1. Oral Health Care During Pregnancy: A Patient Safety Perspective Katy Battani, RDH, MS Jonelle Grant, DDS, MPH

2. Objectives Identify Maryland’s gaps in oral health care before and during pregnancy Understand that oral health care is safe and important during pregnancy Recognize practioner’s role in caring for a pregnant woman’s oral health Recognize the impact of maternal oral health on the future oral health of the child (e.g., prevention of tooth decay) Identify resources related to oral health and pregnancy Understand when and how to access oral health care services during pregnancy

3. 2011 Maryland PRAMS In the 12 months before pregnancy, 40% of women had not had a dental cleaning. Dental Cleaning: 1-5 years= 28% 5 or more years ago= 7% Never= 5% Highest among: Black Non Hispanic Hispanic Age 25-29 Less than 12 years of education

4. Oral Health and Pregnancy Approximately 40% of pregnant women have periodontal (gum) disease 1 Most prevalent during pregnancy among African American, cigarette smokers, and user of public assistance programs Studies have been conflicting regarding an association between maternal periodontal disease and preterm birth; however, treatment of periodontal disease during pregnancy has not been associated with any adverse maternal or birth outcomes Dental care during pregnancy has been associated with improvement of maternal oral health ACOG Committee Opinion 2013

6. ACOG Committee Opinion Released August 2013 Dental coverage: Women with Medicaid insurance have dental coverage during pregnancy Dental care is SAFE during pregnancy Prenatal counseling on oral health has been highly correlated with women obtaining dental care during pregnancy Education about healthy habits Pregnant Woman Child

7. SAFETY

9. Practice Recommendations First prenatal visit= assess woman’s oral health Screening questions Encourage and refer to a dental provider if it has been more than 6 months since last visit or if she has any dental issues Oral Health Resource Guide 2103 Reassure woman that dental care is SAFE and IMPORTANT Oral Health During Pregnancy: A National Consensus Statement Counseling: Pregnant Woman Brush twice daily with fluoride toothpaste Floss daily Limit sugary foods/drinks Dental visits twice/year Child

10. Infant Oral Health

11. Before teeth= WIPE gums Once teeth erupt= BRUSH with fluoride toothpaste Oral Hygiene

12. Dental Home by Age 1

13. Oral Health Resources ACOG Committee Opinion: “Oral Health Care During Pregnancy and Through the Lifespan” (8/13) http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Health_Care_ For_Underserved_Women/Oral_Health_Care_During_Pregnancy_and_Through_the_Lifespan Oral Health Care During Pregnancy: A National Consensus Statement http://www.mchoralhealth.org/PDFs/Oralhealthpregnancyconsensusmeetingsummary.pdf Oral Health Resource Guide 2013 http://phpa.dhmh.maryland.gov/oralhealth/Documents/OralHealthResourceGuide.pdf Tips for Good Oral Health During Pregnancy http://www.mchoralhealth.org/PDFs/OralHealthPregnancyHandout.pdf Two Healthy Smiles: Tips to Keep You and Your Baby Healthy http://www.mchoralhealth.org/PDFs/PregnancyBrochure.pdf Oral Health Care During Pregnancy: At-a-Glance Reference Guide http://phpa.dhmh.maryland.gov/oralhealth/Documents/Pregnant_Women_Reference_Guide.pdf Oral Health Tips for Pregnant Women http://phpa.dhmh.maryland.gov/oralhealth/docs1/DentalHealthTipsforPregnantWomen.pdf Healthy Teeth, Healthy Kids website http://healthyteethhealthykids.org/

14. Katy Battani, RDH, MS kbattani@mdac.uskbattani@mdac.us Jonelle Grant, DDS, MPH drgrant.mychildrenschoice@gmail.comdrgrant.mychildrenschoice@gmail.com