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4 oral healthcare points for your pregnant patients

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1. Oral health can affect pregnancy outcome

A pregnant women’s oral health can affect the outcome of her pregnancy. Studies have found associations between periodontal infections and preterm birth, or babies being born early. However, research has not shown that pregnancy outcomes improve with dental treatment.

“A mother who has poor oral health has a greater chance of transmitting cavity-causing bacteria to her newborn, even when the newborn doesn’t have teeth.”— Melanie Mayberry, DDS

“Poor oral health can negatively impact birth outcomes,” Dr. Mayberry told DrBicuspid.com.

Avoiding chronic inflammation and maintaining good nutrition are other important factors during pregnancy, as well as at other times, she said.

Pediatric dentist Anupama Tate, DMD, MPH, emphasized the connection between the mouth and the entire body. She is an associate professor of pediatrics at George Washington University School of Medicine and the director of advocacy and research in the division of oral health at Children’s National Medical Center in Washington, DC.

“Poor oral health for a pregnant woman could be linked to birth complications like pre-eclampsia, preterm birth, and low birth-weight infants,” she said.

2. Dental treatment is safe

Studies have found that obtaining dental care, whether regular cleanings, placement of fillings, teeth extractions, imaging, or other procedures, is safe during pregnancy, and dentists and obstetricians who spoke with DrBicuspid.comrecommended it.

“Dental treatment during pregnancy, including dental radiographs with proper shielding and local anesthetics, is safe during all trimesters,” Dr. Tate said.

She also recommended proper oral hygiene using fluoridated toothpaste, chewing sugar-free gum, and eating small amounts of nutritious food throughout the day to help minimize caries risk.

Oral health for oral health’s sake is important, said Kim Boggess, MD. She is an obstetrician/gynecologist (ob/gyn) and a professor of maternal fetal medicine at the University of North Carolina at Chapel Hill School of Medicine.

Dr. Boggess recommended routine dental care when pregnant women are due for a cleaning or checkup but delaying x-rays until after the first trimester.

“Urgent problems that include pain or fever should be addressed immediately regardless of trimester,” she noted.

Keeping the mouth as healthy as possible and free of caries and disease during pregnancy can reduce the chances of pain, infection, swelling, or chronic inflammation that might cause a woman to use antibiotics or an analgesic for a significant period of time, Dr. Mayberry noted.

3. What is normal?

While some oral health changes are normal during pregnancy, losing a tooth is not, the healthcare practitioners advised.

Some changes commonly occur during pregnancy that affect oral health, explained Renee Samelson, MD, an ob/gyn at the Albany Medical Center in New York. These include periodontal disease, increased food cravings and snacking that can affect caries risk, nausea and vomiting, and increased salivation and gum sensitivity.

Vomiting can bring up acid from the stomach. After vomiting, a pregnant woman should rinse her mouth with water mixed with 1 tsp of baking soda, or just plain water, to get rid of the acid, the dentists and ob/gyns recommended. Brushing teeth should be postponed for an hour after vomiting to minimize dental erosion, Dr. Tate said.

Despite and because of these issues, the dentists and ob/gyns advised that continuing with regular toothbrushing and flossing during pregnancy is important. Using mouthwash containing cetylpyridinium chloride can help eliminate bacteria associated with inflammation that can affect gums, Dr. Samelson added.

4. Untreated problems can be passed on

Untreated oral health problems in a mother can be passed on to her baby, experts noted. They also emphasized that early child caries is a preventable infectious disease.

Pediatric dentist Rocio Quinonez, DMD, MPH, an associate professor at the University of North Carolina at Chapel Hill School of Dentistry, discussed the connection between maternal and pediatric oral health, which is not yet completely understood.

“Mothers with cavities have kids with cavities,” Dr. Quinonez said. “There is a biological connection.”

Adults can transmit caries-causing bacteria to children in their households through common activities, such as tasting hot food before letting their child eat it or putting a pacifier in their mouth to clean it off, Dr. Samelson explained. This can affect children’s primary and permanent teeth.

Xylitol and secondarily sorbitol have been found to block the growth of Streptococcus mutans and prevent glucose metabolization, which can help avoid caries, she said. With the exception of gum containing xylitol or sorbitol, she recommended that patients and their children limit consumption of anything that sticks to teeth, which could include dried fruit or certain prenatal vitamins, and brush teeth or chew xylitol gum afterward.

Overall, maintaining good oral health during pregnancy is key but perhaps not as compelling as other aspects of healthcare during the prenatal period.
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Kid-Tested, Dentist-Approved: 6 Teeth Cleaning Tips from Dentist Parents

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As a parent, you may have more in common with your dentist than you think. Many moms and dads—even dentists—struggle to keep their children’s mouths and teeth clean. ADA dentist Dr. Gene Romo is a father of four – ages 13, 10, 8 and 2. “As you can imagine, there can be a wide range of behavior on who wants to brush and who doesn’t in our house,” he says. “I’m not just a dentist, I’m their dad, so making sure they’re establishing good habits early on is important to me.”

To keep your family’s smiles strong, try some of tricks of the trade from dentist moms and dads:

Establish a Fun Family Routine

In Dr. Romo’s house, there’s one rule everyone follows: “You have to brush before bed, and you can’t leave the house in the morning until you brush,” he says. “The most important thing is to make sure your family is brushing for 2 minutes, twice a day.”

Young kids love to imitate their parents, so take the opportunity to lead by example. “One thing I did with all my kids was play a game with them, kind of like monkey-see, monkey-do. We all have our toothbrushes, and they follow what I do,” he says. “When I open my mouth, they open their mouths. When I start brushing my front teeth, they start brushing their front teeth – and so on all the way until it’s time to rinse and spit. It’s just a fun way to teach them how to brush properly, and we get to spend a little time together, too.”

Making brushing a family affair also helps you keep an eye out for healthy habits. “Some kids want to do everything themselves, even toothpaste, so you can watch to make sure they’re not using more than they should – a rice-sized smear for kids 2 and under and a drop the size of a pea for kids 3 and up,” he says. “You can also do a quick final check for any leftover food when brush time is done.”

Try a New Angle

When her daughter was only 6 months old, ADA dentist Dr. Ruchi Sahota asked her husband to hold her while she brushed or brushed when her daughter was laying down. “You can see their teeth from front to back the best at that time,” she says.

If your child is old enough to stand and wants to brush in the bathroom, ADA dentist Dr. Richard Price suggests a different method. “Stand behind your child and have him or her look up at you,” he says. “This causes the mouth to hang open and allows you to help them brush more easily.”

Bigger Kids, Bigger Challenges

Checking up on your child’s daily dental hygiene habits doesn’t end as they get older. It’s more challenging when they get their driver’s license and head off to college, says ADA dentist Dr. Maria Lopez Howell. “The new drivers can drive through any fast food spot for the kinds of food and beverages that they can’t find in a health-minded home,” she says. “The new college student is up late either studying or socializing. They don’t have a nightly routine, so they may be more likely to fall asleep without brushing.”

While your children are still at home, check in on their brushing and talk to them about healthy eating, especially when it comes to sugary drinksor beverages that are acidic. After they leave the nest, encourage good dental habits through care packages with toothbrushes, toothpaste or interdental cleaners like floss with the ADA Seal of Acceptance. And when they’re home on break, make sure they get to the dentist for regular checkups! Or if school break is too hectic– you can find a dentist near campus to make sure they are able to keep up with their regular visits.

Play Detective…

As your children get older, they’re probably taking care of their teeth away from your watchful eye. Dr. Romo asks his older children if they’ve brushed, but if he thinks he needs to check up on them, he will check to see if their toothbrushes are wet. “There have been times that toothbrush was bone dry,” he says. “Then I’ll go back to them and say, ‘OK, it’s time to do it together.’”

If you think your child has caught on and is just running their toothbrush under water, go one step further. “I’ll say, ‘Let me smell your breath so I can smell the toothpaste,’” he says. “It all goes back to establishing that routine and holding your child accountable.”

…And Save the Evidence

It could be as simple as a piece of used floss. It sounds gross, but this tactic has actually helped Dr. Lopez Howell encourage teens to maintain good dental habits throughout high school and college.

To remind them about the importance of flossing, Dr. Lopez Howell will ask her teenage patients to floss their teeth and then have them smell the actual floss. If the floss smells bad, she reminds them that their mouth must smell the same way. “It’s an ‘ah-ha’ moment,” Dr. Lopez Howell explains. “They do not want to have bad breath, especially once they see how removing the smelly plaque might improve their social life!”

Above All, Don’t Give Up

If getting your child to just stand at the sink for two minutes feels like its own accomplishment (much less brush), you’re not alone. “It was so difficult to help my daughter to brush her teeth because she resisted big time,” says ADA dentist Dr. Alice Boghosian. Just remember to keep your cool and remain persistent.

“Eventually, brushing became a pleasure,” Dr. Boghosian says. She advises parents to set a good example by brushing with their children. “Once your child is brushing on their own, they will feel a sense of accomplishment – and you will too!”

From the American Dental Association

Sealants are a Proven and Effective Therapy for Preventing Cavities in Children and Teens

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Study: Sealants may reduce caries by up to 80%

By Tony Edwards, Editor in Chief, www.drbicuspid.com

August 5, 2016 — Sealants may reduce carious lesions on the occlusal surfaces of permanent molars by up to 80%, according to a study jointly published by the ADA and the American Academy of Pediatric Dentistry (AAPD).

The authors of the review, hailing from multiple dental schools, organizations, and institutes, sought to summarize the available evidence regarding the effectiveness of dental sealants for preventing pit-and-fissure occlusal caries in primary and permanent molars on children, adolescents, and adults to develop a joint evidence-based clinical practice guideline (Journal of the American Dental Association, August 2016, Vol. 147:8, pp. 631-645).

“Sealants are a proven and effective therapy for preventing cavities in children and teens,” stated lead author Timothy Wright, DDS, in a release from the ADA and AAPD. “The joint report reaffirms that sealants should be a routine part of cavity prevention, as children with sealants are up to 80% less prone to cavities compared to those without them.”

Caries prevalence

In the U.S., nearly a quarter of children and more than half of adolescents have caries in their permanent teeth, according to data from the National Health and Nutrition Examination Survey 2011-2012. Pits and fissures on occlusal surfaces, especially those on permanent molars, increase the risk of these patients developing carious lesions, the authors noted.

“The joint report reaffirms that sealants should be a routine part of cavity prevention.”
— Timothy Wright, DDS, lead study author

The researchers started with more than 2,800 published studies from 1976 through 2016 for their systemic review and reduced the number to 24, including only parallel and split-mouth randomized controlled trials with at least two years of follow-up. They included studies whose authors reported sealant-effectiveness data compared with a control without sealants, fluoride varnishes, or other head-to-head comparisons.

In comparing sealant use versus nonuse, the researchers reviewed nine studies with a total of 3,542 participants. They found that those who received sealants reduced their risk of developing new carious lesions by 76% (95% confidence interval [CI]: 0.19-0.30; p < 0.00001) compared with participants who did not receive sealants.

The researchers also compared sealant use versus fluoride varnishes by reviewing three studies with a total of 1,715 participants. They found that those who received sealants had a 73% reduction in the risk of developing new carious lesions (95% CI: 0.11-0.69; p = 0.006) compared with participants who received fluoride varnishes.

Age of studies

The authors acknowledged several limitations with the review, including an inability to contact primary authors of the studies if there were issues related to risk of bias, as some of the trials were more than 20 years old. They also noted an inability to assess publication bias by means of using a funnel plot owing to the limited number of included studies per outcome.

More research is needed to provide more data about the merits of the different types of sealant materials, the authors noted.

“Available evidence suggests that sealants are effective and safe to prevent or arrest the progression of noncavitated carious lesions compared with a control without sealants or fluoride varnishes,” they concluded.

4 Tips for Avoiding Bad Breath When You’re On the Go

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Moms, busy professionals, students and many other people are so busy throughout the day that they sometimes forget to take care of their mouths.

You’re so busy throughout the day that you might sometimes forget to take care of your mouth. While this is understandable, the fact that you’re busy shouldn’t mean that you neglect your oral health. When you forget or pass on brushing and flossing, you open to door to bacteria that can lead to bad breath, tooth decay and gum disease. In order to stay healthy, take care of your mouth even when you may not have the time to do so.

People who lead busy lives should remember the following things to help them keep their mouths clean.

1. Carry travel-sized oral health products

Travel-sized oral health products can really come in handy. Many are small enough to easily keep in your car, purse or backpack so that you have them when you need them. If nothing else, try to keep some floss and a small bottle of alcohol-free mouthwash handy. That way, if you have a meal where you get something lodged in your teeth or feel that your breath may have taken a turn for the worse, you can try to take care of it while still out and about. In addition to those two things, you can also carry a travel toothbrush and a small tube of toothpaste. Travel toothbrushes are compact and often have a small case or cover that allows you to carry and use them without any mess.

2. Drink lots of water

Drinking lots of water will help you wash away any food particles and bacteria that collect in your mouth. This will help keep your breath fresh, and because most water in the U.S. is fluoridated, you’ll even be strengthening your teeth. According to the Centers for Disease Control and Prevention, fluoride added into water helps remineralize teeth and prevent cavities. For this reason, it has been added to water supplies for over 70 years. By drinking lots of water and carrying a refillable water bottle, you’ll be able to help keep your teeth healthy.

3. Stay away from certain foods and drinks

Sugary foods and drinks should be avoided. When sugary foods are eaten, bacteria in the mouth interact with the sugar and leave behind an acid that can attack your teeth. This leads to cavities and tooth decay. Starchy foods high in refined carbohydrates, such as fried foods or snacks like potato chips, are no friend to your teeth and can lead to the same result as sugary foods. If you do end up eating these foods, you should make sure to clean your mouth after doing so.

4. Use sugar-free mints, lozenges or gum

Chewing gum or sucking on a mint can help clean your teeth. Gum and mints increase the amount of saliva in your mouth, which will wash away any leftover food or plaque that has collected on your teeth. While any gum or mint will increase the amount of saliva, sugar-fee gum or mints are much better and will help your oral health much more. Try to use products that contain xylitol instead of sugar as this natural alternative to sugar actually fights off the bacteria that cause bad breath and tooth decay.