HJAR May/Jun 2025

40 MAY / JUN 2025 I  HEALTHCARE JOURNAL OF ARKANSAS ORAL HEALTH toothpaste is key. For women who experience morning sickness with recurrent vomiting, the use of antacids or rinsing with baking soda is good for neutralizing the acidity in the oral cavity. For women, obstetricians and gynecolo- gists are the most visited healthcare profes- sionals. 18 These specialists therefore have unique opportunities to advise their patients on the importance of good oral health and recommend that their patients visit their den- tists regularly. Interprofessional collabora- tion between physicians and dentists is es- pecially important in treating the expectant mother. It is essential to emphasize the as- sociation of periodontal disease during preg- nancy, especially when it is uncontrolled and untreated. The risks are even more serious when the expectant mother also has uncon- trolled diabetes or heart disease. Better outcomes for maternal mortality, maternal health, and oral health in our state can improve by addressing key risk factors. Increased training and education, better health policy, and improved collaboration between the medical and dental professions will help make future mothers healthier and ensure the health of their unborn children. n REFERENCES 1. America’s Health Rankings. “Maternal Mortality in Arkansas.” Accessed March 2025. https://www. americashealthrankings.org/explore/measures/ maternal_mortality_c/AR 2. National Center for Health Statistics, National Vital Statistics System. “Maternal deaths and mortality rates: Each state, the District of Columbia, United States, 2018-2022.” Accessed March 2025. https://www.cdc.gov/nchs/maternal- mortality/mmr-2018-2022-state-data.pdf 3. Arkansas State Governor. “Sanders Signs Executive Order to Support Moms, Protect Babies, and Improve Maternal Health.” Press release, March 6, 2024. https://governor.arkansas. gov/news_post/sanders-signs-executive-order- to-support-moms-protect-babies-and-improve- maternal-health/ 4. Farrar, T. “Arkansas Governor unveils $45 million maternal health act to improve care statewide.” KATV, Feb. 6, 2025. https://katv.com/news/local/ arkansas-governor-unveils-45-million-maternal- health-act-to-improve-care-statewide-sarah- huckabee-sanders-healthy-moms-healthy- babies-act-committee-on-maternal-health-missy- irvin-aaron-pilkington 5. Hartnett, E.; Haber, J.; Krainovich-Miller, B.; et al. “Oral Health in Pregnancy.” Journal of Obstettric, Gynecologic, and Neonatal Nursing vol. 45, no. 4 (Jul-Aug 2016): 565-73. DOI: 10.1016/j. jogn.2016.04.005 6. The American College of Obstetricians and Gynecologists. “Oral Health Care During Pregnancy and Through the Lifespan.” Committee Opinion, no. 569 (August 2013, reaffirmed 2002). https://www.acog.org/clinical/clinical-guidance/ committee-opinion/articles/2013/08/oral-health- care-during-pregnancy-and-through-the-lifespan 7. Vamos, C.A.; Cayama, M.R.; Mahony, H.; et al. “Oral health during pregnancy: an analysis of interprofessional guideline awareness and practice behaviors among prenatal and oral health providers.” BMC Pregnancy Childbirth vol. 23, no. 721 (Oct. 11, 2023). https://doi.org/10.1186/s12884- 023-06032-3 8. Saadaoui, M.; Singh, P.; Khodor, S.A. “Oral microbiome and pregnancy: A bidirectional relationship. Journal of Reproductive Immunology vol. 145, art. 103293 (June 2021). https:// www.sciencedirect.com/science/article/pii/ S0165037821000231 9. Rathee, M.; Jain, P. “Gingivitis.” StatPearls, last updated March 27, 2023. https://www.ncbi.nlm.nih . gov/books/NBK557422/ 10. Nannan, M.; Xiaoping, L.; Ying, J. “Periodontal disease in pregnancy and adverse pregnancy outcomes: Progress in related mechanisms and management strategies.” Frontiers in Medicine vol. 9 (Oct. 24, 2022). https://doi.org/10.3389/ fmed.2022.963956 11. Kierce, E.; Rainchuso, L. “Adverse Birth Outcomes and Oral Health.” Dimensions of Dental Hygiend vol. 15, no. 9 (September 2017): 44-47-49. https://dimensionsofdentalhygiene.com/article/ adverse-birth-outcomes-and-oral-health/ 12. Păunică, I.; Giurgiu, M.; Dumitriu, A.S.; et al. “The Bidirectional Relationship between Periodontal Disease and Diabetes Mellitus-A Review.” Diagnostics (Basel) vol. 13, no. 4 (Feb. 11, 2023): 681. DOI: 10.3390/diagnostics13040681 13. Figueiredo, M.G.O.P.; Takita, S.Y.; Dourado, B.M.R.; et al. “Periodontal disease: Repercussions in pregnant woman and newborn health-A cohort study.” PLoS One vol. 14, no. 11 (Nov. 22, 2019): e0225036. DOI: 10.1371/journal.pone.0225036 14. Rainchuso, L. “Improving oral health outcomes from pregnancy through infancy.” Journal of Dental Hygiene vol. 87, no. 6 (December 2013): 330-5. PMID: 24357561 15. Shutter, M.C.; Akhondi, H. “Tetracycline.” StatPearls, last updated June 5, 2023. https:// www.ncbi.nlm.nih.gov/books/NBK549905/ 16. American Dental Association. “Nitrous Oxide Safety for Pregnant Dental Staff and Patients.” Accessed March 2025. https://www.ada.org/ resources/practice/practice-management/ nitrous-oxide-safety-for-pregnant-dental-staff- and-patients 17. Marcin, A.; Robinson, D. “What Are the Best Sleeping Positions When You’re Pregnant?” Healthline, medically reviewed by Carolyn Kay, MD (updated April 13, 2023). https://www.healthline . com/health/pregnancy/sleeping-positions-in- pregnancy#side-sleeping\ 18. Hall, K.S.; Patton, E.W.; Crissman, H.P.; et al. “A population-based study of US women's preferred versus usual sources of reproductive health care.” American Journal of Obstetrics and Gynecology vol. 213, no. 3 (September 2015): 352.e1-14. DOI: 10.1016/j.ajog.2015.04.025 and untreated periodontal disease. There is a misconception that dental treat- ment is unsafe during pregnancy, howev- er this is outdated and untrue. Good oral health is essential during pregnancy. Despite governmental and professional guidelines backed by science-based evidence, both medical and dental healthcare profession- als undertreat women during pregnancy. 14 In fact, delaying necessary dental treatment can lead to complications, resulting in risks for the mother and her unborn child. Ensuring optimal oral health during preg- nancy involves regular visits and obtaining dental treatment when needed. The safest or most ideal time for recommended dental treatment is the second trimester. However, if infection is present in the first or third tri- mester, treatment should not be delayed. If dental infection exists, antibiotics such as amoxicillin, penicillin, erythromycin, and clindamycin are all safe, given that there is no history of allergy. Tetracycline should be avoided, however, as it causes staining of the teeth for the unborn child. 15 Local anesthetic, such as lidocaine or prilocaine, is completely safe when given properly and in correct dos- age. Nitrous oxide is not recommended for inhalation for relaxation during pregnancy. Studies are inconclusive and controversial for nitrous oxide use during pregnancy, so caution is needed due to potential harm to the developing fetus. 16 Positioning of the expectant mother is im- portant, as the supine position can be un- comfortable. It compresses the vena cava and aorta and can result in postural hypoten- sion. Lying moderately on either side with a hip elevated in a tilted position for shorter appointments is recommended. 17 These po- sition alterations are most beneficial in the third trimester. Healthcare professionals should advise expectant mothers to practice extra good oral health habits during these months of preg- nancy. Advising routine exams and cleanings, limiting sugary foods, and using fluoridated