Good Oral Health Is Essential During Pregnancy
It’s no secret that pregnancy is an important time in a woman’s life. While women often hear about how pregnancy causes physical changes that affect their hormone or appetite levels, these changes can have a great effect on their oral health as well. Despite the fact that good oral health is essential for the overall health of both mother and child, only 22 to 34 percent of women in the United States visit a dentist during pregnancy. In fact, dental care during pregnancy is not only safe and effective, it’s essential for combating the adverse effects of oral disease, according to an article published in the May/June 2010 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry (AGD). Dentists have the ability to maintain the oral health of expectant mothers by treating the dental findings that are common during pregnancy.
“Hormonal changes during pregnancy can result in several changes in the mouth,” says Homa Amini, DDS, co-author of the article. “Reports show that the most common oral disease is gingivitis, which has been reported in 30 to 100 percent of pregnancies.”
Gingivitis, a buildup of plaque that causes inflammation of the gums, should be treated with a professional cleaning and proper toothbrushing and flossing. If left untreated, gingivitis can lead to periodontitis, a more serious form of gum disease. “Patients tend to delay the treatment of oral disease due to concerns for fetal safety; however, routine dental treatment can be performed safely at any time during pregnancy,” says Dr. Amini. What’s more, untreated dental disease can lead to pain, infections and unnecessary exposure to medications, any of which could harm the developing fetus. Poor oral health also can affect the nutritional intake of expectant mothers, which is essential for fetal growth and survival.
The hormonal fluctuations that result from pregnancy can produce benign pregnancy tumors in the mouth. These tumors usually appear after the first trimester and typically go away after delivery; however, surgical removal may be required when these tumors bleed, interfere with eating or do not resolve after delivery.
In addition to examining for oral disease, dentists may notice dental erosion—the chemical or mechanochemical destruction of tooth material—in pregnant women, due to increased acid in the mouth following morning sickness.
“To neutralize acid after vomiting, pregnant women should rinse the mouth with a mixture of a teaspoon of baking soda dissolved in a cup of water,” says Patricia Meredith, DDS, FAGD, spokesperson for the AGD. “The teeth should be brushed only after the mouth has been rinsed and the acid has been neutralized to prevent further damage to the enamel.”
Oral health assessment and treatment should be an essential part of prenatal care, as these steps allow the patient to receive ongoing advice concerning proper oral hygiene and infant oral health care.
Children with Special Needs Are at Increased Risk for Oral Disease
At the beginning of 2010, as many as 17 percent of children in the United States were reported as having special health care needs. Behavioral issues, developmental disorders, cognitive disorders, genetic disorders and systemic diseases may increase a child’s risk of developing oral disease, according to an article published in the May/June 2010 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry (AGD). For a child with special health care needs, special diets, frequent use of medicine and lack of proper oral hygiene can make it challenging to maintain good oral health.
“By the time these children are 12 months old, they should have a ‘dental home’ that will allow a dentist to administer preventive care and educate parents about good oral health habits tailored to fit their child’s needs,” says Maria Regina P. Estrella, DMD, MS, lead author of the article.
For example, some parents may not know that special diets for children with below-average weight or unique food allergies can unintentionally promote tooth decay. Underweight children may be directed to consume drinks containing high amounts of carbohydrates, which can cause demineralization of teeth. Medications can also be a source of concern. Because children often find it difficult to swallow pills, many of their medicines may utilize flavored, sugary syrups. When parents or guardians give these syrups to a child, especially at bedtime, the sugars can pool around the child’s teeth and gums, promoting decay.
“Children should continue with the diet and medications as directed by their physician, but a dentist may recommend more frequent applications of fluoridated toothpaste and mouthrinse and rinsing with water to decrease the risk of decay,” says Vincent Mayher, DMD, MAGD, spokesperson for the AGD.
Additionally, adults will need to help children who lack the dexterity to brush their own teeth. When brushing a child’s teeth, it may be helpful for caregivers to approach their child from behind the head, which will provide caregivers with good visibility and allow them to control the movement of both the child’s head and the toothbrush. This approach is especially helpful with wheelchair-bound children.
Taking children with special health care needs to the dentist is as important as caring for their other medical needs. A dentist who understands a child’s medical history and special needs can provide preventive and routine oral care, reducing the likelihood that the child will develop otherwise preventable oral diseases.
What Are Porcelain Laminate Veneers?
Sometimes simple bonding is not enough for the demands in the mouth where cosmetic changes are needed. This is when porcelain laminate veneers may be used. Porcelain veneers (sometimes referred to as laminates) can change an entire smile. Porcelain laminate veneers are quick, painless (which most patients appreciate), and the results are usually quite impressive. They can change color, size, shape and arrangement of the teeth. It is often used in place of orthodontic treatment. The great part about these types of veneers is that they can be done in just two visits.
The technique consists of first shaving a thin layer of outer tooth structure (about the thickness of an eggshell). An impression is then taken of the prepared teeth and is sent to a dental laboratory. In the lab, a ceramist will make very thin porcelain facings consisting of all the changes in shape, size, color and teeth arrangement that are needed to have a great looking smile. At the second visit, the laminates are bonded onto the prepared teeth with a white light gun. The bonding material acts as an adhesive for the laminates. Porcelain laminates are the most popular technique used for dramatic smile makeovers.
