![\"Dentist](\"http:\/\/www.greenspandental.com\/en\/wp-content\/uploads\/2013\/05\/ddpb026skihai_008_rep.jpg\")
<\/a><\/p>\nIn pain because of infected teeth, Luatany Caseres, 34, then a factory worker in Durham, N.C., was desperate to see a dentist.<\/p>\n
At an emergency dental clinic that treats the uninsured, a receptionist told Ms. Caseres that the schedule was full. When she returned a second time in still greater pain, the receptionist told her, \u201cI can\u2019t get you seen.\u201d On her third visit, Ms. Caseres\u2019 swollen cheek bulged as if a lollipop were stuck there. Still, she was told that she would have to wait.<\/p>\n
Why? \u201cIt was because I was pregnant,\u201d Ms. Caseres said. She was in her second trimester, and the receptionist said she needed a doctor\u2019s note before the office would consider treating her.<\/p>\n
Dental treatment during pregnancy<\/h1>\n
Finally, Ms. Caseres found Dr. George Soung, a fourth-year dental student who was trained in a new prenatal program at the University of North Carolina at Chapel Hill. By that time, two premolars had broken to the gums, exposing nerves. Her pain was so acute she was bedridden, taking sleeping pills and painkillers.<\/p>\n
Dr. Soung extracted Ms. Caseres\u2019s two abscessed teeth at once, because a far-gone infection could spread to the jaw or even throughout the body. \u201cThis wasn\u2019t something that popped up a week ago,\u201d he said. \u201cNobody would treat her.\u201d<\/p>\n
Too many pregnant women like Ms. Caseres are not getting timely\u00a0dental care<\/a>, experts say. There are plenty of reasons: Some dentists are reluctant to treat pregnant patients, in no small part because of\u00a0outdated thinking<\/a>. OB-GYNs too often fail to check for oral problems and to refer women to dentists. And many women fail to seek out oral care or mistakenly think it\u2019s dangerous, even though\u00a0pregnancy<\/a>\u00a0itself may lead to\u00a0gum inflammation<\/a>.<\/p>\n The problem among dentists is decades old. Many \u201cwere taught in dental school that you can\u2019t treat a pregnant woman,\u201d said Dr. Renee Samelson, a professor of obstetrics and gynecology at Albany Medical Center, who was an editor of the first guidelines on oral health in pregnancy, which were published by the New York State Department of Health and advised on two more sets of guidelines. Dentists simply erred on the side of caution, she added: \u201cThere was no evidence of harm.\u201d<\/p>\n Today, although dental treatment during pregnancy is considered beneficial, some dentists still hesitate to see pregnant women, because they fear litigation or harm to the fetus, or their knowledge of appropriate care lags behind the current evidence. One 2009 survey of 351 obstetrician gynecologists nationwide found 77 percent reported their patients had been\u201cdeclined dental services because of pregnancy.\u201d<\/a><\/p>\n \u201cA lot of dentists still fear treating pregnant women, and think, \u2018What happens if I have to do an\u00a0X-ray<\/a>?\u2019 or \u2018What happens if I give\u00a0antibiotics<\/a>\u00a0or local\u00a0anesthesia<\/a>?\u2019\u201d said Dr. Howard Minkoff, the chairman of obstetrics and gynecology at Maimonides Medical Center in Brooklyn. \u201cNone of these are legitimate reasons not to provide appropriate care for women.\u201d<\/p>\n Since 2006, a few\u00a0state<\/a>\u00a0organizations and\u00a0dental<\/a>\u00a0associations have issued practice guidelines declaring that dental care is\u00a0safe<\/a>\u00a0and effective at any stage of pregnancy, including diagnostic X-rays, cavity restorations and root canals.<\/p>\n OB-GYNs should check for\u00a0bleeding gums<\/a>\u00a0or oral infection and refer a patient to a dentist if her last visit was longer than six months ago, according to\u00a0the first national consensus statement on dental care during pregnancy, published in September by the National Maternal and Child Oral Health Resource Center at Georgetown University.<\/p>\n The statement advised dentists to provide emergency care in any trimester. OB-GYNs can be consulted, as necessary, if a pregnant patient is diabetic or hypertensive, or if general anesthesia is required.<\/p>\n Dr. Sally Cram, a periodontist in Washington, and a spokeswoman for the American Dental Association, said dentists she knows provide complete care. She added, \u201cIn the last 10 to 15 years, a lot of dentists have promoted the importance of pregnant women having regular cleanings.\u201d<\/p>\n Delaying oral care can have serious consequences.\u00a0Gingivitis<\/a>, or gum inflammation, affects\u00a060 to 75 percent of pregnant women, and left unchecked, it can become periodontal disease. Untreated periodontal disease can lead to tooth loss. And a mother with active\u00a0tooth decay<\/a>\u00a0can spread cavity-causing bacteria to her child through saliva, perpetuating poor oral health.<\/p>\n Pregnant women with dental pain also may self-medicate inappropriately. In a March 2001 letter to the New York State Department of Health, a doctor described a patient who was unable to get urgent care for her abscessed teeth in upstate New York. She took such excessive doses of Tylenol that she developed acute liver failure, and the fetus died. That prompted the drafting of new state guidelines.<\/p>\n Still, some OB-GYNs do not address oral health during visits with pregnant women, an oversight that angers some dentists. \u201cIf you take your dog to the vet, the first thing they do is look in their mouth,\u201d said Dr. Nancy Newhouse, a periodontist in Independence, Mo., and the president of the American Academy of Periodontology.<\/p>\n Many pregnant women simply don\u2019t seek dental care, perhaps out of misplaced fear or neglect. Some states offer dental\u00a0Medicaid<\/a>\u00a0benefits to low-income expectant mothers, for example, but utilization rates are low.Only 28 percent of eligible women\u00a0<\/a>seek and receive services in Oklahoma. In New York, 41 percent of pregnant women on Medicaid visited dentists in 2010, up from 30 percent in 2006.<\/p>\n Such a multifactorial problem requires a coordinated effort between OB-GYNs and dentists to reach mothers-to-be, said Dr. Stefanie Russell, a dentist and an epidemiologist at New York University. But for women with low-risk pregnancies, she said, \u201cthings will change when women realize dental care is their right during pregnancy.\u201d<\/p>\n Deborah Acosta contributed reporting.<\/em><\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" FAMILY MAY 6, 2013 Obstacles for Pregnant Women Seeking Dental Care By CATHERINE SAINT LOUIS In pain because of infected teeth, Luatany Caseres, 34, then a [\u2026]<\/span><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[47,13,14,52],"tags":[],"class_list":["post-1066","post","type-post","status-publish","format-standard","hentry","category-breastfeeding","category-israel-dentist","category-jerusalem-dentist","category-oral-hygiene"],"_links":{"self":[{"href":"https:\/\/greenspandental.com\/en\/wp-json\/wp\/v2\/posts\/1066","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/greenspandental.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/greenspandental.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/greenspandental.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/greenspandental.com\/en\/wp-json\/wp\/v2\/comments?post=1066"}],"version-history":[{"count":6,"href":"https:\/\/greenspandental.com\/en\/wp-json\/wp\/v2\/posts\/1066\/revisions"}],"predecessor-version":[{"id":2229,"href":"https:\/\/greenspandental.com\/en\/wp-json\/wp\/v2\/posts\/1066\/revisions\/2229"}],"wp:attachment":[{"href":"https:\/\/greenspandental.com\/en\/wp-json\/wp\/v2\/media?parent=1066"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/greenspandental.com\/en\/wp-json\/wp\/v2\/categories?post=1066"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/greenspandental.com\/en\/wp-json\/wp\/v2\/tags?post=1066"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}Dentists fear offering\u00a0dental treatment during pregnancy<\/strong><\/h2>\n
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