Dental care and treatment during pregnancy Oral health professionals are responsible for providing preventive care and treatment before, during, and after pregnancy. Screenings for oral health risks, counseling on proper oral hygiene, and referrals for dental treatment when necessary should be available to every pregnant woman. Dental care during pregnancy is considered necessary and safe for the well-being of the mother and the developing fetus (Vogell, Oral healthcare visits The oral healthcare visit is an occasion to educate pregnant women about improving their oral health. Pregnant women may be more receptive to changing behaviors that are potentially associated with a higher risk of poor pregnancy outcomes. In addition, pregnant women are more likely to adopt better health behaviors when they understand the impact their actions have on their children (Flynn, 2009). The following practices utilized by women can promote optimal oral health during their pregnancy: Reducing caries risk Oral healthcare professionals can implement best practices to assess caries risk and manage caries in pregnant women. Furthermore, these guidelines cite several strategies for decreasing the maternal cariogenic bacterial load, including: ● Restoration of untreated caries. ● Use of fluoride toothpaste and fluoride mouth rinses, depending on water fluoridation status. ● Appropriate use of chlorhexidine mouth rinses and fluoride varnish. ● Use of chewing gum that contains xylitol. These strategies reflect efforts to reduce the transmission of cariogenic bacteria from mother to child by decreasing the maternal reservoir and avoiding transmission and colonization vectors (Kolen, 2020; Vogell, 2017). Consistent with the New York State Department of Health guidelines, the CDC recommendations note that evidence supports the use of fluorides and dietary controls for reducing Periodontal interventions Several guidelines, policy statements, and recommendations provide guidance regarding periodontal interventions in pregnant patients. A complete periodontal assessment is essential in the early stages of the pregnancy and women must be educated about the potential for the development of pregnancy gingivitis (Lee and Hoerler, 2019). The American Academy of Periodontology published a policy statement regarding periodontal management of pregnant patients, which concluded that preventive oral care services should be provided to such patients as early as possible to reduce the amount of periodontal pathogens associated with gingivitis and periodontal Nutrition during pregnancy Optimal nutrition during pregnancy has been shown to enhance dental health for both mother and fetus by providing important nutrients that are necessary for gingival health of the mother and mineralization of the baby’s teeth (Vogell, 2017). Fetal tooth development begins by week 6 of gestation for primary dentition and by week 10 for permanent teeth. Tooth development can be affected by severe maternal malnutrition. Oral health education during pregnancy should include the importance of proper nutrition to ensure maternal and fetal oral health, including eating foods that are high in the right nutrients and taking prenatal vitamins. Nutrients that are important to maternal and fetal oral health include vitamins A, C, and D; folic acid; calcium; phosphorus; protein; and fluoride (March of Dimes, 2018). Healthy foods are the best sources of vitamins and minerals, and pregnant women should be encouraged to satisfy their vitamin requirements through food sources:
2017). After the birth of the child, preventive healthcare visits for the child during the first year of life provide an opportunity for dentists and pediatric health professionals to also improve the oral health of the mother. Women who have obtained oral health care while they were pregnant will usually continue to receive routine dental care for themselves and their child (Vogell, 2017). ● Twice-daily brushing with a fluoride toothpaste and daily flossing. ● Restricting sugar-containing foods to mealtimes. ● Selecting water or low-fat milk and avoiding carbonated beverages during pregnancy. ● Selecting fruit instead of fruit juice to meet the recommended daily intake of fruit. (Yenen and Atacag, 2019; Vogell, 2017) reservoirs of cariogenic bacteria in maternal saliva to decrease transmission from mother to child (Vogell, 2017). The use of xylitol-containing gum during pregnancy has been shown to reduce the transmission of the cariogenic S. mutans from mother to child late in the pregnancy and during the postpartum period (Drugs.com, 2021; Lee et.al, 2019). Lin and colleagues (2016) also found a significant reduction in transmission in their meta- analysis of randomized controlled trials. Another strategy is to minimize saliva-sharing activities because cariogenic bacteria can be transmitted from mother to child by behaviors that directly pass saliva (Lee and Hoerler, 2019). Interventions focused on the child are also appropriate to reduce caries risk. The New York State Department of Health guidelines indicate that increasing the child’s resistance to colonization can be achieved by applying fluoride varnish and limiting the frequency of carbohydrate intake. disease during pregnancy (Vogell, 2017). A high level of oral hygiene should be encouraged in women before they become pregnant and throughout their pregnancies. Procedures such as periodontal scaling and root planing or more involved periodontal treatments are usually scheduled early in the second trimester. However, prompt intervention for acute infection, abscess, or other potentially disseminating sources of sepsis is warranted irrespective of the stage of pregnancy as these issues can have an adverse effect upon the health of the developing baby (Yenen and Atacag, 2019). ● Vitamin A : Found in deep green leafy vegetables, dark yellow vegetables, fruits, egg yolks, liver, fortified milk, dairy products, and breakfast cereals. ● Vitamin C : Found in citrus fruits, strawberries, collard greens, spinach, broccoli, tomatoes, and green and red peppers. ● Vitamin D : Found in liver, fish liver oils, and eggs. It is important for pregnant women to get adequate amounts of folic acid, a B vitamin that helps prevent birth defects of the brain and spinal cord. Folic acid is available in most multivitamins, as supplements, and in some foods. The March of Dimes (2018) recommends that pregnant women should get 600 mcg of folic acid every day from food and supplements. An important mineral throughout pregnancy is calcium, which is used in the formation of the fetal skeleton and tooth buds. Calcium is also used to conduct nerve impulses and to form muscle (including cardiac muscle). Maternal calcium absorption increases during pregnancy; thus, the calcium needs of pregnant women are similar to those of nonpregnant women. According to the Dietary Reference Intake (DRI) values set by the Food and
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