最好在怀孕前进行彻底的牙科检查,消除隐患（为什么孕前检查要注意检查牙齿）

许多女性朋友对怀孕的理解是：吃叶酸，穿防辐射服，屯儿童服。

经常忽略一个大问题，那就是口腔检查。

许多准妈妈在怀孕期间患有智齿炎症、牙龈肿胀和牙齿神经痛。当他们最需要营养和休息时，他们睡不着觉。准爸爸也参与其中。

最好在怀孕前进行彻底的牙科检查，消除隐患。 但是怀孕期间牙痛怎么办？能拍片吗？能打麻药吗？能治牙吗？

2013年，美国妇产科医生协会向妇产科医生发布了关于孕妇口腔健康的指导意见，并于2015年进行了修订。

有一些有价值的意见。我翻译了这份报告的建议供你参考。附上英文原文和全文链接。

建议

• 与所有患者讨论口腔健康问题，包括怀孕和产后。

• 通知女性患者口腔保健可促进全身健康，减少母婴致龋菌的传播。

• 第一次产前检查应安排患者进行口腔检查。

• 为了帮助患者消除担忧，在怀孕期间进行口腔预防、诊断和治疗，包括拍摄x光片（在腹部和甲状腺保护的前提下）和局部麻醉（使用利多卡因加肾或不加肾）是安全的。

• 告诉女性，当口腔需要立即治疗时，如拔牙、根管治疗、未经治疗的龋齿（使用汞或树脂）可以在怀孕的任何阶段进行治疗。延迟治疗会带来更复杂的问题。

• 当患者出现妊娠反应引起的呕吐或妊娠晚期消化道反流时，使用抗酸药物或用苏打水漱口（一茶匙苏打溶解在一杯水中）可以帮助中和消化道中酸对牙齿的腐蚀。

• 要注意病人的牙科保险，以便将她转诊到合适的牙科诊所，注意每个州的医疗保险政策是不同的。

• 与附近的牙医建立良好的工作关系，就像与其他临床医生合作一样，通过电话或转诊表将患者转诊到牙科诊所。

• 提倡扩大孕前、孕中、孕后妇女牙科保险报销范围。怀孕是女性经历的一个特殊时期，在此期间应该得到更多的牙科保健支持。

• 加强患者定期口腔保健意识，包括少吃甜食和饮料，每天刷牙两次，使用氟牙膏，每天使用牙线，每年看两次牙医。

Recommendations

Discuss oral health with all patients, including those who are pregnant or in the postpartum period.

Advise women that oral health care improves a woman’s general health through her lifespan and may also reduce the transmission of potentially caries-producing oral bacteria from mothers to their infants.

Conduct an oral health assessment during the first prenatal visit.

Reassure patients that prevention, diagnosis, and treatment oral conditions, including dental X-rays (with shielding of the abdomen and thyroid) and local anesthesia (lidocaine with or without epinephrine), are safe during pregnancy.

Inform women that conditions that require immediate treatment, such as extractions, root canals, and restoration(amalgam or composite) of untreated caries, may be managed at any time during pregnancy. Delaying treatment may result in more complex problems.

For patients with vomiting secondary to morning sickness, hyperemesis gravidarum, or gastric reflux during late pregnancy, the use of antacids or rinsing with a baking soda solution( ie, 1 teaspoon of baking soda dissolved in 1 cup of water)may help neutralize the associated acid.

Be aware of patients’ health coverage for dental services during pregnancy so that referrals to the appropriate dental provider can be made. Note that each state’s Medicaid coverage for oral health may vary considerably.

Develop a working relationship with local dentists. Refer patients for oral health care with a written note or call, as would be the practice with referrals to any medical specialist.

Advocate for broader oral health coverage of women before, during, and after pregnancy. Pregnancy is a unique time when women may gain access to oral health coverage.

Reinforce routine oral health maintenance, such as limiting sugary foods and drinks, brushing twice a day with fluoridated toothpaste, flossing ocne daily, and dental visits twice a year.

全文链接：
http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Oral-Health-Care-During-Pregnancy-and-Through-the-Lifespan