1. DENTAL CARIES:
‘A tooth for every child’ has been quoted widely since many years .Its a misconception since there is no mechanism for the physiologic withdrawal of calcium from teeth as there is from bone,so that a developing fetus cannot calcify at the expense of mothers teeth.
Women usually neglect her ordinary oral care because of other duties associated with he baby.To conclude that the higher incidences of caries are more due to neglect.
2. PERIODONTAL PROBLEMS:
Gingval enlargements are commonly seen in pregnant females.The enlargements maybe marginal or may occur as single or multiple tumour like masses.
The severity of gingivitis is increased during second or third month.This aggravaion is attributed to increased levels of progesterone and oestrogen.Gingivitis is seen to be increased during the first trimester when there is increased production of gonadotrophins and during the third trimester when oestrogen and progesterone are highest.
Clinically the gingiva is bright red or magenta, soft, friable and has a smooth and shiny surface.Bleeding occurs spontaneously.
Tumour like enlargements or pregnancy tumor or pregnancy epulis is not a neoplasm but inflammatory response to local irritation.
TREATMENT:
Meticulous plaque control ,scaling,root planning and polishing should be the only non emergency periodotal procedures performed.
During the first trimester ,the fetus is particularly subject to malfunction ,so most of the medications and procedure should be postponed until second trimester.The third trimester provides greatest cardiovascular and metabolic stress.
Supine hypotensive syndrome occurs in the third trimester if the patient is allowed to lie in supine position for more than 3-7 minutes.It has been seen that flaccid and gravid uterus compresses the inferior vena cava ,decreasing venous return from the legs.If patient is allowed to alter her position to left lateral or standing position ,the weight of uterus is taken off the venacava and clinical symptoms are rapidly reversed.
Hence during pregnancy the emphasis should be on:
1. Preventing the gingival disease before it occurs.
2. Treating disease before it becomes worse
3. Every patient should be scheduled for periodic dental visits.