Promoting Oral Health Care for Pregnant Women | Maneesh Gupta

Overview• Importance of Oral

Health• Current CA Availability

Issues• National and Situation

Updates• Possible Solutions to

Enhance Access• Local Program Examples

Oral Health as Part of Prenatal Care

Improving the Oral Health of a Pregnant Woman

1. Prevents problems of dental diseases during pregnancy

2. Has the potential to decrease beginning youth caries

3. May decrease preterm and low starting weight deliveries

Are Pregnant Women Getting Dental Care in CA?

• 34.5% of members visited a spoken professional or oral hospital during their pregnancy

• Most were non-Hispanic white, English talking about, experienced beyond school, and had insurance

Are Expecting Females Getting Oral Proper care in CA?

• 40% of females with higher education educations or in maximum earnings classification did not have a oral check out during pregnancy

• 62% of females confirming oral issues did not get good care during pregnancy

• 21% of females confirming a oral issue considered they didn’t need to go to a dentist

Primary Reason for not Getting Oral Care among each woman sampled

• Did not understand a need to go (38%)• No insurance plan or it cost too much

(21%)• Didn’t want to go or too active (19%)• Believed oral treatment was risky (14%)• Provider guidance against getting proper

care (8%)

Factors Dental practitioners May Not Be Dealing with Expecting Women

• Therapy often prevented and misinterpreted by health professionals

• Fear of hurting either the girl or the fetus• Failure of recommendation due to deficiency of

training• Pregnant females more likely to search for

healthcare care/advice• Lack of suppliers who will cure females with

community insurance policy (Denti-Cal)

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Expecting Individual Population: Nearly all interviewed are currently dealing with pregnant sufferers, and recognizing new

sufferers who are pregnant. A little community (15%) only agree to new sufferers with a pre-natal provider’s launch. Few

cure pregnant sufferers under condition applications.

96%

4%

82%, always

15%, with provider release

Currently treat pregnantpatients

Accept new patients whoare pregnant

Yes No Yes, with pre-natal provider's release

20% say they treat pregnant patients insured by state programs

Why is it challenging to relate a customer to a Medi-Cal oral provider?

So how do we enhance dental medical care for pregnant women?

Cash is an Issue!

Recent Access Reports

• Two IOM reports on accessibility this year• Advancing Oral Wellness in American• Improving Access Oral Wellness Care for

Vulnerable and Underserved Populations• Pew Children’s Oral Campaign• Children’s Partnership – Oral Wellness Agenda• ADA/CDA efforts

ADA Access to Dental Care Summit – March, 2009

“What are we going to do, in rapid and thelong phrase, both independently and jointly, to

assure maximum dental wellness through prevention

and strategy to underserved people?”

CDA’s Access ReportPhased Strategies for Reducing the Barriers to Dental

Care in California

• Developing State Oral Health Management and Improving Current Sources (Years 1-3)

• Focusing on Protection and Early Involvement for Children (Years 3-5)

• Innovate the Oral Distribution System to Increase Potential (Years 4-7)

Current Medicaid Focus

Solutions

Integrate Oral Health Care into Overall Health Care

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Usage of Prenatal Care Guidelines: Two-thirds of dental practitioners say they currently use some sort of recommendations when dealing with expecting sufferers. Almost all would use such recommendations if they were available from a reliable resource.

Yes, 68%DK, 10%

No, 22%

Do you currently utilize clinical guideline/s for pregnant women?

If recommendations on appropriate take good care of expectant mothers were easily obtainable from a reliable resource, how likely would you be to use them?

Very Likely: 90%Somewhat Likely: 7%

Dental Wellness During Maternity and Early Childhood: Evidence-based Recommendations

for Wellness Professionals

Improve Oral Health Literacy

Enhance the Delivery System within Dental Profession

Health Collaborations• CHDP • WIC• Head Start• Home visitation• Obesity and nutrition• Diabetes and other serious disease• Substance abuse• Childhood injury• First 5 Commissions

Client Education

Prevention

Ask Questions During Prenatal Exam

• Do you have loss of blood vessels gum area, teeth discomfort, area, decrease teeth or other issues in your mouth?

• Have you had a dental check out in the last 6 months?

Guidelines for Health Care Professionals

• Advise that dental proper care is safe and effective during pregnancy

• Can be done any time while pregnant with no additional risk as compared to not providing care

• Don’t delay treatment

Safety Concerns in the Dental Office

• Analytic x-rays can be used during pregnancy

• Xylocaine with epinephrine can be used during pregnancy

Tips to Keep Mom Healthy

• Sweep tooth 2 X day with fluoride tooth paste, especially before bed time, and get flossing daily

• Chew xylitol gum 4 to 5 X day, especially after meals

• http://www.first5oralhealth.org/

• Drink fluoridated water

Reduce Risk of Decay in Children

• Decrease the decay-causing bacteria in the mouth

• Reduce the visibility of these bacteria to fermentable carbohydrate food and sugars

• Increase the corrosion level of resistance of the teeth

Client Brochures

Cavity Keep Away Two Healthy Smiles

cdafoundation.org mchoralhealth.org

Examples of Local Efforts• Alameda – lead venture with Early Head Start

focusing on expecting teens• Contra Costa – markets company details and

prescribed design to CPSP suppliers, designed customer brochure

• Imperial/Plumas – manager provides outreach and education

• Siskiyou – 100 OH packages through OB providers

• Stanislaus – attention campaign

Summary• Continue to do the best we can with the sources

we have• Educate medical/dental providers• Watch for and improve nationwide dental health

knowledge campaign• Create new ways to use workforce• Collaborate and system with OH advocates• Enhance customer knowledge to improve

prevention

Thank You!