The relationship between maternal periodontitis and adverse pregnancy outcomes has been investigated in many studies in recent years. Periodontal disease is common during pregnancy and although it has been linked to adverse pregnancy outcomes such as low birthweight and pre-eclampsia, systematic reviews attempting to clarify these associations have reached mixed conclusions. Daalderop and colleagues1 performed a recent synthesis of findings from systematic reviews (“overview of reviews”) assessing the link between periodontal disease and a range of adverse pregnancy outcomes, focusing on interpretation of findings from high-quality reviews.The systematic review research protocol was peer-reviewed and published2 and had been registered with the PROSPERO international prospective register of systematic reviews (PROSPERO: CRD42015030132). Registration with PROSPERO helps to avoid research duplication and reduces opportunity for reporting bias by allowing a comparison of the completed review with what was planned in the protocol.Six online literature databases were electronically searched through November 2016; references and citations of eligible papers were manually searched. Systematic literature reviews comparing pregnancy outcomes among women with and without periodontal disease were considered eligible for inclusion. The primary health outcomes assessed were maternal mortality, preterm birth, and perinatal mortality; secondary outcomes included miscarriage, premature rupture of membranes, pre-eclampsia, and low birthweight. Two reviewers performed data abstraction and assessed the risk of bias of individual systematic reviews.Twenty-three systematic reviews (each including between 3 and 45 studies) were included in the overview. None of the systematic reviews reported the association between periodontal disease and maternal or perinatal mortality. Systematic reviews with the lowest risk of bias consistently demonstrated positive associations between periodontal disease and risk of preterm birth (relative risk [RR], 1.6; 95% confidence interval [CI], 1.3 to 2.0; 17 studies, N=6,741), low birthweight (RR, 1.7; 95% CI, 1.3 to 2.1; 10 studies, N=5,693), pre-eclampsia (odds ratio [OR], 2.2; 95% CI, 1.4 to 3.4; 15 studies, N=5,111), and preterm low birthweight (RR 3.4; 95% CI, 1.3 to 8.8; 4 studies, N=2,263). In terms of limitations, the authors noted that as several primary studies did not adjust for confounding, meta-analyses may have overestimated the strength of the associations being studied. Because of “substantial overlap” in the included primary studies, researchers were unable to aggregate results across reviews. They concluded, “Consistent evidence from systematic reviews with low risk of bias indicates that pregnant women with periodontal disease are at increased risk of developing preeclampsia and delivering a preterm and/or [low birthweight] baby,” and that “Research is needed to develop novel preventive and treatment strategies.
”ReferencesDaalderop LA, Wieland BV, Tomsin K, et al. Periodontal Disease and Pregnancy Outcomes: Overview of Systematic Reviews. JDR Clinical & Translational Research 2017;Online ahead of print.Vanterpool SF, Tomsin K, Reyes L, et al. Risk of adverse pregnancy outcomes in women with periodontal disease and the effectiveness of interventions in decreasing this risk: protocol for systematic overview of systematic reviews. Syst Rev 2016;5:16.Prepared by: Center for Scientific Information, ADA Science Institute
Several medications are available to help create more relaxed, comfortable dental visits. Some drugs control pain, some help you relax, and others put you into a deep sleep during dental treatment. You and your dentist can discuss a number of factors when deciding which drugs to use for your treatment. The type of procedure, your overall health, history of allergies and your anxiety level are considered when determining which approach is best for your particular case.
Your dentist might recommend that your child be administered anesthesia or sedation to relax them in order to safely complete some dental procedures.
Local anesthesia is a type of anesthetic used to prevent pain in a specific area of your mouth during treatment by blocking the nerves that sense or transmit pain, which numbs mouth tissues. Your dentist may apply a topical anesthetic to numb an area in preparation for administering an injectable local anesthetic. Topical anesthetics also may be used to soothe painful mouth sores. Injectable anesthetics may be used in such procedures as filling cavities, preparing teeth for crowns or treating gum disease.
Depending on the procedure, you may need a pain reliever after treatment. Analgesics are used to relieve pain and can be broken into two groups: non-narcotic and narcotic. Non-narcotic are the most commonly used drugs for relief of toothache or pain following dental treatment. They include aspirin, acetaminophen and non-steroidal, anti-inflammatory drugs such as ibuprofen. Narcotic analgesics, such as opioids, act on the central nervous system to relieve pain. They are used for more severe pain.
Be sure to talk with your dentist about how to properly secure and dispose of any unused, unwanted or expired medications, especially if there are any children in the household. Also, take the time to talk with your children about the dangers of using prescription drugs for non-medical purposes.
For some dental visits, your dentist may use a sedative, which can induce moderate sedation. Sedatives can be administered before or during dental procedures. Sedation methods include inhalation (using nitrous oxide), oral (by taking a pill) and intravenous (by injection). More complex treatments may require drugs that can induce deep sedation, reducing consciousness in order to relieve both pain and anxiety. On occasion, general anesthesia can be used, in which drugs cause a temporary loss of consciousness.
Dentists use the pain and anxiety control techniques mentioned above to treat millions of patients safely every year. Even so, taking any medication involves a certain amount of risk. That's why the ADA urges you to take an active role in your oral health care. This means understanding the risks and benefits involved in dental treatment, so that you and your dentist can make the best decisions about the treatment that is right for you. Working together, you and your dentist can choose the appropriate steps to make your dental visit as safe and comfortable as possible, and to help you keep a healthy smile.
Even though we’ve been brushing and flossing our teeth for years and years, many of us are surprised to learn that we’re not doing it properly. Case in point: Did you know that proper brushing takes at least two minutes? Most adults do not come close to brushing that long.
These four steps are the best and easiest ways to help you remember how to care for your mouth, teeth and gums:
Not blessed with naturally perfect teeth? No worries. Leading cosmetic dentists with the American Academy of Cosmetic Dentistry say that more patients are now requesting cosmetic services that embrace naturalism over idealism.
Whereas people used to want the most perfectly shaped teeth possible, more and more customers, especially those in the Generation Y demographic, are requesting cosmetic treatments that subtly enhance their smiles. An AACD survey shows that one in two Americans are most likely to remember a person’s smile more than other features after a first meeting.
While teeth whitening remains the number one requested cosmetic dental service, veneers are the second most popular procedure because porcelain veneer technology allows changes look organic, not contrived.
“There’s a misperception that cosmetic dentists only make teeth look great,” says Dr. Betsy Bakeman, an AACD Accredited Fellow with a dental practice in Grand Rapids, Mich. “Most often, when teeth break down over time, we look to rebuild them to bring back their functionality. Our number one goal is smile preservation, followed by making renewed teeth appear as natural as possible.”
And teeth take a beating over time. Those with significant wear and tear have to address both functional and cosmetic dental issues.
Cosmetic dentists are experts at assessing how a person’s teeth work in conjunction with their lips and overall face shape. There are mathematical elements and artistic nuances that work together to create the perfect harmony of a fantastic smile.
In the case of celebrities, temporary veneers allow plenty of time for fans and media to react to an enhanced smile.
“If no one comments negatively - or if the changes go unnoticed - the celebrity is happy with the results,” explains Dr. Wells. It works just the same for his regular patients too when test driving smiles with family and friends. Over the test period time, patients have the opportunity to make adjustments to their new smile before it’s permanent.
While veneers are the top-of-the-line option for the most natural looking teeth, they are expensive, and are not the only solution used by cosmetic dentists. “The advanced technology found in today’s dentures and crowns can be just as good an option for patients,” explains Bakeman.
Top Tooth Problems Corrected with Cosmetic Dentistry:
Problem: Tooth color can change throughout one’s life, generally yellowing with age and time.
Solution: In office whitening treatments work for most patients. But for those whose teeth have excessive discoloration, veneers have the ability to mask color and become any shade the patient desires.
Problem: Sometimes, people are born with small teeth. Others may have shorter teeth because they’ve worn down over time.
Solution: Veneers can be used to make teeth appear larger. However, if tooth structure has been lost due to decay or trauma, a porcelain crown that covers the entire tooth can reduce the risk for future problems.
Problem: Wear and tear can make teeth appear shorter, flatter or rough along the edges. Generally younger teeth have round edges.
Solution: Veneers can give a youthful smiles by giving a natural, youthful appearance.
ALIGNMENT / SPACING
Problem: Tooth gaps, misaligned and crooked teeth are common problems cosmetic dentists regularly address.
Solution: Very bad alignment is most often corrected with orthodontic treatment. Veneers can fix minor alignment or spacing issues. Many times, both treatments are used to achieve the most dramatic results.
Mouth breathing can have dire consequences when it is left untreated in children. Some of the problems that are encountered in untreated cases are abnormal facial and dental development. Some of the abnormal development issues may include gummy smiles, crooked teeth, long and narrow faces. One of the main causes of mouth breathing is severe allergies that cause upper airway blockage predisposing the person to mouth breathe. In addition, this can cause oxygen concentrations to be very low which will predispose to high blood pressure, heart problems and sleep apnea.
Mouth breathing is extremely dangerous because the upper and lower jaws will not grow together and they develop independent of each other. Normally your tongue is pressed against the palate and it helps with development of the jaw by expanding the upper arch. However, in mouth breathing this process no longer occurs and now the jaw arches get severely constricted and teeth get crowded . Eventually develop a forward head posture in order to breathe better. This means the head will sit too far forward of the body. Forward head posture will force the shoulders to roll forward which will cause neck and back problems.
This abnormal tongue position will cause swallowing and speech problems. If left untreated it will be the source of jaw and TMJ problems. Dentists should check for swollen tonsils or adenoids and refer patients to an ear-nose and throat specialist if these abnormalities are discovered. As dentists we can widen the palate with expansion appliances this will open and widen the sinuses and open nasal airways. With proper intervention should see an improvement in energy level, growth and health improvements. It is extremely important to find out early in development of a child if they are suffering from allergies because mouth breathing is a matter of health.