Improving Prenatal Oral Health

Discusses the role of prenatal dental screening in improving maternal oral health, birth outcomes, and family oral hygiene practices.

IMPLEMENTING A DENTAL SCREENING TOOL IN THE ANTENATAL SETTING FOR MARYLAND MEDICAID PATIENTS

Abstract

Background: Poor oral health in pregnant women specifically periodontal disease is associated

with adverse birth outcomes. Additionally, pediatric dental caries, one of the most common

pediatric illnesses in the United States, is influence by family oral hygiene habits. Dental

screening and knowledge during pregnancy can set the tone for family oral hygiene habits.

Almost 40% of pregnant women have dental concerns including dental caries and periodontal

disease (American College of Obstetricians and Gynecologists, 2013). Pregnant women are

eligible for Maryland Medicaid which includes dental visits, yet only 26.1% of these women

utilize these services. Poor oral health is avoidable and routine dental screenings in pregnant

women is one method to promote preventive dental health and refer patients to dental services.

Problem: Poor oral health is avoidable, leads to periodontal disease in pregnant women and

dental caries in children, and dental caries are one of the most chronic common pediatric

illnesses in the United States. These concerns are preventable by routine dental screenings,

particularly during pregnancy. Dental screenings and subsequent dental referrals are suggested

by the American College of Obstetricians and Gynecologists, yet many prenatal clinics do not

screen for it. The purpose of this scholarly project was to implement the maternal oral screening

(MOS) tool, a known dental screening used in the prenatal setting, to identify dental problems, in

women of lower socioeconomic status in the prenatal setting and improve the use of dental

referrals among prenatal providers.

Interventions: The MOS tool is a 2-question dental screening tool that prompts dental referral

with positive screenings. A positive screen was scoring 1 point on either question out of a 2-

point system. It was incorporated into the first obstetrical visit for new patients. Based on the

screening, patients were referred to a local dentist if they screened positive.

Results: During the 8 weeks of implementation, 7 women completed the MOS tool. There were

4 women (57%) who screened positive. Of the completed positive screenings, there were 2

women who referred to a dentist (29%). This project found that an increase in dental hygiene

signage and dental screening garnered more conversation about oral health.

Conclusions: The MOS tool is an easy, quick dental screening that can be smoothly incorporated

into prenatal care visits. It can be helpful in finding dental caries and/or periodontal disease in

patients with lower socioeconomic status who may be at higher risk for having dental

complaints. The tool would be more helpful if it could promote oral health education to mothers,

although dental referrals may promote dentistry and subsequent dental education