Facial anthropometric measurements in offspring of epileptic mothers.

BACKGROUND: Minor facial anomalies in 14-33% of exposed fetuses have been associated with the teratogenic effect of antiepileptic drugs (AED) since 1968. The purpose of this article is to describe the facial characteristics of offspring of epileptic mothers with and without exposure to AED by means of 22 anthropometric measurements, for the purpose of comparison with the measurements of offspring of non-epileptic women previously described in the literature, and to correlate the facial anomalies with the specific drug. METHODS: An interval was defined where 95% of the central values were considered as "common values" and the remaining 5% as "uncommon values" (UV) or as being in the "alert zone"; the odds ratio with Wolf modification was used and then Fisher's test for comparison with healthy newborns. Full-term eutrophic newborns of epileptic mothers who received attention at the epilepsy clinic of a gyneco-obstetric center were included. RESULTS: During the study period, 72 eutrophic, full-term newborns were included; in 70 cases at least one measurement was found in the alert zone, with a predominance of the mid-line area. No differences were found between neonates who received monotherapy vs. polytherapy. The groups exposed to phenobarbital, clonazepam and multiple AED showed more uncommon values (p < 0.05), identified as minor dysmorphisms by other authors. It seems to be a particular susceptibility of the mid-line of the face to show the effects of AED and, additionally, of environmental agents. CONCLUSIONS: No differences were found in the facial values among the different AED used in monotherapy form. It is suggested that the choice of drug used during pregnancy must be decided on according to the clinical diagnosis of each mother's epilepsy, and not on the basis of potential teratogenic risk.

[Myths, prejudices and reality about dental treatment during pregnancy. A medical opinion]. / Mitos, prejuicios y realidades del tratamiento odontológico durante el embarazo. Opinión médica.

The education and assistance strategies aimed al preserving oral health must play an important role in the overall care of the pregnant woman. It has been demonstrated that there are beliefs and practices in our culture that relegate, odontologic care in this stage, where attitudes and behaviors on the health-disease process are influenced by the prevailing medical culture, which includes the physician's opinion. The objective was To obtain the physician's opinion on the odontologic care during pregnancy. A previously validate survey which included 15 questions, was applied to a randomly selected sample of 700 physicians. Of the 650 surveys analyzed, 57% were applied to general practitioners, 24% to gynecologists and obstetrician, and 19% to other medical specialist regularly consulted by women during their prenatal care. There is low referral of pregnant women to the regularly check their patients teeth of gums 53% physicians said that the odontologist did not need to consult them about dental treatment, while 593 thought otherwise, 362 surveyed practitioners point out the convenience of using the lead apron when taking periapical x-ray. These results point out the importance of establishing a good communication channel between the physician and dentist. It is clear that there is a lack of truth in the oral health specialist's ability to provide treatment to pregnant patients, and that the physician ignores many of the odontological procedures and their low risk.

[Prevalence of dental caries, gingivitis and periodontal disease in pregnant diabetic women]. / Prevalencia de caries dental, gingivitis y enfermedad periodontal en la paciente gestante diabética.

OBJECTIVE: To determine the difference in the prevalence of dental caries, gingivitis, and periodontal disease among non-diabetic, type-II diabetic and pregnant diabetic women. MATERIAL AND METHODS: In the period from June 1993 to January 1994, a cross-sectional study was carried out at the Instituto Nacional de Perinatología among 160 pregnant women; eighty non-diabetic women were included in the control group, while 40 type-II diabetic and 40 gestational diabetic women conformed the study group. In each patient the following variables were recorded: age, week of pregnancy, the Simplified Oral Hygiene Index, the Decayed, Missing and Filled Teeth Index, the Gingival Index, and the Extent and Severity Index. Statistical analysis was carried out using Analysis of Variance and the Multiple Range Test, with a 95% confidence internal. RESULTS: All of the groups had similar prevalences of dental caries (100%). Type-II diabetic women showed a higher prevalence of gingivitis (42.5%) than non-diabetic (36.25%) and gestational diabetic (10%) women, but the differences were not statistically significant between the non-diabetic and type-II diabetic women. Type-II diabetic women had a statistically significant higher prevalence of periodontal disease (12.5%) than the women in the other groups. CONCLUSIONS: It is very important to establish proper metabolic control and a fitting oral hygiene in pregnant diabetic women, since type-II diabetes was shown to be associated with a higher prevalence of periodontal disease. Besides, gestational diabetes is likely to pose a high risk of periodontal disease in the absence of preventive measures.

[Maxillofacial anthropometry tables in healthy newborns]. / Tablas de antropometría maxilofacial en recién nacidos sanos.

With the purpose of having parameters which can be useful to evaluate the maxillofacial anthropometric characteristics at birth, we present the results of maxillofacial anthropometric measurements of 22 items in 373 healthy eutrophic newborns of both sexes delivered at the National Institute of Perinatology in Mexico City. Minor alterations of facial structures may indicate the presence of a dysmorphological syndrome such as: wide nasal bridge and wide intercantal distance. This study did not show big increments in the different anthropometric measurements from one week of gestation to the next, except for the bizygomatic and intercommissural measurements.

[Anomalies of the oral cavity in Mexican neonates]. / Anomalías de la cavidad oral en neonatos mexicanos.

The results of 1,200 physical oral cavity examinations in neonates born at the National Institute of Perinatology (INPer) are reported here, finding the frequency of occurrence of inclusion cysts, natal and neonatal teeth. We found that 46% (551 neonates) of those examined had inclusion cysts, among which the Bohn nodules were the most frequent (36 cases); a case of natal teeth was found as well as 30 cases of neonatal teeth. We emphasize the importance of these findings to both the pediatrician and the dentist since they constitute a frequent motive for visits during the perinatal period.

[Dental care for the pregnant hypertensive patient]. / Atención estomatológica de la paciente embarazada hipertensa.

Different odontology publications have stressed how important it is for every D.D.S. to be familiar with the fundamentals of detection and treatment to be considered in all cases of patients who suffer from hypertension. This condition has of late been occurring at increasingly early ages, and it is now known that children of hypertensive parents have higher blood pressures than those of parents with normal readings, all ages considered. The state of stress in which individuals currently live, conditions young persons with labile hypertension to develop essential hypertension, which becomes fixed within briefer periods.

[Odontogenic infection in pregnancy]. / Infección odontógena en la embarazada.

In stomatology, odontogenous infections are the clinical pictures with the highest potential of complications. A brief analysis of the immunitarian system in the materno-fetal relationship is presented; some considerations of the maternal response to odontogenous infection are discussed, with treatment alternatives.

[Education for dental health in pregnancy]. / Educación para la salud dental durante el embarazo.

In health education it is important to emphasize knowledge about oral hygienic techniques in order to decrease the morbidity due to caries and periodontal disease. The Dental Office of the National Institute of Perinatology has developed educational activities with patients during the last ten years. With this experience, we have created an educational program concerning hygienic techniques designed to prevent the commonest oral diseases. We undertook an investigation to evaluate the results of this educational program. Experimental and control groups were subjected to a program including a 90 minute conference, a booklet and a video about caries, periodontal disease and oral hygienic techniques. The experimental group also had six practical sessions related to teeth brushing and dental thread usage. We evaluated the knowledge and the oral hygienic techniques. The results show an initial increase in knowledge in both groups; however, a later evaluation showed a decrease towards the original level. The difference in the group with practical training was evident. We agree with other authors on the necessity of a continuous education program.

[Oral health education for expectant mothers]. / Educación para la salud bucal en la madre gestante.

Current tendency in education for oral health centers on identifying high-risk groups, in order to offer them proper attention as to preventive measures. As a specific strategy toward such ends, the authors propose performing a program of education for oral health during the gestation period, which may enable women to prevent oral diseases both in themselves and their babies.