Providing pregnant women with clear, updated guidance

By: Risa Nakajima

Over the last decade, many disciplines within the health and medical communities have elevated the issue of oral health during pregnancy because they recognize the implications for both the mother’s and newborn’s health. Although this trend is encouraging, misconceptions and systemic barriers continue to feed into the challenges of providing oral health care to pregnant woman.

In general, oral health remains “siloed” from overall health. Dental providers are usually assumed to be solely responsible for one’s oral health — an assumption that ignores the important roles that should be played by medical providers and other professionals, such as home visitors or social workers. As frontline staff and initial touch points for pregnant women, women’s health professionals and Ob-Gyn providers can create opportunities to address oral health needs. Although many health professionals may know the importance of dental care during pregnancy, they may struggle to coordinate and integrate their efforts with other health professionals.  

Dental providers aren't the only ones who have key roles to play in raising awareness among women of oral health's importance during pregnancy.

Despite the National Consensus Statement that was issued more than five years ago, there is not a uniform understanding among providers and professionals that allows for seamless coordination of care. The HRSA-funded Perinatal and Infant Oral Health Quality Improvement (PIOHQI) project among the 16 states has provided insight on the significant amount of time required to implement and coordinate with various stakeholders in order to gain buy-in — and some are still working to gain buy-in.

Furthermore, misconceptions about oral health care during pregnancy can create more barriers. Well-intended articles such as this physician’s op-ed about oral health care during pregnancy may raise women’s anxiety.This article discusses ways for a pregnant woman to get oral health care; however it contains some misinformation and does not reflect information included in the ACOG Committee Opinion, the National Consensus Statement or state guidelines that were developed in the last decade.

Telling women that “it is best to shoot for” a dental visit during certain months of pregnancy could make them believe dental care is time-sensitive.

  • Women can see a dentist anytime during pregnancy. Telling women that “it is best to shoot for” a dental visit during certain months during pregnancy could confuse them by making them believe dental care during pregnancy is time-sensitive. Because many pregnant women struggle to access a dentist, steering them to do so within a particular window of their pregnancy could make access an even bigger issue.
  • Oral health care — including the use of X-rays, pain medication and local anesthesia — is safe throughout pregnancy with standard precautions. Informing women that some of these dental services are typically “not prescribed during the first trimester” could be misinterpreted by women as a reason to decline these services. The National Consensus Statement also provides a list of medication that is allowed during pregnancy.

It is great for health professionals to champion the issue of oral health during pregnancy. In doing so, we hope they will review recent updates in clinical guidance and research. And it’s important to choose words carefully to avoid sending an unintended message to women. Here are some recommendations for ways medical providers and other professionals can positively impact this issue:

  • State provider chapters and stakeholders should consider developing provider-specific clinical guidelines and interprofessional guidelines to establish uniform understanding and standard of care.  
  • Medical and dental professionals should monitor and review any new guidelines and standards to provide accurate information and optimal care to pregnant women.
  • Oral health champions can use this infographic as a tool to start dialogue with other stakeholders to work interprofessionally to provide optimal care to pregnant women.

Visit http://www.endcavities.org/during-pregnancy/ to learn more about why oral health matters during pregnancy.

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