Oral Health

Question 1

What is the oral health delivery framework?

Answer 1

Ask about oral health risk factors/sx of oral disease

Look for signs of risk or active oral disease

Decide on most appropriate response

Act offer prevention & referral

Document

Question 2

Why do women have a greater likelihood of bacteria entering the bloodstream and triggering inflammation?

Answer 2

Unique hormonal changes causing an increased blood flow to gums they experience during:
puberty
menstruation
pregnancy
menopause

Question 3

Poor oral health is associated with

Answer 3

pregnancy complications
CV 
Uncontrolled DM
respiratory infx
dementia
RA
osteoporosis

Question 4

Is there an association between dental care & pregnancy loss?

Answer 4

No; however, many dentists will decline care to pregnant people

Question 5

Approximately 40% of pregnant women have periodontal disease. Evidence has shown an association between periodontal disease and:

Answer 5

1. miscarriage
2. premature birth
3. pre-eclampsia
4. low birth weight
5. C-reactive protein has been found to be up to 65% higher in pregnant women with periodontal disease

Question 6

What are the two main types of periodontal disease?

Answer 6

Gingivitis
The early stage of periodontal disease when the gums become swollen and red due to inflammation.

Periodontitis
The most serious form of periodontal disease - gums pull away from the tooth and supporting gum tissues are destroyed.

Normal plaque in beginning – in second trimester, changes to an anaerobic bacteria, increased periodontal inflammation and potential loss of tooth!

Question 7

What is the pathway linking oral health problems and conditions such as diabetes, coronary artery disease, and adverse pregnancy outcomes?

Answer 7

Inflammation

Question 8

How does inflammation indirectly affect PTL?

Answer 8

PTB photo

Question 9

Education for patient with vomiting, HG, or GERD:

Answer 9

1. Rinse with water or bicarbonate to reduce acid in mouth immediately after vomiting.
2. Avoid brushing vigorously..

Question 10

What is this?

Insert photo or oral tumor granuloma

Answer 10

Pregnancy Oral Tumor Granuloma

• Lesion caused by increased progesterone
• Appears between 2nd-8th month of pregnancy
• Occurs in 5% of pregnant women
• Bleeds easily when touched
• Offer reassurance
• Observe unless bleeding excessively – refer to dentist for excision
• Can occur on gum, side of cheek, tongue, lip
• Can subside after hormone levels decrease
• Can be removed

Question 11

Which of the following is a true statement?

A. Mothers with caries pass their genetic predisposition for caries on to their babies.

B. Mothers with caries pass caries-causing bacteria to their babies in utero.

C. Mothers with caries pass caries-causing bacteria to their infants early in life via saliva transmission.

D. All of the above

Answer 11

C. Mothers with caries pass caries-causing bacteria to their infants early in life via saliva transmission.

Dental care while pregnant decreases bacterial load

Question 12

A pregnant patient asks you for guidance about having dental treatment during her pregnancy. What would you say?

A. Dental treatment should only be performed during the second and third trimesters.

B. Dental treatment should only be performed during the third trimester because organogenesis is complete.

C. Dental treatment should only be performed during the second trimester for comfort and safety reasons.

D. Dental treatment can be performed during any trimester.

Answer 12

D. Dental treatment can be performed during any trimester.

Most comfortable time? Second trimester
First: higher risk of morning sickness
Third: may be more uncomfortable laying flat for procedure

Question 13

What guidance should you give a pregnant patient about having dental X-rays during her pregnancy?
A. Dental x-rays should be avoided during pregnancy.

B. Dental x-rays should be limited to only one film per pregnancy.

C. Dental x-rays should be taken as necessary to reach a full diagnosis.

D. Dental treatment can be performed during any trimester.

Answer 13

D. Dental treatment can be performed during any trimester.

Only as necessary, but can be performed with lead coverings

Question 14

General Safety of Dental Treatment in Pregnancy

Answer 14

Dental treatment is ideal during the second trimester of pregnancy.

Evidence shows that dental care, including X-rays, local anesthesia, and oral pain medication, is SAFE throughout pregnancy.

Dental care during pregnancy is often delayed because of fear.

If a pregnant woman has not seen a dentist in the last 6 months, she should be referred.

Question 15

Treatment tips for each trimester

Answer 15

pic of treatment tips

Question 16

Safe abx in pregnancy

Answer 16

penicillin
amoxicillin
cephalexin
erythromycin base*
clindamycin*
metronidazole; not in 1st tri

*Appropriate alternative for non-type 1 penicillin allergic patients

Question 17

Safe Anesthetics in Pregnancy

Answer 17

Lidocaine with or w/o epi
Procaine
Nitrous Oxide

Question 18

Are BF children more or less likely to develop dental caries?

Answer 18

Less likely.

Question 19

Child dental care suggestions

Answer 19

1. ensure children are not put to bed with a bottle
2. clean infants’ teeth twice daily with a smear of toothpaste. clean baby’s gums after feeding
3. recommend children see a dentist at 12 mos