HJAR Mar/Apr 2021

56 MAR / APR 2021 I  HEALTHCARE JOURNAL OF ARKANSAS ORAL HEALTH REFERENCES 1 Hartnett E, Haber J, Krainovich-Miller B, Bella A, Vasilyeva A, Lange Kessler J. Oral Health in Preg- nancy. J Obstet Gynecol Neonatal Nurs. 2016 Jul- Aug;45(4):565-73. doi: 10.1016/j.jogn.2016.04.005. Epub 2016Jun 6.PMID: 27281467 .https://www.jognn. org/article/S0884-2175(16)30159-9/fulltext 2 Deghatipour,M.,Ghorbani,Z.,Ghanbari ,S.et al.Oral health status in relation to socioeconomic and behav- ioral factors among pregnant women: a community- based cross-sectional study. BMCOral Health 19, 117 (2019). https://doi.org/10.1186/s12903-019-0801-x 3 MarlaV, Srii R, Roy DK, et al.The Importance of Oral Health during Pregnancy: A review. MedicalExpress. 2018;5:1–6.. 4 Cleveland Clinic.Hormones and Oral Health.What is the link between hormones and women’s oral health? 1-19-2021. https://my.clevelandclinic.org/health/ articles/11192-hormones-and-oral-health 5 Naseem M et al. Oral health challenges in preg- nant women: Recommendations for dental care professionals,The Saudi Journal forDen- tal Research(2015), http://dx.doi.org/10.1016/ j.sjdr.2015.11.002 6 Daalderop LA,Wieland BV,Tomsin K,Reyes L,Kram- er BW, Vanterpool SF, Been JV. Periodontal Disease and Pregnancy Outcomes: Overview of System- atic Reviews. JDR Clin Trans Res. 2018 Jan;3(1):10- 27. doi: 10.1177/2380084417731097. Epub 2017 Sep 25. PMID: 30370334; PMCID: PMC6191679. https://pubmed.ncbi.nlm.nih.gov/30370334/ 7 Erin A. Kierce et al. (2017), Adverse Pregnancy Outcomes and Maternal Periodontal Health. Int J Dent & Oral Heal. 3:7, 69-73. DOI: 10.25141/2471- 657X-2017-7.0060. https://www.biocoreopen.org/ ijdoh/Adverse-Pregnancy-Outcomes-and-Maternal- Periodontal-Health.pdf 8 Llambés F, Arias-Herrera S, Caffesse R. Relation- ship between diabetes and periodontal infection. World J Diabetes. 2015;6(7):927-935. doi:10.4239/ wjd.v6.i7.927 9 Cobb CM, Kelly PJ, Williams KB, Babbar S, Angol- kar M, Derman RJ.The oral microbiome and adverse pregnancy outcomes. Int J Womens Health. 2017 Aug 8;9:551-559. doi: 10.2147/IJWH.S142730. PMID: 28848365; PMCID: PMC5557618. https://pubmed. ncbi.nlm.nih.gov/28848365/ 10 FigueiredoMGOP,Takita SY,Dourado BMR,Mendes HdS, Terakado EO, Nunes HRdC, et al. (2019) Peri- odontal disease: Repercussions in pregnant wom- an and newborn health—A cohort study. PLoS ONE 14(11): e0225036. https://doi.org/10.1371/journal. pone.0225036 11 Rainchuse, L. Improving Oral Health Outcomes from Pregnancy through Infancy. Amer Dent Ass. Dec. 2013, 87 (6) 330-335. https://jdh.adha.org/ content/87/6/330 12 Wagle M, D'Antonio F,Reierth E, et al. Dental car- ies and preterm birth:a systematic review andmeta- analysis. BMJ Open2018;8:e018556. doi:10.1136/ bmjopen-2017-018556 https://bmjopen.bmj.com/ content/bmjopen/8/3/e018556.full.pdf 13 Committee Opinion No. 569: oral health care dur- ing pregnancy and through the lifespan. Obstet Gy- necol. 2013 Aug;122(2 Pt 1):417-422. doi:1097/01. AOG.0000433007.16843.10 .PMID:23969828.https: // pubmed.ncbi.nlm.nih.gov/23969828/ 14 Muralidharan C, Merrill RM. Dental care during pregnancy based on the pregnancy risk assess- ment monitoring system in Utah. BMC Oral Health. 2019 Nov 6;19(1):237. doi: 10.1186/s12903-019- 0921-3. PMID: 31694634; PMCID: PMC6836497. https://pubmed.ncbi.nlm.nih.gov/31694634/ spontaneous abortions. 5 Positioning of the expectant patient is im- portant, as the supine position can be un- comfortable. Since it compresses the vena cava and aorta, this position can lead to pos- tural hypotension. Lying slightly on either side with a hip elevated in a tilted position for shorter length appointments is optimal for comfort. These alterations are most useful in the third trimester. 5 Healthcare professionals should advise expectant mothers to practice exceptional oral health habits during these months of pregnancy. Advising routine exams and cleanings, limiting sugary foods, and using fluoridated toothpaste is key. 12 For women who experience morning sickness with recur- rent vomiting, the use of antacids or rinsing with baking soda is good for neutralizing the acidity in the oral cavity. For many women, obstetricians and gy- necologists are the most visited health care professionals. 13 This gives these specialists the unique opportunity to advise their pa- tients of the importance of good oral health and recommend that their patients regularly visit their dentists. Interprofessional collabo- ration between physicians and dentists is es- pecially important in treating the expectant mother. It is paramount to emphasize that not only are expectant women unaware of the association between oral health and their unborn child during pregnancy, but many healthcare professionals do not realize the health implications of active and chronic periodontal disease association during preg- nancy. 14 Increased training, education and collaboration is essential in medical-dental integration. Knowing that it is not possible to have good overall health without good oral health is key information for future mothers and healthcare professionals to ensure the health of the unborn child. n promote tissue destruction affecting the pla- centa. These cytokines have the potential to stimulate uterine contractions, dilate the cer- vix, and trigger preterm birth. In essence, ac- tive periodontal disease increases the chance of maternal and fetal negative outcomes. 10 The misconception that dental treatment is unsafe during pregnancy is outdated and false. Despite government and professional guidelines, which are structured on science- based evidence that good oral health is of utmost importance during pregnancy, both medical and dental healthcare professionals undertreat women during pregnancy. 11 Im- proving awareness about this fact is a step in the right direction. In fact, delaying necessary dental treatment can lead to complications that become a bigger risk for mother and her unborn child. Regular visits and dental treatment en- sure optimal oral health during pregnancy. The second trimester is the ideal time for any needed dental treatment or elective treat- ment to take place. If an infection is present, the second trimester is best, but treatment should not be delayed even in the first or third trimester. 5 The risk from diagnostic x- rays is very low, but every protection should be taken with thyroid collars and lead aprons used. 11 If dental infection exists, antibiotics such as amoxicillin, penicillin, erythromycin and clindamycin are all safe, given there is no history of allergy. Gentamycin should be avoided, as it is reported to cause fetal oto- toxicity. Tetracycline should also be avoided, as it causes staining of the permanent teeth for the unborn child. Local anesthetic, such as lidocaine and prilocaine, is completely safe when given properly and in correct dosage. Nitrous oxide is not recommended for inha- lation for relaxation. It is controversial for use during pregnancy and has had reports of an association with preterm births and