Pregnancy and the first twelve months of a child’s life are critical to the development of the child. The average term of pregnancy in humans is forty weeks. For pregnancy to occur, the sperm meets the ovum forming a mass of cells that grows into a zygote then a fetus then a neonate. During the period of pregnancy, the fetus gets its nutrients and protection from the mother. It is therefore essential for the mother to be knowledgeable about the risks associated with pregnancy and diseases that can be transmitted to the child, including infections that can affect the child’s oral health.
The most common infections that may be transmitted from mother to child are
- Syphilis
- Herpes
- Candida
- HIV
Syphilis
Exposure of the fetus to syphilis during pregnancy is termed congenital syphilis. Syphilis is a sexually transmitted infection that first appears as an ulcer or chancre at the primary site of infection that is, on the lips, tongue, and other parts of the mouth.
If left untreated it may be transmitted to the unborn fetus.
Signs and symptoms may appear in the first 3 to 14 weeks after birth or later after the child is 5 years.
Early symptoms include:
- Fever
- Low birth weight
- Skin rash
- Aseptic meningitis
- Anemia
- Enlarge liver and spleen
- Convulsions
- Mental retardation
Symptoms that appear late or after the first 5 years are:
- The defective appearance of teeth –Hutchinson’s incisor and Mulberry molar
- Facial defects-bony prominence of the head, saddle nose, high arched palate, short upper jawbone
- Eye diseases such as retinitis, blurred vision, eye pain, and abnormal sensitivity to light
Treatment
Once diagnosed early in the mother, antibiotics are administered as treatment. If late, a multidisciplinary approach involving the primary physician, an ophthalmologist, and a dentist should be considered.
Herpes
Herpes is a viral infection caused by the herpes simplex virus (HSV). Primary infection occurs commonly in children under the age of 5.
Signs and symptoms include:
- Fever
- Malaise
- Painful ulcers in the mouth
- Inflamed gums
- Swollen lymph nodes
Treatment
- Supportive care-soft diet and increased intake of fluids
- Analgesics like paracetamol
- In children whose immune is compromised, antivirals are prescribed.
Candida
Candida is a fungal infection caused by Candida Albicans. It is commonly referred to as thrush. Candida transmission occurs in the birth canal during delivery.
It appears as a soft white patch in the mouth that when scraped away leaves a red, raw bleeding base.
Treatment is by antifungal medication prescribed by a doctor.
HIV
Human Immunodeficiency Virus (HIV) is a global epidemic that affects about 37 million people worldwide. Severe clinical manifestations have been on the decline since the acceptance of antiretroviral therapy but mother-to-child transmission is still prevalent.
Herpes and Candida as listed above can also occur in the background of HIV.
Signs and symptoms of HIV in infants include:
- Candida/Oral thrush
- Diarrhea
- Swollen lymph nodes
- Swollen abdomen
- Failure to thrive
Consultation with the pediatrician should be done for therapy to begin.
It is important for parents to be on the lookout for these symptoms and to seek dental care. Prevention of transmission of oral infections as well as other infections through partner testing, and having protected sex should be practiced and encouraged.