SRUTI
PREGNANT women when struck by toothache are quite often in a dilemma. There is apprehension about undergoing dental treatment in this phase which is justified arguably. Theurgency in getting rid of the umbearable pain is weighed against the gravity of the possible consequences. Anxiety being the main ingredient, the significance of following few specific instructions while at the dental office cannot be overmphasised.

Guidelines to be followed at the dental office during pregnancy

1. The secon trimester is the safest time to perform treatment. All elective dental care is deferred; the nondeferrable treatment (caries control) is completed during the second trimester

2. Many pregnant women get gestational diabetes (diabetes during pregnancy) or pre-eclampsia (high blood pressure and protein in the urine). Its always better to get sugar levels tested and blood pressure checked before undergoing treatment even in the secon trimester.

3. Long, stressful appointments and periodontal surgical procedures should be avoided. the appointments should be short and the patient allowed to change positions frequently. A fully reclined position should be avoided as it causes pressure on the inferior vena cava and

aorta which in turn may result in low blood pressure, syncope and loss of consciousness.

4. Radiographs are contra indicated in all but emergency situations. When taken, lead shielding is mandatory.

5. Other precautions relate to the potential toxic or teratogenic effects of therapy on the foetus. Ideally, no medications should be prescibed unless the situation is an emergency. The patient's obsterician should be consulted as to whether a drug could cross the placenta or cause foetal respiratory depression.

The Author is a dental sur- geon and can be contacted at ALL SMILES DENTAL CARE 6673439, 98450 85230