Perinatal Oral Care

The perinatal period is defined as the period around the time of birth, beginning with the completion of the 20-28th week of gestation and ending 1-4 weeks after birth. Infant oral care starts in this period.

Many expectant mothers are unaware of the implications of poor oral health for themselves, their pregnancy and/or their unborn child. There is a crucial role in the overall health and well being of pregnant women. It is also essential for the health and well being of their newborn children. Many women do not seek dental care during their pregnancy, and those that do often confront unwillingness by dentists to provide care. Periodontal disease has been linked to preterm labor. The results of initial trials suggest the periodontal therapy can decrease the risk of prematurity.

Elective dental care should be timed to occur during the second trimester and first half of the third trimester. The first trimester is the period of organogenesis when the fetus is highly susceptible to environmental influences.

Dental emergencies should be dealt with as they arise throughout the entire pregnancy. The management of pain and elimination of infection that otherwise could result in increased stress for the mother and endangerment of the fetus are hallmarks of emergent dental care.

Once the child is born, mothers with poor oral health and high levels of cariogenic oral bacteria have a higher risk of infecting their children at an early age through vertical transmission (kissing, using same utensils for food).

The goal is to decrease the number of cariogenic bacteria in the expectant mother so the colonization of Mutans Streptococci (MS) in the infant is delayed. Chewing gum containing 1 gm of xylitol (6-10 sticks a day, 5 minutes per stick) is proven to decrease the levels of MS in mothers and decreasing the levels in their children. It has even showed a decrease in the level of bacteria in infants since it decreases the bacterial transmission from the mother (vertical transmission).