Question 1

Which of the following is the safest period during which to provide routine dental care for the pregnant patient?&#10;A) the first trimester&#10;B) the second trimester&#10;C) the third trimester&#10;D) the immediate postpartum period

Accepted Answer

The second trimester is the safest period during which to provide routine dental care.Emphasis should be placed on controlling active disease and eliminating potential problems that could occur later in pregnancy or during the immediate postpartum period,because providing dental care during these periods is often difficult.Other than as part of a good plaque control program,elective dental care is best avoided during the first trimester because of the potential vulnerability of the fetus.The early part of the third trimester is still a good time to provide routine dental care.After the middle of the third trimester,elective dental care is best postponed.

Question 2

The most common cause of spontaneous abortion is __________.&#10;A) immune suppression due to a shift in helper T cell type dominance&#10;B) morphologic or chromosomal abnormalities that prevent successful implantation&#10;C) the development of gestational diabetes&#10;D) a benign systolic ejection murmur in the mother

Accepted Answer

Morphologic or chromosomal abnormalities that prevent successful implantation are the most common cause.It is most unlikely that any dental procedure would be implicated in spontaneous abortion,provided fetal hypoxia and exposure of the fetus to teratogens are avoided.

Question 3

Which of the following normally decreases during pregnancy?&#10;A) blood volume&#10;B) blood clotting factors&#10;C) white blood cell count&#10;D) hematocrit

Accepted Answer

Blood changes during pregnancy include anemia and a decreased hematocrit value.Anemia occurs because blood volume increases more rapidly than red blood cell mass.As a result,a fall in hemoglobin and a marked need for additional folate and iron occur.Several blood clotting factors,especially fibrinogen and factors VII,VIII,IX,and X,are increased.The white blood cell count increases progressively throughout pregnancy,primarily because of an increase in neutrophils,and is nearly doubled by term.

Question 4

Which of the following is the most common oral complication of pregnancy?&#10;A) xerostomia&#10;B) pyogenic granuloma&#10;C) pregnancy gingivitis&#10;D) dental caries

Accepted Answer

The most common oral complication of pregnancy is pregnancy gingivitis.This condition results from an exaggerated inflammatory response to local irritants and less-than-meticulous oral hygiene during periods of increased secretion of estrogen and progesterone and altered fibrinolysis.In approximately 1% of gravid women,the hyperplastic response may exacerbate in a localized area,resulting in a pyogenic granuloma or "pregnancy tumor." A relationship between dental caries and the physiologic process of pregnancy has not been demonstrated.

Question 5

Which of the following is the analgesic of choice during pregnancy?&#10;A) aspirin&#10;B) acetaminophen&#10;C) nonsteroidal anti-inflammatory&#10;D) codeine

Accepted Answer

Acetaminophen is the analgesic of choice during pregnancy.Aspirin and nonsteroidal anti-inflammatory drugs convey risks for constriction of the ductus arteriosus,as well as for postpartum hemorrhage and delayed labor.The risk of these adverse events increases when agents are administered during the third trimester.Codeine and propoxyphene are associated with multiple congenital defects and should be used cautiously and only if needed.

Question 6

What should a pregnant dental auxiliary or dentist do to protect herself and her baby from potential fetal exposure to x-radiation?&#10;A) Stay in a remote area of the dental office, and avoid locations where x-radiation is utilized.&#10;B) Wear a lead apron the entire time in the office, and avoid circumstances of exposing x-ray films.&#10;C) Utilize digital radiography rather than film-based radiography.&#10;D) Wear a film badge, stand more than 6 feet from the tubehead, and position herself at between 90 and 130 degrees of the beam, preferably behind a protective wall.

Accepted Answer

When these guidelines are followed,no clinical contraindication to operation of the x-ray machine by pregnant women arises.However,dentists should familiarize themselves with federal and state regulations that would supersede these guidelines.

Question 7

The gonadal/fetal dose incurred with two periapical dental films (when a lead apron is used)is __________ that for 1 day of average exposure to natural background radiation in the United States.&#10;A) 700 times less than&#10;B) 7 times less than&#10;C) equal to&#10;D) 7 times more than

Accepted Answer

It is 700 times less than that for 1 day of average exposure to natural background radiation in the United States.Despite the negligible risks of dental radiography,radiographs should be obtained selectively and only when necessary and appropriate to aid in diagnosis and treatment.To further reduce the radiation dose,the following measures should be employed: rectangular collimation,E-speed or F-speed film or faster techniques,lead shielding,high-kilovoltage (kV)or constant beams,and an ongoing quality-assurance program for equipment and technique.

Question 8

Supine hypotensive syndrome during late pregnancy is due to __________.&#10;A) an increase in blood volume&#10;B) compression of the inferior vena cava by the gravid uterus&#10;C) a fall in maternal hematocrit&#10;D) a benign systolic ejection murmur

Accepted Answer

Supine hypotensive syndrome manifests as an abrupt fall in blood pressure,bradycardia,sweating,nausea,weakness,and air hunger when the patient is in a supine position.Symptoms and signs are caused by impaired venous return to the heart resulting from compression of the inferior vena cava.This leads to decreased blood pressure,reduced cardiac output,and impairment or loss of consciousness.

Deck 17: Pregnancy and Breast Feeding