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    a 38-year-old woman with severe periodontitis is in her 10th week of pregnancy. when the dental assistant tries to discuss oral hygiene and future appointments for scaling, the patient becomes angry and says that she can live with bleeding gums and brown teeth from her former smoking habit. she also says that she is not interested in learning about hygiene because her teeth will eventually fall out anyway. how could the dental assistant convince this patient of the importance of oral hygiene?

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    get a 38-year-old woman with severe periodontitis is in her 10th week of pregnancy. when the dental assistant tries to discuss oral hygiene and future appointments for scaling, the patient becomes angry and says that she can live with bleeding gums and brown teeth from her former smoking habit. she also says that she is not interested in learning about hygiene because her teeth will eventually fall out anyway. how could the dental assistant convince this patient of the importance of oral hygiene? from EN Bilgi.

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    A 38-year-old woman with severe periodontitis is in her 10th week...

    A 38-year-old woman with severe periodontitis is in her 10th week of pregnancy. When the dental assistant tries to discuss oral hygiene and future appointments for scaling, the patient becomes angry and says that she can live with bleeding gums and brown teeth from her former smoking habit. She also says that she is not interested in learning about hygiene because her teeth will eventually fall out anyway. How could the dental assistant convince this patient of the importance of oral hygiene?

    Science Health Science DENTAL ASSISTANT MODULE 160

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    How gum disease in pregnant women poses a risk to their newborns

    Up to 70% of women develop gingivitis during their pregnancy but not many seek dental treatment for bleeding gums. This could be detrimental for their babies.

    How gum disease in pregnant women poses a risk to their newborns

    Published: February 13, 2017 2.44pm GMT

    Charlene Africa, University of the Western Cape

    Mothers-to-be must go for dental check-ups early on in their pregnancies to ensure that they don’t develop pregnancy gingivitis. Shutterstock

    Women who develop severe mouth infections and suffer from bleeding gums when they are pregnant have a greater chance of delivering their babies preterm if they don’t treat the infection.

    Up to 70% of women develop inflammation of the gums, or gingivitis, during their pregnancy. It’s commonly referred to as pregnancy gingivitis. This is due to the changes in a mother’s hormone levels during pregnancy. This promotes an inflammatory response which increases the risk of developing periodontal disease.

    Periodontal diseases are infections of the structures around the teeth including the gums, ligaments and bone. They may cause bleeding of the gums and in severe cases, loss of teeth.

    The challenge is that not many mothers seek dental treatment for bleeding gums during pregnancy. And antenatal clinics pay little, if any, attention to the mother’s oral health status. As a result, this complication often goes undetected.

    Our research shows that incorporating a rapid point-of-care test into routine antenatal examinations could help diagnose periodontal disease. The test is simple and inexpensive and is widely used as a diagnostic test for periodontal disease.

    If the test is set up before the patient is examined, it can deliver a result by the time her examination is complete. This would alert antenatal health care providers of the risk of adverse pregnancy outcomes. Mothers can then be referred to a dental clinic for prompt treatment to reduce their risk.

    Premature babies

    Across the world, about 6.9 million babies die due to prematurity. Many as a result of their birth weight being low. In the US about 7% of babies are born with a low birth weight while in the UK, this figure sits at 6%.

    But in Africa up to 12% of babies are born with a low birth weight. In South Africa neonatal deaths account for about 40% of all deaths in children under the age of 5. In Angola and the Central African Republic, close to 100 babies in every 1000 die within the first four weeks of birth. These are the highest known rates of infant death in the world. This compares to the UK and the US where only seven in every 1000 infants die within the first four weeks of life.

    Studies have linked babies born prematurely with a low birth weight to their mothers’ smoking habits, and her ethnicity. Other factors have also played a role such as the mother’s age, whether she previously delivered a baby that had a low birth weight, whether she had pregnancy complications and the type of delivery she had.

    Some research found a link between periodontal disease and adverse pregnancy outcomes but other studies couldn’t establish a conclusive link. None of these studies were in the developing world.

    But our research in South Africa and Rwanda has found a link between mothers with periodontal disease that deliver underweight preterm babies. Our study was the first in Africa to link periodontal disease to pre-term delivery.

    What we found

    As part of our research we did two studies. One focused on pregnant women during their antenatal visits to maternal obstetric units in Kwazulu-Natal. The other looked at mothers admitted to labour wards in Rwanda’s Butare Hospital.

    One study showed there was a strong likelihood that there would be an adverse pregnancy outcome when a mother was clinically diagnosed with periodontal disease. Those who didn’t have periodontal disease were more likely to have normal pregnancy outcomes.

    The other study focused on the specifics of the bacteria associated with periodontal disease.

    In the immune system there are two sets of proteins called cytokines, which regulate the body’s response to an inflammation. There are pro-inflammatory cytokines and anti-inflammatory cytokines. In normal full term pregnancies, proteins that encourage inflammation in the body are regulated by those that dismiss the inflammation. This prevents the body developing an inflammation and rejecting the fetus.

    But our studies confirmed that when a woman had periodontal disease there was an imbalance in these proteins which could create an inflammation in the woman’s body and induce preterm labour.

    Changing testing patterns

    The earlier periodontal disease is diagnosed in pregnant women, the less of a chance it has of having an impact on their delivery.

    Surveys into practice behaviours of obstetricians in other countries show there’s growing awareness of the link between periodontal disease and adverse pregnancy outcomes.

    But not enough is being done to forge the collaboration between the antenatal health care providers and oral health care professionals.

    Obstetricians argue that they have no time to perform oral examinations during antenatal consultations. And, they argue, these would be better performed by oral health care workers.

    Public health Rwanda South Africa Child mortality

    Source : theconversation.com

    Pregnancy and teeth

    betterhealth.vic.gov.au

    Healthy pregnancy

    Pregnancy and teeth

    Actions for this page

    Pregnancy and teeth Actions for this page Summary

    Pregnancy can lead to dental problems in some women.

    Caring for teeth during pregnancy is important for the mother and baby’s health.

    Visit the dentist during pregnancy for a check-up.

    It’s safe to visit the dentist during pregnancy.

    On this page

    About pregnancy and teeth

    Some dental problems can affect a developing baby

    Looking after your teeth before pregnancy

    Always tell your dentist if you are pregnant

    Causes of dental health problems

    Food cravings while pregnant

    Increase your calcium during pregnancy

    Increase your vitamin D during pregnancy

    Where to get help

    About pregnancy and teeth

    Pregnancy can lead to dental problems in some women, including gum disease and tooth decay. During pregnancy, hormones affect gums and teeth.

    Brushing teeth twice a day with fluoride toothpaste and visiting your dentist will help keep your teeth and gums as healthy as possible during pregnancy.

    Some dental problems can affect a developing baby

    Research has found a link between severe gum disease in pregnant women and premature birth with low birth weight. Babies who are born prematurely can have a risk of brain injury, and problems with their eyesight and hearing.

    It’s been suggested that up to 18 out of every 100 premature births could be linked to severe gum infection (periodontal disease). Gum disease can be treated by a dentist during pregnancy.

    Looking after your teeth before pregnancy

    You’re less likely to have dental problems during pregnancy if you look after your teeth and gums before you are pregnant. You can do this by:

    Brushing your teeth at least twice a day with fluoride toothpaste.

    Flossing between your teeth once a day.

    Eating a healthy diet and limiting food and drinks high in added sugar.

    Avoiding tobacco products and minimising alcohol (it’s advised not to drink alcohol during pregnancy, and tobacco products should be avoided at all times).

    Visiting your dentist every 6 to 12 months.

    If you’re planning on getting pregnant, see your dentist to discuss any treatments that can be done before your pregnancy. If you need dental treatment during pregnancy, non-urgent procedures can often be performed after the first trimester.

    Always tell your dentist if you are pregnant

    Dentists will take extra precautions when they know you’re pregnant to ensure your care is safe for you and your baby.

    Causes of dental health problems

    Common causes of dental health problems during pregnancy can include:

    gum problems vomiting

    cravings for sugary foods

    gagging while brushing teeth.

    Gum problems

    Pregnancy hormones can make some women be at risk of gum problems including:

    gingivitis (infection of the gum) – this is likely to occur during the second trimester. Symptoms include swelling of the gums and bleeding, mostly during brushing and when flossing between teeth

    periodontal disease –  infection of the structures supporting the tooth (gums, ligament and bone). It’s caused by untreated gingivitis, which and can lead to tooth loss

    pregnancy epulis or pyogenic granuloma – a red, round growth that appears on the gum, which can bleed easily.

    If you have gum problems during pregnancy, it’s important to get them checked by a dentist before you give birth. While most types of gum problems caused by pregnancy hormones resolve after birth, a small number of women may develop a deeper level of gum disease that will need treatment after pregnancy.

    If your gums bleed, don’t stop brushing your teeth. Use a soft-headed toothbrush and fluoride toothpaste, and brush at least twice a day.

    Vomiting can damage teeth

    Pregnancy hormones soften the ring of muscle that keeps food inside the stomach. Gastric reflux (regurgitating food or drink) or the vomiting associated with morning sickness can cover your teeth with strong stomach acids. Repeated reflux and vomiting can damage the surface of the tooth (the enamel) and increase the risk of decay.

    Try these suggestions if you’re experiencing vomiting:

    Avoid brushing your teeth immediately after vomiting. While the teeth are covered in stomach acids, the actions of brushing may scratch the tooth enamel.

    Rinse your mouth thoroughly with plain tap water.

    Follow up with a mouthwash containing fluoride.

    If you don't have a fluoridated mouthwash, put a blob of toothpaste containing fluoride on your finger and smear it over your teeth. Rinse thoroughly with water.

    Wait for an hour after vomiting before you brush.

    Retching or gagging while brushing teeth

    Some pregnant women find that brushing their teeth, particularly the back teeth, can cause gagging. However, it’s important to brush all of your teeth to avoid tooth decay.

    Some tips to help prevent gagging include:

    Use a toothbrush with a small soft head, such as a brush made for toddlers.

    Take your time. Go slowly when you brush.

    It may help to close your eyes and concentrate on your breathing.

    Try listening to music.

    If the taste of the toothpaste causes you to gag, switch to another brand. Or brush your teeth with water and then use a mouthwash containing fluoride. Go back to brushing with toothpaste containing fluoride as soon as you can.

    Source : www.betterhealth.vic.gov.au

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