Oral health care during pregnancy

There are many obstacles for pregnant women seeking dental care. In many cases, pregnant women do not understand that oral health care is an important component of a healthy pregnancy. There is also a common belief that poor oral health during pregnancy is normal. On May 6, 2013, the New York Times published an article about the challenges pregnant women face in obtaining needed oral health care.(1) The article discusses some dentists’ reluctance to treat pregnant women for fear of litigation or harm to the fetus. Also, some obstetricians and gynecologists (OB-GYNs) frequently do not check pregnant women for oral health problems, and do not refer them to dentists or dental hygienists. As well, pregnant women are sometimes reluctant to seek oral health care. The article shares that more dentists seem to be promoting the importance of oral health care during pregnancy now than in the past and that the percentage of pregnant women enrolled in Medicaid who visit dentists may be rising.

The New York Times article refers to guidelines on oral health care during pregnancy that have been produced by states in recent years and to Oral Health Care during Pregnancy: A National Consensus Statement produced in 2012.(2) The consensus statement resulted from an expert workgroup meeting convened by the Health Resources and Services Administration in collaboration with the American College of Obstetricians and Gynecologists and the American Dental Association held on October 18, 2011, in Washington, DC.(3) The meeting was coordinated by the National Maternal and Child Oral Health Resource Center. The consensus statement provides guidance on oral health care for pregnant women for both prenatal care health professionals and oral health professionals, pharmacological considerations for pregnant women, and guidance for health professionals to share with pregnant women.

Tips for Good Oral Health during Pregnancy is excerpted from the consensus statement. It is a two-page handout for pregnant women (online only).(4)

Educating pregnant women about preventing and treating dental caries is critical. Evidence suggests that most infants and young children acquire caries-causing bacteria from their mothers. Providing pregnant women with counseling to promote healthy oral health behaviors may reduce transmission of such bacteria from mothers to infants and young children, thereby delaying or preventing the onset of caries.

Several states developed guidelines for oral health care during pregnancy. New York (2006); South Carolina (2009); Washington (2009); and California (2010). Educational resources were created for health professionals and pregnant women. As well, many national organizations have issued statements and recommendations created to improve oral health care during pregnancy, such as the American Academy of Pediatric Dentistry.

Oral health professionals can advise pregnant women about oral health care by reassuring them that oral health care, including radiographs, pain medication, and local anesthesia, is safe during pregnancy and encouraging them to seek oral health care, practice good oral hygiene, eat healthy foods, and attend prenatal classes during pregnancy.

References
1. http://well.blogs.nytimes.com/2013/05/06/obstacles-for-pregnant-women-seeking-dental-care/.
2. http://www.mchoralhealth.org/materials/consensus_statement.html.
3. http://www.mchoralhealth.org/PDFs/OralHealthPregnancyConsensus.pdf.
4. http://www.mchoralhealth.org/PDFs/OralHealthPregnancyHandout.pdf.

http://www.mchoralhealth.org

Additional Resources • Association of State and Territorial Dental Directors. 2012. Perinatal Oral Health Policy Statement. Sparks, NV: Association of State and Territorial Dental Directors. http://www.astdd.org/docs/Perinatal_Oral_Health_Policy_Statement_July_26_2012.pdf. • Association of State and Territorial Dental Directors, Best Practices Committee. 2012. Best Practice Approach: Perinatal Oral Health. Sparks, NV: Association of State and Territorial Dental Directors. http://www.astdd.org/perinatal-oral-health-introduction. • Bertness J, Holt K, eds. 2012. Oral Health Care During Pregnancy: A Resource Guide. Washington, DC: National Maternal and Child Oral Health Resource Center. http://www.mchoralhealth.org/PDFs/OralHealthPregnancyResGuide.pdf. • Holt K, Barzel R, Clark M. 2009. Two Healthy Smiles: Tips to Keep You and Your Baby Healthy (also in Spanish). Washington, DC: National Maternal and Child Oral Health Resource Center. http://www.mchoralhealth.org/PDFs/PregnancyBrochure.pdf. • National Maternal and Child Oral Health Policy Center. 2012. Improving the Oral Health of Pregnant Women and Young Children: Opportunities for Policymakers. Washington, DC: National Maternal and Child Oral Health Policy Center. http://nmcohpc.net/2012/improving-oral-health-pregnant-women. • National Maternal and Child Oral Health Resource Center. 2012. Resource Highlights: Focus on Pregnancy. Washington, DC: National Maternal and Child Oral Health Resource Center. http://www.mchoralhealth.org/highlights/pregperio.html.

Maria Perno Goldie, RDH, MS

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