Training frontline workers on COVID

We have been getting requests for COVID -19 Training for frontline workers nearly everyday. That is not surprising.

Pregnant women in urban slum and rural communities are facing unexpected hardship because of COVID -19. The antenatal support provided through Government of India's Janani Sishu Suraksha Karyakram programme in Andhra Pradesh has come to a standstill as Anganwadi Centres (AWCs) have had to be closed because of the COVID - 19 related lockdown.

The closure has not only meant that services such as routine checkups, educational sessions, peer support and distribution of food has been affected. It has also compounded pregnancy related anxiety. In such circumstances, front line community health workers, that is, ASHA and AWC workers who are from the communities too feel helpless and despondent that they are not able to do more.

Most of these frontline champions have been reassigned to COVID related general awareness raising duties. However, there remains a huge gap in knowledge and information in relation to pregnancy at the time of the COVID-19 pandemic.

We keep getting requests from our frontline colleagues for information and training on pregnancy and COVID - 19. In response, we have developed a one hour training session curriculum which helps community health workers answer questions and give advice on antenatal issues in relation to COVID. The training will equip them to reach out and advice and support pregnant women with wellness and allay anxiety.

To know more about the training curriculum you can view the deck here.

How to prevent bleeding gums in pregnancy

Good oral hygiene is a must during pregnancy for a healthy baby.

Bleeding gums during pregnancy

It is quite common to hear of bleeding gums in pregnancy. Pregnant women want to know how to prevent and avoid problems in relation to teeth and oral health.

In fact, nearly 60 - 75% of pregnant women have gingivitis, an early stage of periodontal disease (Centres for Disease Control and Prevention, USA). Reports suggest that pregnant women are 7 times at higher risk. In gingivitis, the gums become red and swollen. Changing hormones during pregnancy are responsible for the condition but it gets worse as a result of poor dental hygiene practices that lead to plaque and debris. If untreated, the bone that supports teeth gets brittle and gums get infected. Though we do not know for certain the reasons for adverse pregnancy outcomes, periodontitis is associated with preterm birth and low birth weight.

Another complaint often heard is that of a small rounded tumour like growth in the gums between teeth. Commonly called pregnancy tumour, it can bleed when brushing teeth or eating. A pregnancy tumour usually disappears after the baby is born.If it persists after child birth you must visit a dentist.

Morning sickness especially when severe can erode the enamel in your teeth. That happens because of exposure of teeth to gastric juices and acids as a result of reflux. Increased exposure to acidity is a cause for tooth decay too.

To keep your teeth and gums healthy -

1. Brush your teeth twice day with a floured toothpaste.
2. If you have morning sickness, don't brush straight away after throwing up. Wait for an hour or so and then brush your teeth.
3. Daily salt rinse your mouth - 1 tsp of salt added to a cup of water. Swirl the wash a few times in your mouth and then spit it out. Avoid mouthwashes that contain alcohol.
4. Floss once a day.

X-rays including dental x-rays should be avoided in pregnancy. If unavoidable, an LED apron with coat and neck collar must be worn to prevent radiation exposure to the abdominal region and thyroid glands. However, it is safe to get dental treatment during the second trimester of pregnancy.

Always consult your doctor when in doubt.

Sravani
Vijaywada
10 June 2020

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