A growing focus on pregnant women's oral health

By: Meg Booth

Pregnancy is an amazing and exciting time for a woman and her family. There is endless information on pregnancy and it can be difficult to decipher what is most important. However, taking care of your mouth and teeth is often missing from recommendations from medical and dental providers.

Fortunately, that is changing. These changes are a welcome development given roughly 4 out of 10 pregnant women have tooth decay or gum disease, and these factors put their children at higher risk for poor oral health.

This week, the Michigan Department of Community Health hosted the first Advisory Committee meeting of its Perinatal and Infant Oral Health Program. The multi-disciplined Advisory Committee is responsible for implementing the state’s five-year action plan to improve the oral health of women and children. While many states have created perinatal oral health guidelines and actions plans, this project recognizes the importance of oral health as part of a larger health and social system — this action plan is part of the Michigan Infant Mortality Reduction Plan.  

Research released in 1996 sparked discussions about a possible association between periodontal disease (gum disease) and preterm birth. Since that research was released, many studies have followed with varying results. Although a causal relationship has never been established, a growing body of research is focused on untreated gum disease and adverse birth outcomes including preeclampsia, preterm birth, and low birth weight.

Last summer, the American College of Obstetrics and Gynecologists (ACOG) released a committee opinion that supports oral health care during pregnancy. ACOG’s opinion closely followed the release of a national consensus statement on oral health during pregnancy. These documents come after guidelines were released by many states, including (but not limited to) New York, California, West Virginia, South Carolina and Connecticut.

This growing momentum to recognize the importance of the mouth to the health of a woman and her pregnancy is missing one key factor: Medicaid coverage. Women over the age of 21 lack comprehensive dental coverage in Medicaid. Even where dental coverage is available for adult women in Medicaid, it rarely provides all the services necessary to address her dental problems and, for some women, that coverage ends with her pregnancy.

There is growing discussion by state legislators and health organizations about the gaps that exist in Medicaid coverage. The needs of pregnant women are — and should be — one of the gaps that states seek to close. 

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children ages 6-12 suffered a toothache in the previous six months.
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