1
|
Kuzekanani M. Latest Concepts in Endodontic Management of Pregnant Patients. Int J Dent 2023; 2023:9714515. [PMID: 37899798 PMCID: PMC10611540 DOI: 10.1155/2023/9714515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/09/2023] [Accepted: 09/08/2023] [Indexed: 10/31/2023] Open
Abstract
Pregnant patients and how to manage their treatments is one of the most important challenges in endodontic practice. Endodontic treatment on pregnant women is sometimes an emergency condition to control toothache due to irreversible pulpitis and odontogenic infection. Tooth decay, oral health, local and general anesthesia, analgesics, antibiotic prescription, drug interactions, and X-ray radiation are the most important considerations that may impact treatment planning and endodontic practice in pregnancy. The aim of this article is to notify and explain the latest concepts in the endodontic management of pregnant patients.
Collapse
Affiliation(s)
- Maryam Kuzekanani
- Department of Endodontics, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
2
|
Coffey CH, Casper LM, Reno EM, Casper SJ, Hillis E, Klein DA, Schlein SM, Keyes LE. First-Trimester Pregnancy: Considerations for Wilderness and Remote Travel. Wilderness Environ Med 2023; 34:201-210. [PMID: 36842861 DOI: 10.1016/j.wem.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 02/28/2023]
Abstract
Women increasingly participate in outdoor activities in wilderness and remote environments. We performed a literature review to address diagnostic and therapeutic considerations during first-trimester pregnancy for remote multiday travel. Pretrip planning for pregnant patients traveling outside access to advanced medical care should include performing a transvaginal ultrasound to confirm pregnancy location and checking D rhesus status. We discuss the risk of potential travel-related infections and recommended vaccinations prior to departure based on destination. Immediate evacuation to definitive medical care is required for patients with a pregnancy of unknown location and vaginal bleeding. We propose algorithms for determining the need for evacuation and present therapeutic options for nausea and vomiting, urinary tract infections, and candidiasis in the field.
Collapse
Affiliation(s)
- Christanne H Coffey
- Department of Emergency Medicine, University of California, San Diego, San Diego, CA.
| | | | - Elaine M Reno
- Department of Emergency Medicine, University of Colorado, Aurora, CO
| | - Sierra J Casper
- Mammoth Hospital, San Diego Fire-Rescue Department, San Diego, CA
| | | | - David A Klein
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, San Diego, CA
| | - Sarah M Schlein
- Larner College of Medicine, University of Vermont, Burlington, VT
| | - Linda E Keyes
- Department of Emergency Medicine, University of Colorado, Aurora, CO
| |
Collapse
|
3
|
Duarte da Silva K, Vargas-Ferreira F, Dâmaso Bertoldi A, Celso Lopes Fernandes de Barros F, Fernando Demarco F, Britto Correa M, Beatriz Chaves Tarquinio S. Oral mucosal lesions in pregnant women: A population-based study. Oral Dis 2021; 28:1891-1900. [PMID: 34333827 DOI: 10.1111/odi.13981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/29/2021] [Accepted: 07/13/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate the prevalence of oral mucosal lesions (OML) and oral self-examination and their associated factors among pregnant women from the 2015 Pelotas Birth Cohort Study, Brazil. METHODS Pregnant women who would deliver babies in 2015 were included in the antenatal study. Data related to demographic, socio-economic and behavioural conditions were collected using questionnaires. Participants were also clinically assessed for oral health outcomes. The outcomes were the presence of OMLs and oral self-examination. Size, location, time of onset and symptomatology of the lesions were collected. Descriptive and bivariate analysis, and Poisson regression were performed. p-Value <0.05 was set to indicate statistical significance. RESULTS Data from 2481 pregnant women were analysed. Four hundred and nine (16.5%) had at least one OML. The most prevalent lesions were exostosis (80/16.6%), coated tongue (70/14.5%) and benign oral brownish pigmentation (68/14.1%). Non-white skin colour was associated with a higher prevalence of OMLs (PR 1.3; 95% CI 1.1-1.6), while daily use of dental floss was positively associated with the prevalence of oral self-examination (PR 1.4; 95% CI 1.2; 1.5). CONCLUSIONS Almost 20% of pregnant women presented OML, which were more prevalent in non-white individuals. Women with better oral care were more likely to perform oral self-examination.
Collapse
Affiliation(s)
| | - Fabiana Vargas-Ferreira
- Department of Social and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Flávio Fernando Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | | |
Collapse
|
4
|
Fakheran O, Saied-Moallemi Z, Khademi A, Sahebkar A. Oral Health-Related Quality of Life during Pregnancy: A Systematic Review. Curr Pharm Des 2021; 26:4014-4021. [PMID: 32445450 DOI: 10.2174/1381612826666200523171639] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 04/14/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE High prevalence of Dental and periodontal problems during the gestation period may have a negative effect on oral health-related quality of life (OHRQoL) in pregnant women. This systematic review aimed to perform a quality assessment and provide a critical overview of the current research available on OHRQoL in pregnant women. METHODS For this systemic review, all original and peer-reviewed human studies, which investigated OHRQoL of women during pregnancy or post- partum period, were searched. Studies were screened in title and abstract for the relevance by two independent investigators. Methodological quality was assessed using modified items recommended by the Newcastle-Ottawa Scale for observational studies. RESULTS All of the eight included studies had a cross-sectional design. Meta-analysis was not possible due to the heterogeneity of key aspects among the included studies. Thus, the data from the studies were evaluated qualitatively. The overall risk of bias of the included studies was low. CONCLUSION The main conclusion of this review is that the presence of signs and symptoms of dental and gingival disease negatively affects the self-perception of OHRQoL in pregnant women. The most affected domains of OHRQoL in pregnant women were related to mental and psychological discomfort, followed by physical and functional problems.
Collapse
Affiliation(s)
- Omid Fakheran
- Dental Research Center, Department of Periodontics, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Saied-Moallemi
- Department of Oral Health and Community Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbasali Khademi
- Department of Endodontics and Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | |
Collapse
|
5
|
Costantinides F, Vettori E, Conte M, Tonni I, Nicolin V, Ricci G, Di Lenarda R. Pregnancy, oral health and dental education: an overview on the northeast of Italy. J Perinat Med 2020; 48:829-835. [PMID: 32710719 DOI: 10.1515/jpm-2020-0032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/02/2020] [Indexed: 02/07/2023]
Abstract
Objectives To evaluate the level of knowledge of pregnant women and puerpers about oral health and prevention during and after gestation. Methods One hundred women aged 18-49 years (mean age 33±6 years) were included in this cross-sectional study. An anonymous questionnaire with 24 items related to oral health has been administered during or just after pregnancy. Firstly, answers have been analyzed on the full population and then subdividing the sample on the base of age ranges (G1: 18-25 years, G2: 26-35 years and G3: >35 years) and number of pregnancies (FP: first pregnancy; SP: second or more pregnancies). Parametric tests have been chosen for the statistical analysis; in particular, Anova test for independent samples was used to evaluate differences of baseline demographic characteristics among subgroups G1, G2, G3 while chi-square test was used for FP and SP subgroups. Anova test was also used to intercept differences on answers given to the questionnaire among G1, G2 and G3 group; for FP and SP group was used t-test. Results Level of information and knowledge of the full sample was medium-low and no significant differences have been observed between groups regarding awareness of the own level of the oral hygiene and knowledge of oral care. Conclusions Results of this survey underline the high necessity of educational programs regarding oral care in pregnant and puerpers women. A strict collaboration between medical figures (dentist, oral hygienist, gynecologist and obstetric) is strongly encouraged to spread the concept of prevention.
Collapse
Affiliation(s)
| | - Erica Vettori
- School of Dental Sciences, University of Trieste, Trieste, Italy
| | - Martina Conte
- School of Dental Sciences, University of Trieste, Trieste, Italy
| | - Ingrid Tonni
- School of Dental Sciences, University of Brescia, Brescia, Italy
| | - Vanessa Nicolin
- School of Dental Sciences, University of Trieste, Trieste, Italy
| | - Giuseppe Ricci
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.,Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | | |
Collapse
|
6
|
Oral varicose veins: Clinical features and its association with medical conditions. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2020. [DOI: 10.1016/j.ajoms.2019.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
7
|
Carbon Monoxide and Cyanide Poisoning in the Burned Pregnant Patient: An Indication for Hyperbaric Oxygen Therapy. Ann Plast Surg 2019; 80:S106-S112. [PMID: 29461288 DOI: 10.1097/sap.0000000000001351] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Carbon monoxide (CO) is a small molecule poison released as a product of incomplete combustion. Carbon monoxide binds hemoglobin, reducing oxygen delivery. This effect is exacerbated in the burned pregnant patient by fetal hemoglobin that binds CO 2.5- to 3-fold stronger than maternal hemoglobin. With no signature clinical symptom, diagnosis depends on patient injury history, elevated carboxyhemoglobin levels, and alterations in mental status. The standard of care for treatment of CO intoxication is 100% normobaric oxygen, which decreases the half-life of CO in the bloodstream from 5 hours to 1 hour. Hyperbaric oxygen (HBO2) is a useful adjunct to rapidly reduce the half-life of CO to 20 minutes and the incidence of delayed neurologic sequelae. Because of the slow disassociation of CO from hemoglobin in the fetus, there is a far stronger indication for HBO2 in the burned pregnant patient than in other burn patient populations.Cyanide intoxication is often a comorbid disease with CO in inhalation injury from an enclosed fire, but may be the predominant toxin. It acts synergistically with CO to effectively lower the lethal doses of both cyanide and CO. Diagnosis is best made in the presence of high lactate levels, carboxyhemoglobin concentrations greater than 10%, injury history of smoke inhalation from an enclosed fire, and alterations in consciousness. While treatment with hydroxocobalamin is the standard of care and has the effect of reducing concomitant CO toxicity, data indicate cyanide may also be displaced by HBO2.Carbon monoxide and cyanide poisoning presents potential complications impacting care. This review addresses the mechanism of action, presentation, diagnosis, and treatment of CO and cyanide poisonings in the burned pregnant patient and the use of HBO2 therapy.
Collapse
|
8
|
Hans M, Hans VM, Kahlon N, Ramavat PKR, Gupta U, Das A. Oral health awareness and practices in pregnant females: A hospital-based observational study. J Indian Soc Periodontol 2019; 23:264-268. [PMID: 31143008 PMCID: PMC6519098 DOI: 10.4103/jisp.jisp_372_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: The aim of this study was to assess the oral health awareness, methods adopted to maintain hygiene, prevalent myths regarding oral health in pregnancy, and importance of oral health during pregnancy, to help formulate oral health program for pregnant females in partaking hospital. Materials and Methods: A total of 225 pregnant females participated in the study. After complete demographic assessment of participants, a questionnaire was provided to them. Questionnaire included simple multiple choice questions on how they maintained oral hygiene, their oral health status, visit to the dentist, and barriers in seeking treatment. This was followed by a questionnaire regarding common myths and understanding of the importance of oral health during pregnancy which had three choices: true, false, and do not know. The results were expressed in percentages, and one sample t-test for percentages was applied where ever required. Results: Majority of participants self-reported some form of oral health problems with bleeding gums as a chief complaint leading the survey. Around half of the participants had never visited a dentist, and an abundant number of pregnant females reported safety concerns for developing the child as a reason for not taking any treatment during pregnancy. A highly significant number of participants were unaware of the importance of oral health during pregnancy and believed in age-old myths. Conclusion: The oral health care still remains on the backseat in care provided to pregnant female. A complete overhaul of understanding through individual, family, and community counseling is required to spread awareness.
Collapse
Affiliation(s)
- Mayank Hans
- Department of Dentistry, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Veenu Madaan Hans
- Department of Dentistry, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Namrata Kahlon
- Department of Physiology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | | | - Usha Gupta
- Department of Obstetrics and Gynecology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Asim Das
- Department of Physiology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| |
Collapse
|
9
|
Lee S, Czuzoj-Shulman N, Abenhaim HA. Behcet's disease and pregnancy: obstetrical and neonatal outcomes in a population-based cohort of 12 million births. J Perinat Med 2019; 47:381-387. [PMID: 30763266 DOI: 10.1515/jpm-2018-0161] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 01/09/2019] [Indexed: 01/29/2023]
Abstract
Background Behcet's disease (BD) is a rare, multi-systemic inflammatory disorder for which only limited and contradictory data exists in the context of pregnancy. Our objective was to estimate the prevalence of BD in pregnancy and to evaluate maternal and fetal outcomes associated with pregnant women living with BD. Methods Using the 1999-2013 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample from the United States, we performed a population-based retrospective cohort study consisting of pregnancies that occurred during this time period. ICD-9 codes were used to identify delivery admissions to women with or without BD. Multivariate logistic regression was used to estimate the adjusted effects of BD on maternal and fetal outcomes. Results Among the 12,592,676 pregnancies in our cohort, 144 were to women with BD, for an overall prevalence of 1.14 cases/100,000 births between 1999 and 2013. Over the study period, the prevalence of BD rose from 0.5 to 2.4/100,000 births. Women with BD demonstrated a two-fold greater frequency of non-delivery hospital admissions during pregnancy, and were more likely to be Caucasian, have private medical insurance, be of the upper income quartiles, and deliver at an urban teaching hospital. Women with BD were at greater risk for preterm labor and postpartum venous thromboembolism, while their newborns were more likely to be born premature. Conclusion BD-associated pregnancies are increasing in prevalence and are associated with a greater risk for adverse maternal and fetal outcomes in pregnancy. Appropriate thromboprophylaxis during pregnancy should be considered given the increased risk for venous thromboembolism.
Collapse
Affiliation(s)
- Seohyuk Lee
- Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Nicholas Czuzoj-Shulman
- Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec, Canada
| | - Haim Arie Abenhaim
- Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.,Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec, Canada
| |
Collapse
|
10
|
Bett JVS, Batistella EÂ, Melo G, Munhoz EDA, Silva CAB, Guerra ENDS, Porporatti AL, De Luca Canto G. Prevalence of oral mucosal disorders during pregnancy: A systematic review and meta‐analysis. J Oral Pathol Med 2019; 48:270-277. [PMID: 30673134 DOI: 10.1111/jop.12831] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 12/11/2018] [Accepted: 01/20/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the prevalence of oral mucosal disorders during pregnancy. METHODS Observational studies were selected by two reviewers in a two-phase process. Search strategies were applied at CINAHL, LILACS, LIVIVO, PubMed, Scopus, Web of Science, Google Scholar, OpenGrey, and ProQuest. The risk of bias was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data. Synthesis of results was calculated by the software R Statistics version 3.5.1 (The R Foundation, Vienna, Austria). Confidence in cumulative evidence was assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. RESULTS Fifteen studies met the eligibility criteria and were selected for qualitative synthesis and meta-analysis, of which 5935 participants were enrolled. The overall prevalence of oral mucosal disorders was 11.8%. Gingival hyperplasia (17.1%), morsicatio buccarum (10%), oral candidiasis (4.4%), pyogenic granuloma (3%), and benign migratory glossitis (2.8%) were the most prevalent lesions. The overall risk of bias was considered moderate, and the quality of evidence was very low. CONCLUSION Disorders of the oral mucosa were present in approximately 1 out of 10 pregnant women. Gingival hyperplasia was the most prevalent lesion. Further studies should apply homogeneous methodology to improve the quality of evidence.
Collapse
Affiliation(s)
- João Victor Silva Bett
- Brazilian Centre for Evidence‐Based ResearchFederal University of Santa Catarina (UFSC) Florianópolis Santa Catarina Brazil
| | - Elis Ângela Batistella
- Brazilian Centre for Evidence‐Based ResearchFederal University of Santa Catarina (UFSC) Florianópolis Santa Catarina Brazil
| | - Gilberto Melo
- Brazilian Centre for Evidence‐Based ResearchFederal University of Santa Catarina (UFSC) Florianópolis Santa Catarina Brazil
| | - Etiene de Andrade Munhoz
- Department of DentistryFederal University of Santa Catarina (UFSC) Florianópolis Santa Catarina Brazil
| | | | | | - André Luís Porporatti
- Brazilian Centre for Evidence‐Based ResearchFederal University of Santa Catarina (UFSC) Florianópolis Santa Catarina Brazil
- Department of DentistryFederal University of Santa Catarina (UFSC) Florianópolis Santa Catarina Brazil
| | - Graziela De Luca Canto
- Brazilian Centre for Evidence‐Based ResearchFederal University of Santa Catarina (UFSC) Florianópolis Santa Catarina Brazil
- Department of DentistryFederal University of Santa Catarina (UFSC) Florianópolis Santa Catarina Brazil
| |
Collapse
|
11
|
Motosko CC, Bieber AK, Pomeranz MK, Stein JA, Martires KJ. Physiologic changes of pregnancy: A review of the literature. Int J Womens Dermatol 2017; 3:219-224. [PMID: 29234716 PMCID: PMC5715231 DOI: 10.1016/j.ijwd.2017.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 09/17/2017] [Accepted: 09/17/2017] [Indexed: 01/25/2023] Open
Abstract
Throughout pregnancy, the body undergoes a variety of physiologic changes. The cutaneous findings can be most noticeable and often worrisome to both physicians and patients. Obstetricians and dermatologists must be able to differentiate between changes that are benign and those that may be pathologic. Most physicians recognize benign changes that are commonly described in literature such as hyperpigmentation, melasma, striae gravidarum, and telogen effluvium; however, they may be unaware of changes that tend to be less frequently discussed. This comprehensive review provides a broad overview of the physiologic cutaneous changes that occur during pregnancy as described in the literature over the past 10 years.
Collapse
Affiliation(s)
- Catherine C Motosko
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY
| | - Amy Kalowitz Bieber
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY
| | - Miriam Keltz Pomeranz
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY
| | - Jennifer A Stein
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY
| | - Kathryn J Martires
- Department of Dermatology, Stanford University School of Medicine, Redwood City, CA
| |
Collapse
|
12
|
Kroumpouzos G. Advances in obstetric dermatology: A better understanding of skin disease in pregnancy. Clin Dermatol 2016; 34:311-3. [PMID: 27265067 DOI: 10.1016/j.clindermatol.2016.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- George Kroumpouzos
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
| |
Collapse
|