Tasos
Tsagkaris GYNAECOLOGIST
Professor of University Athens
The pregnancy is as we
know a situation where the feminine organism exists during the
40 weeks of gestation a lot of changes. Almost all the bodies
and the systems of organism present small or bigger anatomic,
functional, biochemical and
endocrines
modifications. Thus, between the other changes exist and those
that present interest from dental opinion. It is known in the
dentistry that exists in pregnancy generalised hypertrophy
bleeding of gums. These seldom absorbed by alone them and most
times should they are removed surgery.
Pregnant
must be informed for observation right and regular oral
hygiene.
Usual dental small-intervention (e.g. fillings etc) can become
with local callousness without problem in any week of gestation.
The long-lasting educations and treatments should be attempted
afterwards the first quarter of gestation or even later.
Antibiotic treatment is imposed it is granted in cases of
abscesses and in patients with artificial valves of heart etc.
The dentist will be supposed to know that the most sensitive
quarter of pregnancy with regard to in the issuing of medicines,
report in radiation etc and the likely side effects that can
result in the foetus (teratogenesis, relatives abnormalities
etc) or in pregnant (expulsions) it is the first quarter,
because at the duration of first quarter takes place and is
completed the organogenesis of foetus. Thus the dentists as the
remainder doctors of all specialities will be supposed to keep
in mind that medicines she is allowed and who she is prohibited
them grant in pregnant.
Most medicines go through the placenta with mechanism of passive
diffusion. But they go through with active or facilitated
transport. The degree of penetrability of medicine depends from
the size placenta, his molecular weight, his protein connection
with albumins of term and the degree of affinity etc other
factor that has relation with the degree of concentration of
medicine in the mother and the foetus is their absorption from
the maternal organism. The changes in the peptic system pregnant
as the delayed gastric empty, the increase of pH of gastric
liquids, the nausea, the vomiting modify the absorption of
medicines that is granted per os (from the mouth). The doctor
should know that while most medicines are sure for the adult,
not happens always for the foetus. Thus have happened bleedings
in the foetus because issuing of anticoagulants in the mother,
appearance of leukaemia in children where their mothers got
radiation etc
The dentist in the at day dental practice uses usually safe
medicines. Good it would be however he is aware for likely side
effects that: Salicilines (aspirin) it should they are avoided
because they make haemorrhagic disposal in the nursling,
extension of gestation etc, while more sure pain-killers are
fenacetin , the acitaminofen and paracetamol. From the
antibiotics it should they are avoided the aminogycines,
tetracycline (pigmentations teeth and hypoplasia adamantine),
the sulphonamides etc Sure antibiotics in the gestation are
considered penicillin, the erythromycin and in second phase
cefalosporine. Use of local anaesthetics (e.g. xylokain) is
considered sure. More extensive report in contraindications and
side effects of medicines in the gestation does not interest the
dentistry and will not become in this article.
Another question that likely occupies the doctor is it radiates
pregnant, because the radiation irrelevantly applied for
therapeutic or diagnostic aims can harm the foetus. The
embryonic age constitutes the most sensitive period in radiation
of human life. The bigger sensitivity presents the Central
Nervous System, the eye. Enough frequent question that concerns
in the consequences for the foetus, when
pregnant
it is submitted in diagnostic radiological examinations. The
harmful effect of radiation depends from the age of pregnancy
and the dose of radioactivity in rads. Is reported explicit
damage in the b quarter with issuing of 50 rads radiation, while
in the first quarter is reported damage in the shaping of bodies
with dose 10-40 rads, as other abnormalities with issuing 4
rads. The simple radiograph of thorax in any case has dose 300
milirads. The radiographs that are even used in the dental
practice, as simple radiographs teeth, should be considered sure
and no damaged. However for reasons psychological and avoid
concern in the pregnant it will be supposed they are postponed
for 2nd or 3rd quarter of gestation.
