Why is dental treatment of the gravid patient regarded with caution? When is the appropriate time for care--be it emergent or routine--in the gravid patient?

There are myths surrounding pregnancy and the oral cavity, such as, "having a baby causes your gums to swell and your teeth to weaken," or "I don't need to see a dentist, there's nothing wrong with my teeth" or "with each child say bye to a tooth or two." All these myths are just that, myths. During pregnancy, women may experience pregnancy gingivitis or may suffer from pre-existing periodontal disease. The myth of tooth loss during pregnancy, according to the ADA (American Dental Association), has "no histological, chemical or radiographic evidence to support [it]". The biggest myth or misconception is that dental care is unnecessary during pregnancy, and until problems arise, some gravid women draw back from seeking dental treatment. Also, professionals sometimes shy away from care of the gravid patient for reasons associated with teratogenicity and fetotoxicity. Teratogenic effects take place from three to eight weeks after conception, and fetotoxicity can occur at the latter end of the initial trimester on to delivery, according to Donaldson and Goodchild, authors of Pregnancy, breast-feeding and drugs used in dentistry in JADA's (The Journal of the American Dental Association) August, 2012 issue. This article includes reasons dental treatment is regarded with caution; therefore, appropriate timing of dental care and suggested clinical recommendations as they relate to the pregnant patient are reviewed.

Dental treatment of the pregnant patient: literature review and guidelines for the practicing clinician.

The purpose of this review article is to assist the practicing clinician by categorizing and packaging useful clinical information into a format that will assist with the treatment of pregnant patients. Our goal is to offer the scientific foundations that lead to current practice guidelines, specifically those that are of particular relevance to today's dental professional.

Biologics in oral medicine: principles of use and practical considerations.

Oral Diseases (2012) 18, 525-536 Biologic therapies are relatively innovative treatments aimed at modulating lymphocytes or cytokines. There are currently three broad classes of biologic therapies, tumour necrosis factor-alpha inhibitors, lymphocyte modulators and interleukin inhibitors; all are increasingly used in the treatment of inflammatory immune-mediated conditions, and several have potential applications in oral medicine. Guidelines for their use in licensed indications (e.g. rheumatoid arthritis, psoriasis, inflammatory bowel disease) include recommendations and guidance for patient selection and subsequent monitoring with discussion of potential adverse effects. An understanding of these is important when managing patients receiving biologic therapy for systemic disease, and compliance is essential in any use in oral medicine. Key aspects of current guidance are presented with particular emphasis on their relevance to clinicians working within oral and maxillofacial medicine/pathology/surgery and in specialist practice.