam fillings about 1-3 µg/day is below
the toxic level, it is well established that
this amount is not enough to produce any
teratogenic effect.
17.
18. PREGNANCY RELATED ORAL HEALTH PROBLEMS
1. Pregnancy gingivitis
2. Pregnancy epulis
3. Erosion
4. Dental caries
5. Tooth mobility
19. PREGNANCY GINGIVITIS
Gingival inflammation initiated by
plaque & exacerbated by elevated
circulatory estrogen which
increases capillary permeability &
affect epithelium of gingiva.
Estradiol & progestone are
essential growth factors for
provetella intermedia
Occurs commonly in 2nd – 8th
months in 50% - 100% of women
Treated by scaling , root planning
20. Gingivitis associated with pregnancy.
(a) A patient in the last trimester of pregnancy with very inflamed edematous
gingival tissue which tended to bleed with the slightest provocation.
(b) The improvement in gingival health 6 months after birth of the baby and an
intensive course of non-surgical periodontal treatment.
21. PRERAGNANCY EPULIS (GRANULOMA)
Pedunculated fibro-granulomatous lesion develop
during pregnancy due to vascular response to
increased progestron usually at sites with pre-
existing gingivitis.
Bright red , hyperemic & edematous lesion often
occur in anterior papillae of maxillary teeth not
exceed 2cm. In diameter , in up to 5% of women.
Careful oral hygiene & debridement during
pregnancy are important in preventing its
occurrence.
Treated by : - scaling & root planning
- excision if it is too large or bleeds
24. DENTAL EROSION
Erosion= loss of tooth
substance due to exposure to
chemical material.
Vomiting & esophageal reflux
result in acid exposure which
cause weakening of tooth
enamel & dental erosion
25. DENTAL CARIES
Saliva changes:
- decreased minerals
-decreasing flow in 1st & 3rd trimester
- more acidic
Morning sickness
uncontrolled oral hygiene
All are predisposing factors for dental caries
26.
27. MATERNAL PERIODONTAL HEALTH & PREGNANCY
Preterm labor:
- maternal periodontal disease is associated with
increased risk of preterm labor
- anaerobic oral gram-ve bacteria cause inflammatory
response which stimulates prostaglandin & cytokine
production to stimulate labor
Low birth weight:
evidence is not conclusive
Pre eclampsia:
inflammed periodontal tissues produce significant
amount of cytokines mainly interlukin 1 beta(IL1β) ,
IL6, prostaglandin E2 & tumor necrosis factor
alpha(TNFα) , were higher in women with pre
eclampsia compared with healthy matched pregnant
women
(Oettinger-Borak,2003)
28. STUDIES
o In the early 1990s, Offenbacher and his group hypothesized that oral
infections, such as periodontitis, could represent a significant source of
both infection and inflammation during pregnancy. Offenbacher noted that
periodontal disease is a Gram-negative anaerobic infection with the
potential to cause Gramnegative bacteremias in persons with periodontal
disease. He hypothesized that periodontal infections, which serve as
reservoirs for Gram-negative anaerobic organisms, lipopolysaccharide
(LPS, endotoxin) and inflammatory mediators including PGE2 and TNF-a,
may be a potential threat to the fetal-placental unit (Collins et al. 1994a,b).
o Jeffcoat and Hauth have recently confirmed this association in a larger
case-control study. Gathering data on 1313 mothers, Jeffcoat and Hauth
reported
that maternal periodontitis was an independent risk factor for preterm
birth. With increasing severity of periodontal disease as an exposure,
there was an increased risk for preterm birth with odds ratios ranging from
4.45 to 7.07 for moderate to severe periodontitis, adjusting for age, race,
29. CONCLUSION
Establishing a healthy oral environment is the most important objective in
planning the dental care of pregnant patient.
This objective is achieved by adequate plaque control, comprising tooth
brushing, flossing and professional prophylaxis.
A consultation with a physician is necessary specially in cases of disturbed
pregnancy or history of frequent abortion.
The American Dental Association (ADA) recommends
-that pregnant women eat a balanced diet, brush their teeth thoroughly with an
ADA-approved fluoride toothpaste twice a day, and floss daily
-Have preventive exams and cleanings during your pregnancy
-Let your dentist know you are pregnant
-Postpone non-emergency dental work until the second trimester or until after
delivery, if possible
-Elective procedures should be postponed until after the delivery
-Maintain healthy circulation by keeping your legs uncrossed while you sit in the
dentist's chair
-Take a pillow to help keep you and the baby more comfortable
-Bring headphones and some favorite music