what increases during pregnancy and contributes to severity?
Prevotella intermedia
how many pregnant women are affected by pregnancy gingivitis?
25-100% in the 2nd to 8th month
t/f at parturition, inflammation from pregnancy gingivitis will continue if treated
FALSE! if UNtreated
t/f inflammatory mediators may adversely affect the placenta and fetus
true (not clearly defined)
perio disease in a pregnant patient significantly ________ the risk for low birth weight and preterm birth.
INCREASE
t/f there is no convincing evidence that tx of perio disease will REDUCE the risk of low birth weight or preterm birth
true
t/f treatment of perio disease will help reduce the risk of low birth weight or preterm birth
true
pregnancy tumor occurs in what percentage of pregnant patients?
9.6%
what is a pyogenic granuloma?
pregnancy tumor
when is a pyogenic granuloma most frequently occurring?
during the 2nd trimester
where is the pyogenic granuloma going to occur?
interdental papilla in the max anterior
describe a pyogenic granuloma
bright red to blue
bleeds easily
usually painless
t/f your teeth become soft when you are pregnant
FALSE! the diet changes
t/f there is tooth calcium lost during pregnancy from the mom
FALSE! there is NOT
t/f dietary changes may result in increased caries
true
vomiting with morning sickness and xerostomia are both ________ factors for enamel _________
contributing
demineralization
t/f prenatal fluoride supplementation is recommended by AAPD or AAP
FALSE! is NOT recommended
doxycycline is contraindicated during pregnancy because why?
think tetracycline. intrinsic staining of decidious teeth
when meds are necessary during pregnancy, ________ dosages may need to be administered during critical pregnancy
INCREASED
what is the local anes of choice for a pregnant patient?
Lidocaine
t/f a vasoconstrictor keeps anesthetic localized
true (without it, it can go throughout the bloodstream)
how do drugs cross the placenta?
by simple diffusion
what category of anes can be used for pregnant women?
CATEGORY B ONLY (lido and prilocaine)
t/f lido and prilocaine can be administered up to max dosage, using aspiration, and slow administration
true
which category has the GREATES risk?
category X
MOST drugs used in dentistry is category ___
B
what is the major malformation in the first trimester that is a teratogenic effect?
Major malformation during organogenesis
what drug is available that can cause teratogenic affects for placental transfer?
FREE, UNBOUND drugs
what does prilocane affect?
methemoglobinemia in predisposed individuals
when is ASA unsafe to use on a pregnant woman?
3rd trimester ONLY
what causes premature closure of patent ductus arteriosis when taken in the third trimester?
ASA
t/f acidic drugs will enter the milk easily
FALSE, will not enter easily
what can be secreted in breast milk in concentrations similar to levels in maternal plasma (same effect for mother as for infant)
metronidiazole
when during pregnancy is the IDEAL time for elective care?
2nd trimester
what is important for OHE of a pregnant woman? 5
need for effective biofilm removal
possible gingival changes
myth of tooth loss and removal of enamel
benefits of xylitol
caries prevention
during pregnancy, there is an increased pressure (compression) on the _______ and ______ _____ ______ causing reduced ____ _____ in the supine position
aorta and inferior vena cava
cardiac output
how should a patient be placed that is pregnant in the dental chair?
place on LEFT side at an angle of 15 degrees
when should you most definitely minimize the use of diagnostic radiography?
1st trimester
when should OHE for pregnancy begin?
EARLY
what can someone rinse with after vomiting?
sodium bicarbonate solution
the menopausal patient will have a decrease in what production?
ESTROGEN
t/f there is a risk of cardiovascular disease, osteoporosis, and alzheimers increase with a menopausal woman
true
what is the severe thinning and weakening of normal bone called?
osteoporosis
what is ERT?
estrogen replacement therapy
what reduces the risk of hip fracture-greatest long-term users but may be lost after hormone is stopped?
ERT
waht are nonhormonal oral bisphosphonates? 3
fosamax
acteonel
boniva
what are nonhormonal selective estrogen receptor modulators?
raloxifene (Evista)
what is HRT?
hormonal replacement therapy
ADEs of HRT are the formation of _____ _____ (from HRT and raloxifene), ______ BP (less common), smokers lead to _______, long term estrogen/progestin = increased risk for ____ _____, low risk dev of ______ (oral bisphosphonates), and increased risk for _____.
blood clots
increased
stroke
breast cancer
ONJ
dementia
t/f xerostomia and dental caries are oral changes seen in menopause
true
what is the decreased unstimulated and stimulated submandibular and sublingual salivary flow compared with premenopausal women?
xerostomia
why do dental caries increase with menopausal women due to increased age?
because of unfavorable microbial and xerostomic conditions
what is BMS?
burning mouth syndrome
is burning mouth syndrome an oral consideration for menopausal women?
yes
what are 3 (systomatic triad) clinical features of BMS?
oral mucosal pain
dysguesia
xerostomia
what is a treatment option for BMS?
long term therapy of clonazepam and capsaicin
what is it called when there is a presence of metallic or medicinal taste in the mouth?
hypoguesia
what is exacerbated during menopause because of reduction in saliva production and atrophic gingivitis?
taste alterations
what is the tx for taste alterations?
it can't be reversed
perio disease, osteoporosis in the jaw, and tooth loss are associated with oral changes of what?
menopause
the role of osteoporosis in _____ _____ ____ is unclear in menopause
clinical attachment loss
what might be useful for identifying postmenopausal women for low BMD (bone mineral density) or osteoporosis?
a pano
tooth loss risk is lower in women with ____
HRT
what is the most common cause of death among postmenopausal women?
coronary artery disease
cardiovascular disease is an _______ between inflammation and the formation of _________
association
atherosclerosis
what can a menopausal woman take for management of osteoporosis?
bisphosphonate therapy
what should you do if a postmenopausal woman is taking bisphosphonate?
be alert for complications
ask about osteonecrosis
t/f for menopause and osteoporosis, there is a tendency for pyogenic granuloma
