Mangment of Pregnant patient in Periodontology.pptx

This presentation offers an in-depth exploration of the management strategies and considerations for treating pregnant patients in the periodontology department. It covers the physiological changes during pregnancy, their impact on oral health, and the necessary modifications in periodontal treatment protocols to ensure the safety of both the mother and the developing fetus. The presentation also discusses the latest guidelines, risk factors, and evidence-based practices to optimize oral care for pregnant patients, ensuring comprehensive and safe dental management.

1. Name: Dr.Umer Riaz Management of Periodontitis in Pregnant Patients

2. Introduction Good morning everyone, Today, we'll be discussing the management of periodontitis in pregnant patients. Periodontitis, a serious gum infection, can affect pregnant women due to hormonal changes, making it crucial to manage their oral health effectively.

3. Importance of Oral Health in Pregnancy Oral health is paramount for both the mother and the fetus. Poor periodontal health can lead to adverse pregnancy outcomes, including preterm birth and low birth weight. Therefore, maintaining a healthy oral environment during pregnancy is essential.

4. Objectives Our primary objectives for pregnant patients are: Establishing a healthy oral environment. Maintaining optimal oral hygiene. Implementing a preventive periodontal program. This program includes nutritional counseling and rigorous plaque control measures, both in the dental office and at home.

5. Oral Hygiene and Plaque Control Plaque control is crucial during pregnancy due to the increased tendency for gingival inflammation. Patients should be educated about proper oral hygiene techniques, which need to be taught, reinforced, and monitored throughout pregnancy. Scaling, polishing, and root planing can be performed whenever necessary.

6. Scaling and Root Planing Scaling and root planing are safe and necessary procedures during pregnancy to control active periodontal disease. These treatments help in maintaining a healthy oral environment and preventing complications.

7. Use of Antimicrobial Rinses High-alcohol-content antimicrobial rinses are generally avoided for pregnant women. Non-alcohol-based oral rinses are preferred to reduce the risk of adverse effects while maintaining oral hygiene.

8. Prenatal Fluoride Controversy The use of prenatal fluoride supplements is controversial. Although some studies suggest benefits, the American Dental Association does not recommend them due to uncertain efficacy. The American Academy of Pediatric Dentistry supports this position, and the American Academy of Pediatrics has no stated position on prenatal fluorides.

9. Timing of Dental Treatment Elective dental care should be avoided during the first trimester and the last half of the third trimester. The first trimester is a critical period for fetal development The third trimester poses a risk of premature delivery. Routine dental care is best provided early in the second trimester.

10. Managing Supine Hypotensive Syndrome Supine hypotensive syndrome can occur when the gravid uterus compresses the inferior vena cava in a supine position, causing maternal hypotension and decreased cardiac output. This can be managed by turning the patient on her left side and placing a soft wedge on the right side during dental treatment.

11. Dental Radiographs Dental radiographs are safe during pregnancy if proper precautions, such as using a lead apron , are taken. However, it is preferable to minimize radiation exposure, especially during the first trimester. Necessary radiographs should be taken selectively and appropriately.

12. Medications Drug therapy during pregnancy is controversial due to potential effects on the fetus. Medications should be prescribed only when absolutely necessary and after careful consideration of their side effects. Most common dental drugs are relatively safe during pregnancy, but some, including certain antibiotics, should be used with caution.

13. Safe Medications During Pregnancy Antibiotics: Penicillin: Safe to use. Amoxicillin: Safe to use. Clindamycin: Safe to use. Analgesics: Acetaminophen (Tylenol): Safe to use. Local Anesthetics: Lidocaine: Safe to use with or without epinephrine.

14. Prohibited Medications During Pregnancy Antibiotics: Tetracycline: Contraindicated due to the risk of fetal bone and teeth discoloration. Doxycycline: Contraindicated for the same reasons as tetracycline. Metronidazole: Generally avoided, especially in the first trimester. Analgesics: Aspirin: Avoid due to the risk of bleeding complications and potential impact on fetal circulation. NSAIDs (e.g., Ibuprofen, Naproxen): Avoid, particularly in the third trimester, due to the risk of premature closure of the ductus arteriosus. Sedatives: Benzodiazepines: Generally avoided due to potential risks to the fetus.

15. Summary and Recommendations In summary, managing periodontitis in pregnant patients involves * maintaining a healthy oral environment * rigorous plaque control * nutritional counseling * careful timing of dental treatments. Preventive care and patient education are key to ensuring optimal oral health during pregnancy.

16. References Newman and Carranza’s Clinical Periodontology page 988 to1004 Thank you for your attention. I'll be happy to answer any questions you may have.