I am willing to submit that oral care was not previously at the top of my concerns list when evaluating a pregnant patient. As you mentioned, pregnancy affects every aspect of health, and it is likely that concern for other components takes precedent. I was initially surprised by the statement from the Oral Health Care During Pregnancy Workgroup (2012) that caries-causing bacteria in infants and young children may very well be transmitted from mother to child. Nevertheless, as I thought about my children/babies and I (admittedly not a mother), I can think of many ways bacteria could travel from one mouth to the other. Therefore, as a strong proponent of pediatric health promotion and disease prevention I applaud you and others for taking note of this issue and working towards a resolution. Beyond the obvious health benefits of achieving adequate dental coverage and care, there are financial benefits as well. An older study analyzed the financial benefits of preventative dental visits in the medicare population (Moeller, Chen, & Manski, (2010). They found that while the number of dental visits increased when medicare coverage was provided, costly non-preventative procedures were reduced. So, I believe this to be a pertinent issue for both the health and financial benefits it provides.
References
Moeller, J. F., Chen, H., & Manski, R. J. (2010). Investing in preventive dental care for the Medicare population: A preliminary analysis. American Journal of Public Health, 100(11), 2262-2269. doi: 10.2105/AJPH.2009.184747
This information is so important for women’s health providers to be aware of. During clinical rotations, some NPs that I followed asked patients if they had been to the dentist in the last 6 months, but others did not. I wonder how aware providers are of this new bill and the referral process. Further, the fact that it can be difficult to find a dentist that not only accepts Medicaid patients, but will perform dental care on pregnant women makes this an even more difficult process.
Physiologic changes during pregnancy may result in noticeable changes in the oral cavity, such as dental caries, teeth erosion, tooth mobility, and pregnancy gingivitis. Providers such be aware of these changes and emphasize the importance of seeking dental care during pregnancy to recognize these changes before they worsen. Pregnancy is an optimal time to teach women, because they are motivated to adopt healthy behaviors for the wellbeing of their child (American College of Obstetricians and Gynecologists (ACOG), 2013). ACOG (2013) suggests women’s health providers address oral health at the first prenatal visit by asking these three simple questions:
1. Do you have swollen of bleeding gums, a toothache, problems eating or chewing food, or other problems in your mouth?
2. When was your last dental visit?
3. Do you need help finding a dentist?
I plan on incorporating this into my future practice but hope to learn the best way to answer the third question due to all the barriers that exist connecting these patients to who they need to see. I look forward to seeing how you address this issue in your blog and will continue reading your posts.
Reference
American College of Obstetricians and Gynecologists. (2013). ACOG committee opinion no. 569: Oral health care during pregnancy and through the lifespan. Obstetrics and Gynecology, 122, 417-22.
Oral Health Care Screening in Pregnancy 
I am willing to submit that oral care was not previously at the top of my concerns list when evaluating a pregnant patient. As you mentioned, pregnancy affects every aspect of health, and it is likely that concern for other components takes precedent. I was initially surprised by the statement from the Oral Health Care During Pregnancy Workgroup (2012) that caries-causing bacteria in infants and young children may very well be transmitted from mother to child. Nevertheless, as I thought about my children/babies and I (admittedly not a mother), I can think of many ways bacteria could travel from one mouth to the other. Therefore, as a strong proponent of pediatric health promotion and disease prevention I applaud you and others for taking note of this issue and working towards a resolution. Beyond the obvious health benefits of achieving adequate dental coverage and care, there are financial benefits as well. An older study analyzed the financial benefits of preventative dental visits in the medicare population (Moeller, Chen, & Manski, (2010). They found that while the number of dental visits increased when medicare coverage was provided, costly non-preventative procedures were reduced. So, I believe this to be a pertinent issue for both the health and financial benefits it provides.
References
Moeller, J. F., Chen, H., & Manski, R. J. (2010). Investing in preventive dental care for the Medicare population: A preliminary analysis. American Journal of Public Health, 100(11), 2262-2269. doi: 10.2105/AJPH.2009.184747
Oral Health Care During Pregnancy Expert Workgroup. (2012). Oral health care during pregnancy: A national consensus statement [PDF file]. Retrieved from https://www.mchoralhealth.org/PDFs/OralHealthPregnancyConsensus.pdf
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This information is so important for women’s health providers to be aware of. During clinical rotations, some NPs that I followed asked patients if they had been to the dentist in the last 6 months, but others did not. I wonder how aware providers are of this new bill and the referral process. Further, the fact that it can be difficult to find a dentist that not only accepts Medicaid patients, but will perform dental care on pregnant women makes this an even more difficult process.
Physiologic changes during pregnancy may result in noticeable changes in the oral cavity, such as dental caries, teeth erosion, tooth mobility, and pregnancy gingivitis. Providers such be aware of these changes and emphasize the importance of seeking dental care during pregnancy to recognize these changes before they worsen. Pregnancy is an optimal time to teach women, because they are motivated to adopt healthy behaviors for the wellbeing of their child (American College of Obstetricians and Gynecologists (ACOG), 2013). ACOG (2013) suggests women’s health providers address oral health at the first prenatal visit by asking these three simple questions:
1. Do you have swollen of bleeding gums, a toothache, problems eating or chewing food, or other problems in your mouth?
2. When was your last dental visit?
3. Do you need help finding a dentist?
I plan on incorporating this into my future practice but hope to learn the best way to answer the third question due to all the barriers that exist connecting these patients to who they need to see. I look forward to seeing how you address this issue in your blog and will continue reading your posts.
Reference
American College of Obstetricians and Gynecologists. (2013). ACOG committee opinion no. 569: Oral health care during pregnancy and through the lifespan. Obstetrics and Gynecology, 122, 417-22.
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