Pregnancy and Dentistry: A Literature Review on Risk Management during Dental Surgical Procedures

Abstract

Background: Pregnancy is a unique moment in a woman’s life, accompanied with several physiologic changes that have an impact on oral health. Aim of the study: The purpose of the present study was to conduct a critical review of published literature regarding pregnancy and dentistry, the most frequent oral diseases that are encountered during pregnancy, their correlation to adverse pregnancy events, and safe dental treatments that can be performed during pregnancy. Methods: A Medline/COCHRANE search was carried using specific keywords and MeSH terms, combined with the boolean operators “OR” and “AND”. Results: The search led to 146 publications including guidelines, meta-analyses, systematic and non-systematic reviews, published between 2000 and 2021. Discussion and conclusions: Due to the increased inflammatory and immune body response that characterizes pregnancy, periodontal conditions are often aggravated during pregnancy and periodontal disease encountered frequently in pregnant patients. There are conflicting study results in the literature regarding the association between periodontitis and adverse pregnancy outcomes. Periodontal treatment did not show a significant reduction in the adverse outcomes. Many dentists, often due to lack of information, are reluctant to provide dental treatment to pregnant women. However, preventive and restorative dental treatment is safe during pregnancy. Diagnostic radiographs may be performed after the first trimester if absolutely necessary. Analgesics (such as paracetamol) and anesthetics (such as lidocaine) are also considered safe. In case of infection, antibacterial drugs such as amoxicillin, ampicillin, and some cephalosporines and macrolides can also be prescribed. Organogenesis takes place in the first trimester, the time during which the fetus is susceptible to severe malformations (teratogenesis). The ideal time to perform dental treatment is the second trimester (week 17 to 28). However, acute pain or infections make the intervention of the dentist absolutely necessary and emergency treatment can be performed during the whole pregnancy period.

Periodontal disease in pregnancy and adverse pregnancy outcomes: Progress in related mechanisms and management strategies

“…Currently, it has been universally acknowledged that non-surgical periodontal treatment during pregnancy is safe, although oral anti-inflammatory treatment during pregnancy did not significantly lessen adverse pregnancy outcomes ( 100 ). Furthermore, as a vital part of pregnancy health, reasonable intervention of oral diseases during pregnancy is beneficial to the physical and mental health of patients and can reduce the mother-to-child transmission of oral pathogens.…”

Factors influencing adoption of oral health promotion by antenatal care providers in Moyo district, North-Western Uganda

“…About the safety of obtaining dental radiographs in pregnant women, the majority 125 (82.2%) of the ANC providers were not aware that it is safe to obtain dental radiographs in pregnant women and use of dental radiographs, if necessary, after the first trimester does not pose any risk to the developing fetus [58], however, it is recommended to use protective lead aprons and thyroid collar to shield the sensitive areas. This kind of misconception could however be overcome among ANC providers by continuous services professional training and collaboration among different professionals within the different health facilities.…”

The Impact of Simulated Bruxism Forces and Surface Aging Treatments on Two Dental Nano-Biocomposites—A Radiographic and Tomographic Analysis

“…It was reported in the literature that oral biofilm might induce surface changes in dental restorative materials, leading to their chemical degradation and thus a higher chance for the dental fillings to develop marginal percolation and other defects [ 12 ]. It was also reported that chewing gum might lead to leaching of chemical compounds of resin-based composites [ 13 ]. It is well known that any change in the architecture of the oral cavity may interfere with the whole oral equilibrium, disturbing it at different levels (e.g., muscles, teeth, TMJ) [ 8 , 9 ].…”