Source material for this document includes Oral Health Care During Pregnancy and Early Childhood: Practice Guidelines. New York, NY: New York State Department of Health, 2006. Guidelines for Oral Health Care in Pregnancy•*Dental*care*is*safe*and*essential*during*pregnancy•*Pregnancy*is*not*a*reason*to*defer*routine*dental*care* or*treatment•*Diagnostic*measures,*including*needed*dental*x-rays,* can*be*undertaken*safely•*Scaling*and*root*planing*to*control*periodontal*disease* can*be*undertaken*safely;*avoid*using …

Medical Conditions and Dental Treatment Considerations Hypertensive Disorders and Pregnancy Hypertensive*disorders,*including*chronic*or*preexisting* hypertension *and*the*development*of*hypertension*during* pregnancy, *occur*in*12-22%*of*pregnant*women. *Oral*health* professionals*should*be*aware*of*hypertensive*disorders*because* of*increased*risk*of*bleeding*during*procedures.*Consult*with*the* woman’s*prenatal*care*provider*before*initiating*dental*procedures* in *women*with*uncontrolled*severe*hypertension* (blood*pressure* values*greater*than*or*equal*to*160/110mm*Hg). * Diabetes and Pregnancy Gestational *diabetes*occurs*in*2-5%*of*pregnant*women*in*the* U.S.*It*is*usually*diagnosed*after*24*weeks*of*gestation.*Any* inflammation*process,*including*acute*and*chronic*periodontal* infection,*can*make*diabetes*control*more*difficult.*Poorly* controlled*diabetes*is*associated*with*adverse*pregnancy*outcomes* such*as*preeclampsia, *congenital*anomalies,*and*large-for* gestational*age*newborns.*Meticulous*control*to*avoid*or*minimize* dental*infection*is*important*for*pregnant*women*with*diabetes. * Controlling*all*sources*of*acute*or*chronic*inflammation*helps* control*diabetes. * Heparin and Pregnancy A*small*number*of*pregnant*women*with*the*diagnosis*of* thrombophilia* (a*blood*disorder)*may*be*receiving*daily*injections*of* heparin*to*improve*pregnancy*outcome.*Heparin*increases*the*risk*for* bleeding*complications*during*dental*procedures.*Dental*providers* should *consult*with*the*woman’s*prenatal*medical*provider*prior*to* dental*treatment. Risk of Aspiration and Positioning During Pregnancy Pregnant*women*have*delayed*gastric*emptying*and*are*considered* to*always*have*a*”full*stomach.”*Thus,*they*are*at*increased*risk*for* aspiration.*Maintaining*a*semi-seated*position*or*positioning*with*a* pillow*helps*avoid*nausea*or*aspiration*and*can*make*the*woman*feel* more*comfortable .. uidelines for Treatment in Pregnancy IndIcatIons RadIogRaphs analgesIcs (with FDA Category*) local anesthetIc (with FDA Category*) amalgam placement oR Removal nItRous oxIde anesthesIa antIbIotIcs & antI-InfectIves (with FDA Category*) anytime during pregnancy Diagnostic x-rays are safe during pregnancy Use neck (thyroid collar) and abdomen shield Acetaminophen (B) Meperidine (B) Morphine (B) Codeine (C) Acetaminophen + Codeine (C) Acetaminophen + Hydrocodone (C) e.g. Vicodin Acetaminophen + Oxycodone (C) e.g. Percocet Lidocaine with epinephrine (2%) (B), considered safe during pregnancy Mepivacaine (3%) (C), use if benefit out weighs possible risk to fetus No evidence that the type of mercury released from existing fillings harms the fetus Use rubber dam and high-speed evacuation to reduce mercury vapor inhalation 30% nitrous oxide can be used when topical or local anesthetics are inadequate Pregnant women require lower levels of nitrous oxide to achieve sedation Penicillin (B) Amoxicillin (B) Cephalosporins (B) Clindamycin (B) Erythromycin not in estolate form (B) Quinolones (C) Clarithromycin (C) As prophylaxis for dental surgery: use same criteria for all people at risk for bacteremia

Download Guidelines for Oral Health Care in Pregnancy.Pdf