sono una donna

I AM A WOMAN

A girl, a woman, a mother. A special smile for every age.

There are some orthodontic pathologies which mainly affect the female sex in childhood, during pregnancy and adulthood.

They regard dentition, the oral cavity and the temporal-mandibular joint. Another pathology which often affects the female sex is osteoporosis due to menopause. The bone component of our body is subject to a continuous reshuffle and to processes of construction and destruction over time. In some patients, this phenomenon increases with the oestrogen decrease during menopause or some substitute hormone therapies.

The reason of this tendency is due to the social conditioning which sees care and beauty of the female smile as a winning aspect for integration in society. Moreover, girls show a greater openness towards the orthodontic treatment, compared to their male peers, who are more attracted by the body care.

Dental agenesis

It is the most common anomaly in the human race. It is the lack of development of one or more teeth in the dental arch and can affect both baby teeth and permanent ones. The cause is unknown, but it is the consequence of hormone, genetic, environmental and infectious alterations. They affect both males and females in equal way. In females, agenesis is often bilateral and mainly affects the upper lateral incisor and the second upper and lower bicuspid. The presence of supernumerary teeth is another common tendency among Caucasian populations.

During pregnancy

Pregnancy is a very delicate period of time for the oral hygiene. During gestation, indeed, hormone alterations can alter the mucous membranes of the oral cavity, thus making them more sensitive and more exposed to inflammations and infections. All of this can be kept under control by increasing dental check-ups and keeping a correct oral hygiene.

Before pregnancy, we advice you to come to our dental office for a complete mouth check-up. What to do:

– pay particular attention to your domestic and professional oral hygiene;

– get endoral X-rays (bite wing) to evaluate the situation of healthy teeth and old reconstructions;

– get a panorex to see the condition of wisdom teeth;

– make sure there are no broken teeth nor apical injuries;

– if you are under treatment or have braces, we suggest you to talk to your dentist and evaluate the situation.

We suggest you to frequently repeat the professional oral hygiene. Absolutely avoid X-rays during the first three months of pregnancy. It is discouraged also after the first three months, unless it is an emergency and in respect of specific standards of radio protection. You should follow a healthy life style and a correct nutrition, that means without alcohol and smoke. It can sometimes be difficult to eat properly and balanced because of strong nausea, but it is important to constantly generate basic nutrition principles such as vitamin A, B, C, D, iron and calcium, necessary for the bone mineralization. Lack of vitamin D during pregnancy causes a worsening in the quality of tooth development of the fetus. We should never forget that hydration is fundamental to maintain a constant salivary flow which helps to remove food remains, to neutralize plaque acids and keep pathogenic bacteria under control. In cases of nausea or vomit, we should keep in mind that the gastric flow is harmful for the dental enamel and, in the long term, it can damage teeth. We advice you to take anti acids to keep the situation under control.

Gingivitis can often occur during pregnancy and causes red and swollen gums and bleeding. It should not be ignored because it can lead to more severe inflammations, such as periodontitis, which causes the loss of the alveolar bone and damages tooth stability. There have been cases in which a severe periodontitis has caused a preterm birth because oral bacteria in excess tend to spread in the rest of the body. If you have already experienced periodontal problems before pregnancy, we advice you to pay even more attention to your oral health and increase your dental check-ups during the 2nd and 3rd months of pregnancy, with further recalls until the 8th month.

Yes, cavities can be treated also during pregnancy. We suggest you wait the end of the third month and use adrenalin free anaesthetics. If you have any doubts, please contact your gynaecologist.

We advice you not to take any anaesthetics before the end of the third month. After the third month there is no particular counterindication, but you should avoid adrenaline anaesthetics which cause vasoconstriction. As far as antibiotic prescription, it is better to talk to your gynaecologist.  

During pregnancy, we recommend you not to get any endoral X-rays before the end of the third month and only in cases of urgency. There are some radio-protection regulations to be respected, such as the use of an apron with a lead collar to protect the most delicate parts of the fetus and the neck, and the use of digital X-ray instruments which are much less invasive than traditional ones. There is no counterindication during breastfeeding because breast milk and mammary glands are protected by the lead apron and are not altered by X-rays in any way. The Dentisti Vignato clinic is equipped with radio-control protections and certificated X-ray instruments, as in legislation in force.

Since the success of a well-done root canal is influenced by the X-ray evaluation of roots, we suggest you keep the situation stable with some temporary pastes and continue the therapy after pregnancy.  

TMJ disorders

The temporomandibular joint is a complex structure. Mouth opening and closure occur when muscles joining jaw, skull and neck move. When the jaw starts to move, the mandibular condyle moves forward and goes through a bone prominence present in the skull. This flowing movement is protected by a meniscus between the two bones, and a series of ligaments which keep the joint together. Teeth are the starting and arrival point of the mouth opening and closure. Any alteration of this mechanism causes a series of pathological chain reactions.

TMJ disorders appear whenever a joint component is not working correctly. The jaw function is made even more complex because the mouth´s movement is controlled by two joints which must function in perfect harmony. A non-aligned tooth can be sufficient to cause a severe mandibular dysfunction. TMJ disorders can appear at any age but, according to statistics, the most affected age group is between 30 and 50. Females are much more affected than males (twice as much) because of the ligamentous laxity of the joint.  

Among the possible causes are: nocturnal tooth grinding, traumas of the lower jaw, malocclusions and arthrosis of the articulation. Triggering causes are asymmetric craniofacial growth, oral breathing, posture bad habits, anxiety, stress and ligamentous laxity.

Joint pathologies occur when we have difficulties in opening and closing our mouth. The jaw can sometimes stop in a specific position and block normal movements, such as yawning or chewing. We usually hear a series of noises, called clicks, when opening and closing the mouth. These are due to the malposition of the articular meniscus and are noises like squeaks and a feeling of water inside ears. Other symptoms are painful phenomena at neck and face level, migraines, soreness of mandibular muscles, earache, dizziness, buzz and toothache. 

Diagnosis is carried out through: muscle percussion, dentition check-up and some diagnostic procedures. It is important that the patient carefully describes signs and noises. In cases of meniscus injury, the final diagnosis can only be done through a magnetic resonance with the mouth open and closed, in order to highlight the condition of joint structures. The therapy is carried out with appropriate exercises and specific bites. 

Avoid introducing very big bites in the mouth because they force its opening. Food has to be soft and drinks should not contain exciting elements such as caffeine and alcohol, in order to not load tensions on the joint. During the phase of acute pain, it is possible to take anti-inflammatories, painkillers and make ice packs.  

Osteoporosis

Osteoporosis is an autoimmune disease which affects various skeletal parts and alters structure and bone mass. This pathology can also affect maxillary bones. Some studies have shown a correlation between osteoporosis and periodontal diseases with the worsening of the loss of alveolar bone. We advice menopausal women or those affected by osteoporosis to get periodic professional oral hygiene sessions, in order to monitor, prevent or treat these phenomena. 

If osteoporosis is treated with oral or intravenous biophosphonates, the patients has to immediately inform the dentist. He will evaluate the best way to treat the dental pathology. He could recommend the prescription of specific antibiotics before as prophylaxis before the treatment or as therapy after the treatment, in order to avoid possible mandibular and maxillary infections.