Gestione e prevenzione dei pazienti con fragilità sistemiche – Modulo 5: Salute orale in gravidanza

OBJECTIVES During pregnancy, the body undergoes numerous hormonal, metabolic, and immune changes that can affect the health of the oral cavity, requiring special attention by health professionals in the dental field as well. The objective of this paper is to provide the clinician, whether dental surgeon or dental hygienist, with the necessary indications in order to correctly frame the pregnant patient, decide as a team on her rational care and set up an appropriate prevention program for both mother and unborn child. MATERIALS AND METHODS To write this article, a narrative review of the most recent scientific literature was performed by consulting the databases of PubMed, Cochrane and the Italian Ministry of Health. After a brief epidemiological introduction reviewing the latest European and Italian data on pregnant women, the focus was on risk factors, analyzing the close correlation between oral health and systemic changes during gestation. We then focused on the proper dental management of the patient during the three trimesters of pregnancy, finally delving into the dental management of the perinatal period, specifically the first 1,000 days after conception. RESULTS AND CONCLUSIONS From the literature review conducted, the main oral manifestations that can be found during pregnancy are: carious lesions, periodontal diseases, pregnancy epulis, dental erosion, salivary changes and oral infections. Through this paper, dental professionals will have the opportunity to understand how essential it is to educate patients about the importance of oral health during pregnancy, promoting regular visits, supporting a balanced diet, providing advice for the breastfeeding period and giving useful recommendations for oral hygiene at home. The National Prevention Plan (PNP) 2020-2025, published by the Ministry of Health, emphasizes how preventive interventions carried out in the first thousand days of life determine positive health outcomes for both the mother and the unborn child. It is important to encourage parents to adopt conscious behaviors for maintaining adequate oral hygiene of the child, promoting correct eating habits and a healthy lifestyle. In fact, during pregnancy, the pregnant woman is more inclined to change risky behaviours that can negatively affect the health of the unborn child. Finally, aware of the fact that many drugs commonly used in dentistry can be safely prescribed during pregnancy, it is always necessary to clarify which active ingredients require special precautions, underlining the importance of collaboration with gynecologists and obstetricians. CLINICAL SIGNIFICANCE For all professionals involved, both dentists and dental hygienists, it is essential to be adequately trained about the most suitable and up-to-date procedures for managing patients during pregnancy and the first 1000 days. Even in the dental management of this category of patients, it is essential to set up a multidisciplinary plan, supported by an evidence-based approach, in order to guarantee safe and quality dental care for both mother and child.