The significance of oral health is common knowledge among health professionals; however, addressing it exclusively while providing preconception or antenatal care to women is seen as a rarity. An international research found out that “only 44% of the women surveyed said that their doctor talked to them about oral health during their pregnancy visits.” In Pakistan, the numbers are expected to be much lower. Another research discovered that only 62% gynecologists suggested dental visits to their pregnant patients; 69% did not provide any information on oral health issues; and 54% did not investigate about the oral health issues whatsoever. Dental management of pregnant patients requires the following of exclusive, set standards. It is of utmost vitality to be aware of the many stages of pregnancy, its impact on the mother’s general and oral health, and the effect that any treatment (dental or otherwise) will have on the child or/and the mother.
While doing my house job, I witnessed a 34 yr old, pregnant patient who was reporting to the Oral Surgery’s OPD with excruciating pain in her lower left jaw. On investigating we found it out to be a case of impacted third molar, with a superimposed infection. It was distressing to learn that the woman had been in this condition for the past two weeks, and was denied treatment by a ‘dentist’ in her locality. Reason being her pregnancy, the “dentist” asked her to “wait for the pain to pass”, as treatment during pregnancy was best avoided. On further questioning, it became evident that previously she was seeing a quack, who was clearly not equipped with the required knowledge to deal with pregnant patients. In the Diagnosis department it was typical to witness pregnant women that reported with bleeding/swollen gums, or loosening tooth/teeth. Their previous doctors presented them with general causes, and prescribed over the counter painkillers. Almost none of the women was informed of the correlation their oral health had with their pregnancy. Most of these women belonged to low socioeconomic status, and were visiting unprofessional practitioners, which were most likely to be quacks.
Apart from knowing when to delay or avoid the dental management of a pregnant patient, it is equally important to be educated enough to know when to provide the required treatment.
Pregnant women must be informed of the changes that their oral cavity will experience during the antenatal period, just like any other part of their body. This piece of knowledge is crucial for the mother-to-be so that due attention is paid to oral health, and in case any dental issue arises she must know better to seek professional help immediately. This is the step where the decision of an expectant mother holds much more importance than a regular individual.
There are certain gold standards when it comes to the dental management of pregnant women. It is imperative for the dental practitioner to be aware of the range of teratogenic doses, drugs, and dental materials, and the recommended chair and patient positioning. Dental treatments and radiographs that pose risk to the antenatal situation must be delayed. Apart from knowing when to delay or avoid, it is equally important to be educated enough to know when to provide the required treatment. Dental practitioners that are not skilled and knowledgeable enough are unwilling to treat pregnant patients because of liability concerns, while others proceed with their usual procedures without considering the altered physiologic state of a pregnant woman
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In Pakistan, where quacks outnumber qualified dental professionals, choosing the right dentist for help can be somewhat of a challenge. These quacks learn a few techniques by observing other dental surgeons while working for them, or inherit the knowledge from a family member in the quackery business. In this digital age of ease and simplistic solutions, locating genuine helpers, and verifying legit care providers has been made achievable by Sindh Health Care Commission in collaboration with AuthentikTM. AuthentikTM is a smartphone application, available on the Playstore. The installation process is simple, and so is using its anti-quackery feature which verifies the genuineness of your doctor.
-Dr. Hira M. Khan