![]() ![]() That said, emergencies call for immediate implementation of standard emergency protocols. 16 This suggests that decisions made about medications for pain relief should be arrived at after consultation with the obstetrician. Food & Drug Administration backed off that classification, stating that the published research is “too limited to make any recommendations” on pain reliever use in this population. Several analgesics have been placed in pregnancy Category B, which indicates that they are typically safe to use however, in 2015, the U.S. An example of a situation that may benefit from consultation is pain relief. Use of other medications calls for consultation with the patient’s obstetrician to weigh risks and benefits. Local anesthesia (with or without epinephrine) 1, 13, 14.Options considered safe for use in these situations include: Questions about use of local anesthetics or antibiotics in pregnant individuals are common. ![]() The alphabetical system (Table) will continue to be used for over-the-counter (OTC) medications. 9, 10 The new system will be phased-in, with a full compliance date of 2020. Food & Drug Administration began phasing out that system for prescription drugs, replacing it with a narrative section in the package insert that discusses the benefits and risks of using a particular medication with this population. Historically, manufacturers have relied on an alphabetical system to communicate the safety of medications for use with pregnant patients. 1, 4 The ACOG statement on oral care during pregnancy and through the lifespan1 states that “despite the lack of evidence for a causal relationship between periodontal disease and adverse pregnancy outcomes, the treatment of maternal periodontal disease during pregnancy is not associated with any adverse maternal or birth outcomes,” and “prenatal periodontal therapy is associated with the improvement of maternal oral health.” More research is needed to determine the relationship between periodontitis and pregnancy outcomes, however, should periodontitis develop during pregnancy, scaling and root planing is recognized as safe to perform. While findings of individual studies have been mixed, an overview of 23 systematic reviews conducted through 2016 concluded that associations exist between periodontitis and pre-term birth, low birthweight babies, low birthweight babies born prematurely and the development of pre-eclampsia. Much has been written in recent years about the relationship between maternal periodontitis and pregnancy outcomes. Periodontitis and Adverse Pregnancy Outcomes If it is determined that a topical fluoride treatment is needed to minimize the effects of erosion, fluoride varnish may be preferred over gel treatments due to nausea. Brushing twice a day with a soft-bristled brush for two minutes, using a fluoride-containing toothpaste, and cleaning between the teeth once a day should be encouraged. 5ĭue to the increased risk of gingivitis and caries, the importance of good daily oral hygiene should be emphasized to these patients. Instead, they should opt for rinsing with a diluted solution of 1 cup water and 1 teaspoon of baking soda to neutralize the acid. 5 Patients should be encouraged to avoid toothbrushing immediately after vomiting, which exposes the teeth to stomach acids. Erosion stemming from vomiting as a result of morning sickness may be detected.Pyogenic granuloma (also known as granuloma gravidarum) is a round growth, usually connected to the gingivae by a thin cord of tissue, that may develop due to hormonal changes.Dental caries may occur due to changes in diet such as increased snacking due to cravings, increased acidity in the mouth due to vomiting, dry mouth or poor oral hygiene stemming from nausea and vomiting.Gingivitis may result from hormonal changes that exaggerate the response to bacteria in the gum tissue 4.During pregnancy, several oral health conditions are more common: ![]()
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