Abstract | Tijekom 40 tjedana, koliko traje trudnoća, u organizmu majke događaju se raznolike fiziološke promjene ne bi li se prilagodio novonastaloj situaciji. Mijenjaju se svi organski sustavi, ali promjene su privremene, odnosno prolaze nakon poroda. Kao posljedica lokalnih i sistemskih faktora, u trudnoći se mijenja i sluznica usne šupljine te stanje zuba. Dolazi do povećane pojavnosti gingivitisa i parodontitisa, a erozije i zubni karijes češći su nego u žena koje nisu trudne. Tijekom trudnoće nije neuobičajena pojava infekcija, čak mogu biti češće zbog suprimiranoga imunološkog sustava u jednom dijelu trudnoće. Najčešće su to infekcije urogenitalnoga sustava, a od nama bližih odontogena upala. Trudnoća nije stanje u kojem treba izbjegavati liječenje infekcija, već ih treba liječiti oprezno, dobro odabranim lijekovima i inividualiziranim pristupom svakoj pacijentici. Bakterijske se infekcije liječe antibioticima, ali pri antibiotskoj terapiji u trudnoći treba biti oprezan jer antibiotici lako difundiraju kroz placentarnu barijeru i ulaze u fetalni krvotok. Zbog toga je Agencija za hranu i lijekove Sjedinjenih Američkih Država (FDA) uvela klasifikaciju lijekova prema riziku za trudnicu i plod. Antibiotici su uglavnom sigurna skupina lijekova, ali postoje neki kojima treba posvetiti pažnju i oprez pri korištenju. Ako rizični lijek prijeđe u fetalni krvotok, ovisno o periodu trudnoće u kojem se to dogodilo, može utjecati na razvoj organa koji se tada razvijaju. Osim na dijete, antibiotici mogu negativno djelovati i na majčin organizam. Najčešće se nuspojave javljaju na probavnom sustavu i u obliku gljivičnih infekcija, a ako dođe do reakcije preosjetljivosti na penicilin ili cefalosporine, moguća je i pojava anafilaktičkoga šoka. Na oralnoj mukozi također se mogu javiti različite promjene kao reakcija na antibiotsku terapiju. Ovisno o skupini antibiotika, mogu se javiti kandidijaza, vezikulobulozne bolesti, stomatitis, edemi usnica i jezika, disgeuzija i promjena boje zuba. |
Abstract (english) | Throughout the 40 weeks of pregnancy a variety of physiological changes occur in the mother's organism to accommodate to the new situation. The changes take place in all organ systems, but they are of temporary nature, i.e. they vanish after the birth. Due to the local and systemic factors the oral mucosa and overall dental condition also change during pregnancy. There is an increased incidence of gingivitis and periodontitis, erosion and dental cavities are also more common than in non-pregnant women. The occurrence of infections is not uncommon during pregnancy, infections can even occur at a more frequent rate as a result of a suppressed immune system in one part of the pregnancy. The most common among them are the infections of the urogenital system, but odontogenic inflammation can also occur. Pregnancy is not a condition in which infection treatment should be avoided; on the contrary, it should be given but cautiously by way of choosing medication properly and administrating an individualised treatment to each patient. Bacterial infections should be treated with antibiotics, but the antibiotic therapies in pregnancy must be prescribed with utmost care since antibiotics easily diffuse through the placental barrier and enter the foetal bloodstream. Due to this fact, the Food and Drug Administration of the United States of America (FDA) introduced the classification of drugs on the basis of the risk they pose on a child-bearing woman and foetus. Antibiotics are generally a safe group of medicines, but there are some that need to be used with caution and care. If a risky drug enters the foetal bloodstream, it may affect the developing organ depending on the time of pregnancy in which it is administered. Apart from affecting the baby and its organism, antibiotics can also affect the mother's body. The most common side effects occur in the digestive system and in the form of fungal infections. In cases of hypersensitivity reactions to penicillin or cephalosporins an anaphylactic shock may also occur. Various changes may also occur on the oral mucosa in response to an antibiotic therapy. Depending on the antibiotic group, candidiasis, vesicular disease, stomatitis, lip and tongue oedema, dysgeusia and discoloration of the teeth may occur. |