Apparently, oral health care during pregnancy is often misunderstood by treating physicians and their patients. Every pregnant woman should be screened for oral risks, educated about proper oral hygiene, and referred to a dentist where treatment may be necessary. Dental procedures such as periodontal treatment, restorations, and extractions are safe and are best performed during the second trimester. We are hesitant to perform diagnostic radiography regardless of the accepted practice that it’s safe. Xylitol and chlorhexidine may be used as adjuvant therapy for high-risk mothers in the early postpartum period to reduce transmission of cariogenic bacteria to their infants. Appropriate dental care and prevention during pregnancy may reduce poor prenatal outcomes and decrease infant caries.
Every pregnant woman should be assessed by a dentist for dental hygiene habits, access to fluoridated water, oral problems (e.g., caries, gingivitis), and continued access to dental care. Patients should be counseled to perform routine brushing and flossing, to avoid excessive amounts of sugary snacks and drinks, and to consult a dentist. Many dentists are reported to be reluctant to treat pregnant women. Optimally, physicians and dentists can overcome this situation through education, clear communication, and the development of ongoing collaborative relationships. Physicians can share information on the safety of dental treatment in pregnancy with dental colleagues and provide clear referral recommendations.
Novy Scheinfeld, DDS, PC
290 Carpenter Drive, 200A
Atlanta (Sandy Springs), GA 30328
- Dentist Dunwoody: Oral Health, Women and Pregnancy (therightsmile.wordpress.com)
- Dentist Dunwoody: Women and Oral Health Issues (therightsmile.wordpress.com)
 Teratogenic Effects Pregnancy Category B. Reproduction studies have been performed in rats and rabbits at Chlorhexidine gluconate doses up to 300 mg/kg/day and 40 mg/kg/day, respectively, and have not revealed evidence of harm to fetus. However, adequate and well-controlled studies in pregnant women have not been done. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. http://www.drugs.com/pro/chlorhexidine.html
 http://www.mchaccess.org/pdfs/alerts/oral%20health%20during%20pregnancy.pdf. HUGH SILK, MD, University of Massachusetts Medical School and Family Medicine Residency Program, Worcester, Massachusetts. ALAN B. DOUGLASS, MD, Family Medicine Residency Program, Middlesex Hospital, Middletown, Connecticut. JOANNA M. DOUGLASS, BDS, DDS, University of Connecticut School of Dental Medicine, Farmington, Connecticut. LAURA SILK, MD, Health Alliance, Leominster, Massachusetts.
 Am Fam Physician. 2008;77(8):1139-1144. Copyright © 2008 American Academy of Family Physicians.
 Oral examination should include the teeth, gums, tongue, palate, and mucosa.
 Livingston HM, Dellinger TM, Holder R. Considerations in the management of the pregnant patient. Spec Care Dentist. 1998;18(5):183-188