As dental professionals, we play a unique and critical role in our pregnant patients’ team of healthcare providers. To rectify this situation, it is imperative we understand how to help the patients that are still listening to the old wife tails.
Set up an in-house education, go to a Lamaze class, and notify your OBGYN providers in the area. According to the American Public Health Association (APHA), just 46% of pregnant women in the US receive oral prophylaxis during their pregnancy.
Everyone who works in our industry has heard many myths during our time, and they come from the past which truly did not understand the oral cavity is the only accessible area on your body that can be investigated without cutting or putting a tub in. Just looking at the oral cavity can show us red puffy gums, bleeding, or areas of concern. Unlike any other part of our body, our oral cavity can be looked at daily by the patient to track changes. Teach them the word all patients have heard for the last three years, TRANSMISSION. EXCEPT THEY ARE THE ONES TRANSMITTING TO THE UNBORN. They are told not to smoke, or drink, and now we need to add our skills to the mix.
Number one Pregnancy Myth: Don’t go to the dentist when you’re pregnant due to radiation. (That is what I was told when I first became pregnant.)
I find that most of us know some of the myths, but we are stuck in the box we learned to be in and have not truly embraced the future. Sometimes it can harm us just by not attending education programs to embrace the new. Learning should be a part of your everyday life not just for your patients but the community, and your family. Imagine how you feel after you can achieve helping everyone and what you can do to help them.
All of the listed treatment is approved by the medical field, and you should keep a list of the treatments with the information to use when a pregnant woman comes in. That becomes your connection time.
- Oral prophylaxis: Routine oral prophylaxis is safe at any time during pregnancy. It is often most comfortable for the pregnant patient during the second trimester. There is a higher likelihood a pregnant patient will experience nausea during the first trimester making treatment difficult.
- Restorative, endodontic, and periodontal treatment and extractions: Treatment is considered safe at any time during pregnancy.
- Radiograph: Radiographs with abdominal and thyroid shields are safe at any time during pregnancy.
- Local anesthetic: The following local anesthetics with epinephrine may be used at any time during pregnancy: bupivacaine, lidocaine, and mepivacaine.
- Nitrous oxide: As a category C drug, nitrous oxide is considered unsafe for use during pregnancy as there is a risk of fetal harm.2
In addition to reassuring our pregnant patients of the safety of dental care, we can provide education on how oral health contributes to their systemic health and the health of their children. Important topics to discuss with patients include:
- Periodontal disease: Periodontal disease during pregnancy has been linked to an increased risk of preterm birth and low-birth weight.7 These conditions can lead to developmental dental defects such as hypoplastic enamel of the primary and permanent teeth in addition to the myriad of other health concerns associated with preterm birth and low-birth weight. The risk of preeclampsia and gestational diabetes mellitus also increases for pregnant women with periodontal disease.
- Caries: The vertical transmission of mutants streptococci can occur prior to the eruption of the child’s primary teeth. Fortunately, studies have demonstrated that pregnant individuals may reduce or even stave off the transfer of mutants streptococci to their infants by decreasing the level of the bacteria in their own oral microbiome.
As a member of a pregnant person’s healthcare team, we must collaborate with the other members of the team. By establishing productive, working relationships with the OB/GYNs and midwives of our existing pregnant patients, we can provide safe, comprehensive oral healthcare and patient education consistent with the rest of the healthcare team. Consider reaching out to doctors and midwives in your area to establish a referral program early in a person’s pregnancy.
Remind the future mom, that anyone that will be part of the future baby time will need to have treatment no kissing, or hugging will be allowed. Transmission is the keyword
- Case Western Reserve University research ties stillbirth to oral bacteria. Microbiologist Dr. Yiping Han was the first to discover the connection. You can download the story, it’s amazing. ://www.sciencedaily.com/releases/2010/01/100121171411.htm
American Academy of Pediatric Dentistry. Perinatal and infant oral health care. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2016:216-20.
- Join our membership web program to learn how to use PowerPoint to gain referrals from OBGYN Providers.