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OB-GYNs: encourage pregnant patients to see a dentist

Washington—Teeth cleanings and dental X-rays are safe for pregnant women, according to recommendations issued by The American College of Obstetricians and Gynecologists. OB-GYNs are being advised to perform routine oral health assessments at the first prenatal visit and encourage their patients to see a dentist during pregnancy, The College said in a July 26 statement. The statement can be found by visiting the website and clicking on the header "About ACOG," then  clicking on "News Room," then "News Releases," then the June 26 article "Dental X-Rays, Teeth Cleanings=Safe During Pregnancy."

The College Committee on Health Care for Underserved Women issued the guidelines. Committee Opinion #569, which is located at www.acog.org under "Resources & Publications." Click on "Committee Opinions" and under "Current List of Titles", click on item #569. Oral Health Care During Pregnancy and Through the Lifespan, was published in the August issue of the Obstetrics & Gynecology journal.

Opinion #569 was reviewed by the Oral Health Care During Pregnancy Advisory Committee, which includes representatives of the ACOG, the American Dental Association and the Health Resources and Services Administration's Maternal and Child Health Bureau, and coordinated by the National Maternal and Child Oral Health Resource Center at Georgetown University.

"Oral health is an important component of general health and should be maintained during pregnancy and through a woman's lifetime," the committee said. "Maintaining good oral health may have a positive effect on cardiovascular disease, diabetes and other disorders."

The ADA News simultaneously reported May 20 at ADA.org and in the print edition on the developing consensus among health care organizations that dental care is safe and necessary during pregnancy.

The ADA Catalog also offers useful resources on the treatment of expectant mothers. Visit ADAcatalog.org or call 1-800-947-4746 to place an order.

The ACOG committee recommends that obstetricians and gynecologists:

• Discuss oral health with all patients, including those who are pregnant or in the postpartum period.

• Advise women that oral health care improves a woman's general health through her lifespan and may also reduce the transmission of potentially caries-producing oral bacteria from mothers to their infants.

• Conduct an oral health assessment during the first prenatal visit.

• Reassure patients that prevention, diagnosis and treatment of oral conditions, including dental X-rays (with shielding of the abdomen and thyroid) and local anesthesia (lidocaine with or without epinephrine) are safe during pregnancy.

• Inform women that conditions requiring immediate treatment, such as extractions, root canals, and restoration (amalgam or composite) of untreated caries, may be managed at any time during pregnancy. Delaying treatment may result in more complex problems.

• For patients with vomiting secondary to morning sickness, hyperemesis gravidarum, or gastric reflux during late pregnancy, the use of antacids or rinsing with a baking soda solution (i.e., 1 teaspoon of baking soda dissolved in 1 cup of water) may help neutralize the associated acid.

• Be aware of patients' health coverage for dental services during pregnancy so that referrals to the appropriate dental provider can be made. Note that each state's Medicaid coverage for oral health may vary considerably.

• Develop a working relationship with local dentists. Refer patients for oral health care with a written note or call, as would be the practice with referrals to any medical specialist.

• Advocate for broader oral health coverage of women before, during, and after pregnancy. Pregnancy is a unique time when women may gain access to oral health coverage.

• Reinforce routine oral health maintenance, such as limiting sugary foods and drinks, brushing twice a day with fluoridated toothpaste, flossing once daily, and dental visits twice a year.

"This information should not be construed as dictating an exclusive course of treatment or procedure to be followed," the committee said.