Safe Maternal and Newborn Care in Relation to Oral Health
RCSEd Communications Team
This year the WHO are promoting safe maternal and newborn care, which the Dental Faculty of the Royal College of Surgeons of Edinburgh fully support. Oral health should always be a priority, however below are some conditions pertinent to mothers and newborns.
PREGNANCY
It is important that patients see a dentist during pregnancy, however complex treatment is generally avoided during the first trimester (first 3 months) except in an emergency situation. Similarly, dental x-rays are avoided to eliminate any risk to the foetus (developing baby), though the amount of radiation from a dental x-ray is very low. Pregnancy can impact on oral health in mothers who have severe morning sickness, which can result in enamel erosion (tooth wear) and subsequent sensitivity of teeth. This is generally not a long-term problem unless a patient has multiple pregnancies with ongoing morning sickness. It is important that any concern over tooth wear or sensitivity during pregnancy is discussed with a dentist. Oral health is affected during pregnancy due to hormonal changes, and commonly gingivitis (gum inflammation) can develop. Pregnancy gingivitis can result in excessive gum bleeding, and sometimes a localised swelling between teeth known as an epulis, which can be concerning to pregnant and new mothers. However, these conditions are generally reversible, though reassurance from a dental care professional is required with advice on good tooth brushing techniques. An association has been demonstrated between periodontal disease (gum disease with loss of supporting bone), pre-eclampsia, pre-term and low weight babies, though it should be emphasised that causation has yet to be identified. Illnesses in pregnancy and prematurity can sometimes affect the enamel formation of children’s primary (first) teeth - this may require treatment to avoid dental decay.
Further information on periodontal conditions of pregnancy can be accessed:
Periodontal Disease:
Guidelines for Oral Health Professionals
Guidelines for Non-Dental Health Professionals
NEWBORN
In terms of dental health of the newborn, very rarely babies can be born with lower front teeth known as natal teeth. These teeth can cause problems during breast feeding, or discomfort to the baby if they are very mobile. If the tooth is very mobile, or it is interfering with breastfeeding, it is important that a dentist assesses the baby to advise if extraction is indicated to avoid the baby swallowing or inhaling it. Other oral health concerns in newborn babies can be congenital cleft lip and or palate (babies born when their lips or palates have not closed and there is a cleft) which occurs in about 1 in 700 live births in the UK. At birth a cleft lip will be obvious, and a baby with cleft palate will normally be identified in antenatal scanning. If not identified early on feeding will be an issue, and it is therefore important that this is assessed at birth by looking in newborn babies’ mouths. In the UK there is plenty of medical support for this condition, and outcomes are good. The eruption of the first teeth is variable, but most babies have their lower incisors at around 6 months. It is important that parents/carers start to clean babies’ teeth as soon as they erupt with a soft toothbrush and children’s-strength fluoridated toothpaste to reduce the risk of future gum disease and dental decay. It is recommended that all babies visit a dentist by the age of one year to promote a lifetime of good oral health.
Further information can be accessed:
Cleft Lip and Palate:
Oral Health and Prevention of Dental Disease:
A Practical Guide to Children's Teeth
Written by Claire Morgan, Consultant in Restorative Dentistry and Dental Representative to RCSEd Patient Safety Group
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