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DENTAL PROLEM DURING PREGNANCY & ITS MANAGEMENT

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Presentation on theme: "DENTAL PROLEM DURING PREGNANCY & ITS MANAGEMENT"— Presentation transcript:

1 DENTAL PROLEM DURING PREGNANCY & ITS MANAGEMENT
Prof. Dr. S. Ignatius Rex MDS Prof. & HOD. Rajas Dental College Senior Consultant Endodontist Dr. Anto ENT Hospital. Nagercoil

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3 Common Dental Problems
Periodontal infections Dental caries Pulpal infections Periapical infections Cosmetic dental problems

4 DURING PREGNANCY Infections - Having influence on pregnancy
Periodontal diseases Gingivitis Pregnancy Gingivitis Periodontitis

5 PERIODONTAL INFECTIONS
Oral infections Caused by anaerobic bacteria in the plaque bio-film that forms on dental surfaces Gingivitis -Inflammation and infection of the gums Periodontitis-inflammation and infection of gums and bone

6 PREGNANCY GINGIVITIS Inflammation of gums
Redness, swelling, heat and pain Caused by plaque, bacteria on tooth surfaces adjacent the gum tissue Commonly observed in second trimester due to rise in estrogen levels in blood Preventable with 2x daily brushing with F tooth paste and flossing

7 PERIODONTITIS All pregnant women are at risk
Risk is no greater than for women who are not pregnant Gram-negative anaerobic bacteria Infection and inflammation of soft tissues>> gingivitis Progression to hard tissue : Periodontitis Bone loss >> tooth mobility >> potential premature tooth loss

8 Healthy Gums & Periodontal Tissues

9 Severe Periodontal(Gum) Disease & Severe Gum Disease with Recession

10 PTLBW PTLBW - <2500 gm LBW - Short gestational period
- Gestational age < 37 weeks Factors : High > (34 years) Low (17 years) maternal age Low socioeconomic status Inadequate pre natal care Drug use, Alcohol use, tobacco use., Hypertension Diabetes mellitus And now – Periodontal Infection

11 WHAT IS THE LINK Periodontitis - Gram negative infection
Throughout pregnancy, levels of prostaglandins and cytokines steadily increase until a critical threshold level is reached inducing labor, cervical dilation and delivery Periodontitis - Gram negative infection The bacteria associated with periodontatal disease are capable of stimulating excessive production of cytokines and prostaglandins – initiating preterm labor and delivery ( offenbacher, et al )

12 HOW TO SCREEN Do your gums bleed, especially when you brush or floss your teeth ? Do you have bad breath ? or been told you have bad breath ? Do you have a bad taste in your mouth that won't go away ? Do you have pain and discomfort while chewing ?

13 TREATMENT PLAN Scaling and root planning
Treatment in early stage of pregnancy --- Yield Promising results Use of CHX based mouth washes

14 DENTAL CARIES IN PREGNANT WOMEN
All pregnant women are at risk Risk is no greater than for women who are not pregnant Desire for sugar sweetened food and beverage Risk factor : Frequent ingestion for fermentable carbohydrate Presence of SM Compromised salivary flow

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16 DENTAL CARIES

17 PULPITIS Acute Chronic Inflammation of the pulp due to infection
Treatment plan Pulpectmy Root canal treatment Antibiotics ? NSAIDS ?

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20 Acute Alveolar Abscess
Periapical Abscess Acute Alveolar Abscess Localized collection of pus in the alveolar bone at the root apex following death of the pulp Severe throbbing pain with attendant swelling of the overlying soft tissue May progress to sinus tract, cellulitis, osteomyelitis…

21 Management of the lesion
Conventionally – surgical endodontics Current concept – non-surgical endodontic management Recent – Apexum procedure

22 Non-surgical management of Periradicular lesion

23 Apexum procedure

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28 Radiography – Conventional

29 Radiography – Advanced
Digital image enhancement RVG

30 Electronic method of determining working length
Apex locator Electronic method of determining working length Working length is the length of the root canal space from coronal reference point to the point at which canal preparation & obturation should terminate  based on electrical resistance NO RADIATION HAZARD

31 ENAMEL EROSION Vomiting Palatal surfaces of maxillary teeth
Thermal sensitivity Dentin exposure Recommended Therapy Avoid tooth brushing Use of neutral NaF mouth rinse

32 Drugs that can be Prescribed and Those that are Contraindicated During Pregnancy Source:www.agd.org/consumer/topics/pregnancy/main.html Drugs that can be prescribed during pregnancy Drugs that are Contraindicated during pregnancy Antibiotics: Penicillin, Cephalosporin, Amoxicillin, Clindamycin, Erythromycin (except estole form) Tetracycline, Doxycyclines, Erythromycin estolate form Analgesics: Acetaminophen, Acetaminophen with codeine (in small doses) Aspirin, Difunisl, Etodolac

33 Thank You


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