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[edit] Dental Care Before, During & After Pregnancy

What you need to do…

Before pregnancy If you are planning to have a baby, be sure to schedule a dental check-up and schedule appointments to have all your dental treatment completed. It is much wiser to have dental treatment before pregnancy and render yourself “dentally fit” than to delay necessary treatment for another 9 months or beyond.

Even if you have no problems, it is always good to have a dentist check on your brushing habits and give tips on how to improve your oral hygiene.

Don’t use excuses like having “no time” or being “too busy”. After all, when your baby arrives, you will be even busier!

During Pregnancy If you are unlucky enough to develop pain or swelling in or around your mouth while you are pregnant, do not delay treatment. Get the treatment done because anything that improves your health will be good for your baby as well. Do let your dentist know about your pregnancy and any medications you may be on. If your condition requires it, antibiotics will be prescribed to fight the infection. Complete the course. The antibiotic that you should definitely avoid while pregnant is tetracycline, as it will affect the development of your baby’s teeth.

If you should need procedures like root canal treatment that involves X-rays, rest assured that dental x-rays are of very low dosage and specifically targeted to your teeth. If you have a badly decayed tooth, remember that it is like a reservoir of bacteria in your mouth. Get it out. It is safe to have extractions carried out in a normal pregnancy.

There is no reason to avoid routine dental care during your pregnancy. Indeed, you should schedule at least one dental visit during your pregnancy. According to Dr. Asha’s, dental surgeon at Smile Makers Dental Clinic, most women find it comfortable to do this during the 4th to 6th months. A thorough dental cleaning done during this time, will help to minimise the possibility of developing pregnancy gingivitis and give you the comfort of knowing that your oral health will not contribute to the possibility of having a premature baby.

Apart from gum disease there are other issues that can be addressed e.g. morning sickness. Some women may find their teeth too sensitive to brush when they have frequent bouts of vomiting. At times like this, rinse the mouth with plenty of water, brush with bland, non-foaming toothpaste or even just a wet toothbrush. To help reduce sensitivity caused by the wearing out of tooth enamel by acid from the stomach, a calcium cream (Tooth Mousse®) can be applied on the teeth surfaces.

Remember to keep to a healthy, balanced diet. You might develop sweet cravings during pregnancy. However, keep in mind that the more frequently you snack, the greater the chance of developing tooth decay.

Your baby’s first teeth begin to develop as early as 6 weeks into your pregnancy. Healthy diets containing dairy products (e.g. milk, cheese, yoghurt) are good sources of essential minerals and are good for your baby’s developing teeth and bones. Supplements may only be needed if you cannot tolerate certain foods or have dietary restrictions.

After pregnancy Practise excellent oral hygiene even while recovering. If you have been delaying dental treatment, schedule a visit and get it done. Problems in your mouth rarely go away, they often get worse.

Make conscientious dental care part of your life. You will discover that your good habits and good attitudes to oral health will be picked up by your growing child.


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[edit] Carpal Tunnel Syndrome In Pregnancy

Ever wonder why your hands feel painful and numb in the middle of the night or in the early morning, disturbing the peaceful sleep you so desperately need? You may be suffering from Carpal Tunnel Syndrome (CTS). Up to one in 4 pregnant women develop carpal tunnel syndrome during pregnancy or after delivery.

What is Carpal Tunnel Syndrome (CTS)?

CTS is due to compression of the median nerve at the wrist as it passes from the forearm into the hand.

The median nerve is a major nerve that provides sensation to the thumb, index, middle and half of the ring fingers and controls the muscles at the base of the thumb.

At the wrist, the median nerve passes through a tunnel, surrounded by bones on 3 sides and is covered over by a thick unyielding fibrous sheet called the flexor retinaculum.

During pregnancy, as the body swells from water retention, the median nerve becomes compressed in this enclosed space. After delivery, as the body readjusts back to the pre-pregnant state, the retained water is lost and symptoms of CTS will improve.

However breastfeeding can prolong the compression or cause CTS symptoms in mothers who did not have them during pregnancy. This is because of hormonal changes brought on by breastfeeding.

How do I know if I have CTS?

Symptoms of CTS usually occur in the later half of pregnancy, when water retention is at its maximum. Less commonly, it can start during the early part of pregnancy or with the onset of breastfeeding.

Numbness, pain and tingling may occur in one or both hands. This often happens in the early morning, waking you up and preventing you from getting enough sleep. Shaking the hands may temporarily relieve the numbness.

The pain may appear to radiate from the hand, up the elbow and to the shoulder. In severe cases, symptoms can occur throughout the day, leading to clumsiness with the hands, weakness and dropping things.

What can I do about it?

Your doctor will be able to assess the severity of the condition and exclude other causes of your symptoms. Wearing a wrist splint or brace when you sleep can be extremely helpful. This holds the wrist in a position where the carpal tunnel is at its maximum size, thereby decreasing compression on the median nerve. Vitamin B6 supplements may be helpful in some patients.

It is important to avoid repetitive hand movements at work or in the house that may precipitate the symptoms. Similarly, when working on the keyboard, it is important to avoid excessive bending of the wrist and to take frequent breaks away, from the keyboard.

With these measures, most patients with CTS symptoms will improve and recover after the birth of the baby. However it may take as long as one year to do so. Majority of patients with CTS that developed during pregnancy do not need surgery.

Occasionally when symptoms are severe, when they do not improve with treatment as described above or when symptoms start in the early part of pregnancy, surgery may be required to prevent further damage to the nerve.

Surgery for CTS

This is usually done through a longitudinal incision in the base of the palm to release the tough flexor retinaculum. Newer techniques use the endoscope to cut the flexor retinaculum through a small incision in the wrist, along a natural skin crease.

The advantage of this endoscopic method is that the incision is smaller and located away from the thick sensitive palmar skin, making the resulting scar less prominent and less painful. There is less downtime as patients get back the use of their hands earlier. Better patient satisfaction has been reported both in short and long term studies done.

Hand pain and numbness due to CTS in pregnancy is common. It can be easily treated and will resolve after delivery; although some cases may require surgery. Get treated early. Don’t suffer in silence, and do not lose sleep over it!

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[edit] You’re pregnant! 10 early signs…

By Sujatha Rajagopal

The signs of pregnancy, especially for first-timers, may not be as obvious as you think. Some women may be sure they are pregnant only to find that test after test turns out negative. Others may not know that they have conceived, thinking that queasy stomach is just flatulence or indigestion.

Most pregnancy symptoms are universal. But as every woman is unique, the only way to be 100% sure is to consult your doctor. Below, we list some common early signs of pregnancy in the hope that you will not worry in silence, or spend unnecessarily on home pregnancy tests.

1. A missed period This is usually the first hint that a woman is pregnant. Once pregnancy is established, the body starts producing the human chorionic gonadotropin (hCG) hormone which interrupts and stops the menstrual cycle. However, it is normal to have a missed period if you do not have a regular menstrual cycle or suffer from excessive stress. You may also miss your period if you’ve just stopped taking the oral contraceptive pill. Or, it may simply be because your hormones are a little offset that month.

2. Morning sickness (nausea) Although it is called morning sickness, nausea can occur at any time of the day. This is the next most obvious sign of pregnancy, though some women may have no nauseous feelings throughout their pregnancy. Those who do experience morning sickness may just feel queasy while others may actually vomit. Thankfully this usually happens only between the second and eighth week of conception, and goes away after the first trimester (12 weeks). Some women may, however, have a severe form of morning sickness called hyperemesis gravidarum that can lead to dehydration and other problems. Check immediately with your doctor if your nausea or vomiting is uncontrollable.

3. Tender or swollen breasts If even the slightest brush against your breasts makes you go ouch, or if your breasts suddenly seem larger, you could have conceived! You may also notice your areola (the dark area around your nipples) darkening. The veins in your breasts may become more visible and the tiny bumps (called Montgomery’s tubercles) around your areola may increase in number. These changes are happening because your body is preparing for breastfeeding once baby is born. Although it may not be evident till after the first trimester, some women report experiencing this as early as the first month of pregnancy.

4. Constantly feeling tired or sleepy Pregnancy causes your body to go through significant metabolic changes because it needs to begin adjusting to the needs of a growing baby. This in turn, can cause extreme fatigue that may last a few months.

5. Weight gain There is a high chance that as your belly swells, so will you, although some naturally small-framed women may be in their ninth month and still look lithe. These extra pounds may make you feel uncomfortable, but do console yourself that this fat store is for the benefit of your baby’s growth, as well as for breastfeeding. 6. Backache This is to be expected due to the redistribution of weight in your body. A growing baby in the womb will also put stress on your back. However, it is highly advisable to get your pregnancy confirmed as an aching back is also a symptom of other medical conditions. 7. Unexplained food cravings If you’re experiencing some of the above signs and also begin to suddenly yearn for sour foods, foods you normally don’t eat or odd combinations of foods, you know that you need to see your doctor quickly. Food cravings can change from pregnancy to pregnancy, so just because you liked chicken with peanut butter when you had your first child does not mean you will again when pregnant for the second time. Take it easy however, as heartburn during pregnancy can be worsened by indulging some of your cravings.

8. Excessive saliva Some pregnant women may produce more saliva than is usual when they are pregnant, to the extent that they will have to spit constantly into a tissue or cup. This is especially evident if they are also experiencing nausea. The more severe form of this condition is called ptyalism. Experts think that there are a variety of reasons for so much drool, including heartburn and hormonal changes. Brushing your teeth more often or sucking on hard sweets may help.

9. Frequent urination and/or constipation A growing baby tends to squash the bladder, and because of this pressure, you may feel like going to the toilet more often. Moving your bowels, however, may be difficult. Experts think this is because the hormones produced during pregnancy tend to relax the intestines, making them less efficient.

10. Blocked nose It is also common to experience a stuffy nose in early pregnancy. This is because pregnancy hormones also affect mucus production in the nose and sinuses.

If all these changes are taking place in your body, it is a strong sign that there is life growing inside of you. So go ahead and purchase a home pregnancy testing kit or take a deep breath and make a doctor’s appointment. A home pregnancy test can be accurate as early as 10 to 14 days after fertilisation. It works by measuring the level of hCG in your urine. Blood tests may be accurate as early as eight to 10 days after fertilization. If you experience the signs but the test comes out negative, you might want to try again a week later. While highly reliable, these tests are not full-proof. To be certain, your doctor may order an ultrasound.

When to be wary… When you are pregnant, it is possible to have light spotting (pale spots of blood on your panties), although your period would have stopped. Spotting can occur when the embryo attaches itself to the uterus lining (a process called implantation). This bleeding will be scanty and will not follow the pattern of a period. Cramping, similar to the pain you get during your period, is also common and will gradually lessen sometime during the second trimester when the uterus is better-supported by the pelvis. Many women who experience light bleeding and cramping early in their pregnancy go into delivery without any complications.

It is important to note that heavy bleeding could be a sign of trouble. Bleeding or cramping that is more severe than that of a normal period could indicate a miscarriage. Sharp cramping on one side of the lower abdomen may indicate an ectopic pregnancy (fertilized egg implants outside instead of inside the uterus).

When pregnant, the slightest unusual sign is enough to warrant grave concern, so do check with your doctor even if all you need is professional reassurance. Follow his or her instructions carefully…and enjoy your pregnancy as much as you can!


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[edit] May 2008 -- Contributions and Wikipedia policy

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