The sacrifices begin at the instant when those two pink lines show up, and many times ever sooner. As a saying goes ‘pregnancy is a beautiful time in a woman’s life, but it can also be one of the most stressful and tough one, despite how much she may love it.’ Pregnancy causes many changes in the physiology of the female patient. These alterations are sometimes subtle but can lead to disastrous complications if proper precautions are not taken during dental treatment. Hence, as a dental student, the first question that invades our minds would be how pregnancy conditions could affect the management of a dental patient?
First and foremost, the most visible changes in the oral cavity of a pregnant woman will be the changes in gum. For instances, the level of progesterone, a female hormone, projects drastically to 10 times higher than the normal level. This may enhance growth of certain bacteria that cause gingivitis. Because progesterone is a sex steroid hormone which plays a key role in the modulation of bacterial-host interactions. Besides, the immune system may work differently during pregnancy. This could change the way that the body reacts to the bacteria that cause gingivitis, causing their gums to be redder and bleed, particularly during brushing or flossing between teeth. All these changes are referred to as ‘pregnancy gingivitis’. Being a dentist, one should identify the cause, in this case, gum problems encountered by pregnant women are not due to the development of plaque, in fact, it is due to the increase in hormonal level during gestation. To minimize the effect of pregnancy gingivitis, a dentist should know that the clean their oral cavity and use antimicrobial mouth rinse to reduce inflammation of the gums effectively.
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Subsequently, the other problem related to the gums during gestation is pregnancy granuloma. The changes occur at the later stage of pregnancy which is at the second trisemester. They are red nodules, typically found near the upper gum line, but can also be found elsewhere in the mouth. These growths bleed easily and can form an ulcer or crust over. Women with these growths usually have widespread pregnancy gingivitis. Although pregnancy granuloma often interferes when speaking and eating, it will disappear after labor. If a pregnant woman removes it about half the time, it will grow back afterwards. A dentist should privode professional teeth cleaning. However, if periodontal surgery needs to be done, it will be advised to postpone until after giving birth.
In some severe cases, the oral problems that develop in gums may certainly leads to tooth problems. When a pregnant woman leaves their periodontal disease untreated and undiagnosed, pregnancy may gradually worsen and as a result causing chronic gum infection. Gum is a layer of tissue that seal tightly around the tooth to support the bones and at the same time provide protection to the tooth. Gum gives protection by forming a barrier to prevent the invasion of bacteria into the root of the tooth. However, when the gum is infected seriously due to untreated pregnancy gingivitis, it can lead to tooth loss.
It is a known fact that not all pregnant women will experience morning sickness. For some women, morning sickness is a major symptom of pregnancy. Along with the nausea comes, the vomit will content large amount of hydrochloric acid which came from the stomach. The acidity of hydrochloric acid is very low ( pH1-2). If the acid is left in the mouth, it will probably cause enamel erosion especially at the back of the front tooth. A dentist should advise a pregnant woman to rinse her mouth after vomiting. Rinse with a mixture of water and baking soda, which is an alkaline solution, in order to reduce the acidity of her mouth. It is indispensably significant to not brush right away after vomiting, since the acid in your mouth will only help erode the teeth as you brush.
When a dental patient is pregnant, a dentist ought to advise her to not crave for sugary foods. Because most women may have unusual food cravings during gestation. A regular desire for sugary foods may increase the risk of tooth decay. If nothing but sweetness will satisfy your craving, try to sometimes choose healthier options such as fresh fruits.
These collective changes may pose various challenges in providing dental care for the pregnant patient. Treatment of the pregnant patient has the potential to affect the lives of two individuals (the mother and the unborn fetus). Certain principles must be considered in the treatment of the pregnant patients so that, it benefits to the mother while minimizing the risk to the fetus.
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