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My View: Oral health care during pregnacy

December 07, 2015

By Virginia A. Merchant, D.M.D.

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Dr. Merchant
Chances are that you were taught in dental school, as I was, that routine dental care for pregnant women should be limited to the second trimester. Furthermore, it was recommended that treatment should be delayed, when possible, until after the baby was delivered. This advice is no longer valid.

In 2011, an expert workgroup, convened by the U.S. Health Resources and Services Administration in collaboration with the American College of Obstetricians and Gynecologists and the American Dental Association, developed a consensus statement regarding oral health care during pregnancy. This consensus statement “emphasizes the safety and importance of oral health care throughout pregnancy and provides guidance on oral health care for pregnant women for both prenatal care health professionals and oral health professionals, pharmacological consideration or pregnant women and guidance for health professionals to share with pregnant women.”1

Since that release, various agencies and organizations have provided educational materials, policies, programs and training to promote awareness of the importance and safety of oral health care during pregnancy. The ADA Council on Access, Prevention and Interprofessional Relations continues its efforts to make the profession aware of this change in philosophy. As part of these efforts, the council submitted two resolutions, 94H-2014 and 95H-2014, to the 2014 ADA House of Delegates and both were approved. These resolutions are now ADA policy and read as follows:

  • Resolved, that the ADA urge all pregnant women and women of child-bearing age to have a regular dental examination.
  • Resolved, that the ADA acknowledges that preventive, diagnostic and restorative dental treatment is safe throughout pregnancy and is effective in improving and maintaining the oral health of the mother and her child.

Unfortunately, many dentists as well as other health care providers are unaware of this change in philosophy regarding dental care for pregnant women. In addition, a number of dental schools and individuals providing continuing education lectures continue to promulgate the outdated philosophy.

The consensus statement encourages prenatal care health professionals to assess pregnant women’s oral health, advise them about oral health care and refer them to their dentist, or, if they don’t have a dentist, help them obtain care through a referral. Oral health professionals should assess a pregnant woman’s oral health status, advise her about oral health care, work in collaboration with prenatal care health professionals, provide oral disease management and treatment to pregnant women and provide support services for care when needed.

Oral health care, including radiographs, pain medication and local anesthesia is safe throughout pregnancy. An excellent table listing various pharmaceutical agents typically prescribed by dentists is available within the consensus statement and indicates which ones may be used and ones that should be avoided. The table can be downloaded here. Most pharmacological agents that dentists commonly prescribe are safe for use in pregnancy, but there are some antibiotics, including tetracycline, which should be avoided, and a few analgesics that need to be used with caution.

Make certain that your female patients of child-bearing age know that it is important to seek dental care during pregnancy and that it is safe to do so. A recent Delta Dental survey found that 42.5 percent of pregnant women in the U.S. did not visit their dentist during their pregnancy.2 Do not hesitate to provide preventive, diagnostic and restorative dental care to your pregnant patients and take the opportunity to educate them of the importance of having their baby see a dentist within his or her first year of life.

REFERENCES

  1. Oral Health Care During Pregnancy Expert Workshop. 2012. Oral Health Care During Pregnancy: A National Consensus statement. Washington, D.C.: National Maternal and Child Oral Health Resource Center.
  2. ADA Morning Huddle, Wednesday, June 17, 2015.

 This editorial, reprinted with permission, originally appeared in the August 2015 issue of the Journal of the Michigan Dental Association. Dr. Merchant is the editor in chief.