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What should prenatal providers do?
1. Assess oral health status (screening)
2. Advise about oral health care (safety)
3. Collaborate with dental professionals (refer)
What should dental providers do?
1. Assess oral health status (comp exam)
2. Advise about oral health care (safety)
3. Collaborate with prenatal professionals (consult as necessary)
4. Provide oral disease management and treatment
How should you position a pregnant patient during dental treatment?
semi-reclined
pillow on right hip
True or False: Dental services are safe in all trimesters.
TRUE!
True or False: Local anesthetics are unsafe for pregnant patients.
FALSE! The use of local anesthetics is permitted in pregnant patients.
True or False: Nitrous and sedation are safe for pregnant patients.
TRUE! But you must consult with prenatal care provider first.
True or False: Radiographs and analgesics are safe throughout pregnancy.
TRUE! Analgesics, including acetaminophen, codeine, oxycodone, hydrocodone, morphine, and meperidine can be used during pregnancy. However, avoid if possible and prescribe lowest dose for shortest duration possible.
How should you prescribe opioids to pregnant patients if needed?
lowest dose for shortest duration (3 days)
When can NSAIDs be used during pregnancy?
only sparingly in 2nd semester
True or False: NSAIDs can be used throughout pregnancy.
FALSE! Avoid in first and third trimesters.
Why should you avoid tetracycline in pregnant patients?
risk of hepatotoxicity in the mother
permanent discoloration of teeth in the fetus
impairment of fetal long bone growth
What antibiotics can be used for pregnant patients?
amoxicillin
cephalosporins
clindamycin
metronidazole
penicillin
What is the minimum age for tetracycline use?
12 years old
A mother with untreated decay is _____ likely to have a child with untreated decay.
more
What percent of births are financed by Medicaid?
40%
When should a child's first dental visit be?
when first tooth erupts around 6 months old
What are the symptoms of thyroid crisis?
irritability
high systolic/low diastolic
tachycardia
nausea/vomiting/diarrhea
fever
confusion
drowsiness
heart failure symptoms
What causes secondary adrenal insufficiency?
Inadequate secretion of ACTH from the anterior Pituitary due to long term corticosteroid use
Who might be on systemic corticosteroids?
adrenal insufficiency
rheumatic diseases
connective tissue diseases
respiratory diseases
GI diseases
cancer
think inflammation
How is primary adrenal insufficiency treated?
systemic corticosteroids
How is secondary adrenal insufficiency treated?
surgery
radiation therapy
chemotherapy
Why do patients on systemic steroids need profound anesthesia?
hindered stress response
What are the signs of acute adrenal crisis?
hypotension
weakness
nausea/vomiting
headache
fever
hypoglycemia
How is acute adrenal crisis treated?
emergency!
call 911 and administer IV 4 mg dexamethasone
