New research lends insights to PIOHQI initiative

By: Risa Nakajima

In recent years, a national consensus statement and “best practices” documents have been released on improving the oral health of women during pregnancy. Nonetheless, a lot of work remains to address the needs of pregnant women.  Currently, the Children’s Dental Health Project (CDHP) and its national partners are working with 16 state grantees of the Perinatal & Infant Oral Health Quality Improvement (PIOHQI) initiative, which is funded by the Health Resources and Services Administration. These efforts have further been supported by recently released research that provides new insights to shape the efforts of PIOHQI grantees.

Pregnant women and infants are a clear example of a patient population where medical-dental integration and collaboration are crucial to ultimately improving health.

The article in the Journal of Obstetric, Gynecologic and Neonatal Nursing (JOGNN) addresses the importance of prenatal providers to recognize, prevent and address the oral health issues among pregnant women. This includes strategies for incorporating oral health into routine prenatal care. The article also reflects that oral health care providers need to better understand the safety of treating women during pregnancy. It is through the combined efforts of these health providers and stakeholders — and understanding their roles within and across systems — that can help streamline efforts to strengthen access to oral health care during pregnancy.

The co-authors of the JOGNN article offer their perspective on why medical providers are a key part of the solution: “Primary prevention requires more workforce capacity than the dental community alone can provide.” Pregnant women and infants are a clear example of a patient population where medical-dental integration and collaboration are crucial to ultimately improving health.

Additionally, a study presented at the International Association for Dental Research (IADR) conference in Seoul this summer highlighted the need for oral health interventions during pregnancy. This randomized controlled study looked at prenatal gingivitis and found that gingivitis may not be caused by pregnancy as previously believed. The study offered additional support that providers should be more aware of oral health status of their pregnant patients and help to address the implications of oral health in pregnancy.

Appropriate dental services during pregnancy are important because a baby’s ability to lead a healthy life is shaped by her mom’s health. However, a mother cannot address this alone. She needs the support of all health professionals who are involved in her prenatal and preventive care, as well as policymakers at the larger systems level. The need for this kind of collective approach is being driven by the work of PIOHQI.

PIOHQI’s learning collaborative structure facilitates sharing and learning between states. Each grantee has unique projects working with multiple stakeholders in its state to address the issue of oral health among pregnant women and infants. Furthermore, the PIOHQI leadership team, CDHP and its national partners, have been reaching out to a variety of other national groups, including Text4baby and the National WIC Association with programs focused on pregnant women. Our hope is that creating a dialogue with these groups will help activate their state or local chapters to become more engaged in perinatal and infant oral health.

Moreover, these relationships can promote integration across different systems from FQHCs to state health departments to the federal government. The reality of integration is challenging, but the small breakthroughs that we see within and across states are what bring us a step closer to improving access and quality of oral health care for pregnant women and infants. Visit these pages to learn more about the 16 state grantees that are participating in the PIOHQI initiative.

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