Oral Health Care During Pregnancy: A Patient Safety PerspectiveKaty Battani, RDH, MSJonelle Grant, DDS, MPH

Objectives• Identify Maryland’s gaps in oral health care before and during

pregnancy • Understand that oral health care is safe and important during

pregnancy• Recognize practioner’s role in caring for a pregnant woman’s

oral health • Recognize the impact of maternal oral health on the future

oral health of the child (e.g., prevention of tooth decay) • Identify resources related to oral health and pregnancy• Understand when and how to access oral health care services

during pregnancy

2011 Maryland PRAMS• In the 12 months before pregnancy, 40% of

women had not had a dental cleaning.

• Dental Cleaning:• 1-5 years= 28%• 5 or more years ago= 7%• Never= 5% Highest among:

• Black Non Hispanic• Hispanic• Age 25-29 • Less than 12 years of

education

Oral Health and Pregnancy• Approximately 40% of pregnant women have periodontal

(gum) disease1

• Most prevalent during pregnancy among African American, cigarette smokers, and user of public assistance programs

• Studies have been conflicting regarding an association between maternal periodontal disease and preterm birth; however, treatment of periodontal disease during pregnancy has not been associated with any adverse maternal or birth outcomes

• Dental care during pregnancy has been associated with improvement of maternal oral health

ACOG Committee Opinion 2013

ACOG Committee Opinion

• Released August 2013

• Dental coverage: Women with Medicaid insurance have dental coverage during pregnancy

• Dental care is SAFE during pregnancy

• Prenatal counseling on oral health has been highly correlated with women obtaining dental care during pregnancy• Education about healthy habits

• Pregnant Woman• Child

SAFETY

Practice Recommendations• First prenatal visit= assess woman’s oral health• Screening questions

• Encourage and refer to a dental provider if it has been more than 6 months since last visit or if she has any dental issues• Oral Health Resource Guide 2103

• Reassure woman that dental care is SAFE and IMPORTANT• Oral Health During Pregnancy: A National Consensus Statement

• Counseling:• Pregnant Woman

• Brush twice daily with fluoride toothpaste• Floss daily• Limit sugary foods/drinks• Dental visits twice/year

• Child

Infant Oral Health

Before teeth= WIPE gums

Once teeth erupt= BRUSH with fluoride

toothpaste

Oral Hygiene

Dental Home by Age 1

Oral Health Resources• ACOG Committee Opinion: “Oral Health Care During Pregnancy and Through the Lifespan” (8/13)

• http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Health_Care_• For_Underserved_Women/Oral_Health_Care_During_Pregnancy_and_Through_the_Lifespan

• Oral Health Care During Pregnancy: A National Consensus Statement• http://www.mchoralhealth.org/PDFs/Oralhealthpregnancyconsensusmeetingsummary.pdf

• Oral Health Resource Guide 2013• http://phpa.dhmh.maryland.gov/oralhealth/Documents/OralHealthResourceGuide.pdf

• Tips for Good Oral Health During Pregnancy• http://www.mchoralhealth.org/PDFs/OralHealthPregnancyHandout.pdf

• Two Healthy Smiles: Tips to Keep You and Your Baby Healthy

• http://www.mchoralhealth.org/PDFs/PregnancyBrochure.pdf

• Oral Health Care During Pregnancy: At-a-Glance Reference Guide• http://phpa.dhmh.maryland.gov/oralhealth/Documents/Pregnant_Women_Reference_Guide.pdf

•Oral Health Tips for Pregnant Women• http://phpa.dhmh.maryland.gov/oralhealth/docs1/DentalHealthTipsforPregnantWomen.pdf

• Healthy Teeth, Healthy Kids website

• http://healthyteethhealthykids.org/ • • • • • • •

Katy Battani, RDH, MS kbattani@mdac.us

Jonelle Grant, DDS, MPH drgrant.mychildrenschoice@gmail.com