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DENTAL PROLEM DURING PREGNANCY & ITS MANAGEMENT

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. Common Dental Problems . Periodontal infections Dental caries Pulpal infections

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DENTAL PROLEM DURING PREGNANCY & ITS MANAGEMENT

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  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

  2. Common Dental Problems • Periodontal infections • Dental caries • Pulpal infections • Periapical infections • Cosmetic dental problems

  3. DURING PREGNANCY Infections - Having influence on pregnancy Periodontal diseases • Gingivitis • Pregnancy Gingivitis • Periodontitis

  4. 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

  5. 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

  6. 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

  7. Healthy Gums & Periodontal Tissues

  8. Severe Periodontal(Gum) Disease & Severe Gum Disease with Recession

  9. 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

  10. WHAT IS THE LINK 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 )

  11. 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 ?

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

  13. 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

  14. DENTAL CARIES

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

  16. 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…

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

  18. Non-surgical management of Periradicular lesion

  19. Apexum procedure

  20. Radiography – Conventional

  21. Radiography – Advanced Digital image enhancement RVG

  22. 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

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

  24. Drugs that can be Prescribed and Those that are Contraindicated During PregnancySource:www.agd.org/consumer/topics/pregnancy/main.html

  25. Thank You

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