CDA Essentials 2017 • Volume 4 • Issue 7

27 Issue 7 | 2017 | S upporting Y our P ractice Dr. Reza Nouri Dr. Nouri is a certified specialist in pediatric dentistry practising in the Greater Vancouver area. Prenatal Considerations Dr. Reza Nouri encourages general dentists to start caring for pediatric patients at the prenatal stage. As he explains, oral health advice for expectant mothers should cover: • Good nutrition and its effect on teeth: The early stages of tooth formation start about five weeks in utero . • Premature birth and low-birth weight: Pregnancy gingivitis and periodontitis are linked to premature birth and low-birth weight, so prevention is very important. A chlorhexidine mouthwash can be used during pregnancy to prevent gingivitis and periodontal disease. • Dental complications in premature babies: Those include hypoplastic formation of the primary molars, and even sometimes that of the first permanent molars. Parents and clinicians should be vigilant. • Fluoride use which can include: - Systemic fluoride: Dr. Nouri does not recommend fluoride supplements for expectant mothers. "Although fluoride crosses the placental barrier, it doesn’t help prevent caries in the child in the future.” - Topical fluoride: Dr. Nouri recommends the application of topical fluoride (PreviDent® 5000 Plus or Clinpro™ 5000 toothpastes; 0.05% ORO-NaF or OPTI-Rinse fluoride rinses). “Some evidence suggests that a 0.2% fluoride rinse could be used daily instead of weekly, to boost effectiveness.” - Fluoride varnish: “Fluoride varnish could also be applied to the teeth of expectant mothers to reduce the risk of caries,” he says. • Xylitol use: The use of xylitol is another consideration, according to Dr. Nouri. “Research has shown that by using xylitol chewing gum or ingesting xylitol, mothers have reduced their chances of transferring their cariogenic bacteria to their infant. In fact, studies found xylitol to be more effective than fluoride and chlorhexidine over a 5-year period to prevent bacterial transmission to children.” Recent systematic reviews however have shown that there is low quality evidence, which makes the preventive action of xylitol uncertain. 2 • Good maternal oral health: Expectant mothers should be educated about the importance of maintaining good oral health. There is evidence supporting the importance of the mother’s oral microbial status as a contributing influence on their children’s oral health. 3 Thisarticlehasbeencondensedandedited. Theviewsexpressedarethoseoftheauthor anddonotnecessarilyreflecttheopinions orofficialpoliciesoftheCanadianDental Association. Tooth decay in children is an important public health concern in Canada, with early childhood caries (ECC) being the number one reason for day surgery requiring general anesthesia in children under the age of 6. 1 How can general dentists help reverse this trend? Dr. Reza Nouri, a certified specialist in pediatric dentistry practising in the Greater Vancouver area, shared some clinical tips that can be applied in your practice. From theWomb to Adolescence: Clinical tips for treating pediatric patients Watch Dr. Reza Nouri’s video presentation at 2016/08/26/ctpa