Issues to consider when reporting on oral health during pregnancy
By Mary Otto
Maintaining good oral health during pregnancy is important to the overall health of women as well as their children, an interdisciplinary team of health care experts stressed in a respected 2012 national consensus statement on the topic.
“Evidence suggests that most infants and young children acquire caries-causing bacteria from their mothers,” said the authors of report sponsored by the National Maternal and Child Oral Health Resource Center at Georgetown University. “Providing pregnant women with counseling to promote healthy oral health behaviors may reduce the transmission of such bacteria from mothers to infants and young children, thereby delaying or preventing the onset of caries.”
Some studies have examined the biological ties between the oral health of mothers and their children.
Researchers continue to seek a better understanding of the relationship between the bacterial burdens of mothers and the oral health status of their children.
A 2014 paper that is part of the body of ongoing research concluded that maternal bacterial levels serve as predictors of oral infection and caries incidence among their children. The study’s authors stressed that more research was needed to better understand these relationships, as well as the potential benefit of prenatal interventions in improving the oral health outcomes of children.
Researchers also are seeking to learn whether there are causal connections between gum disease and conditions such as low birth weight and preterm birth. They continue to weigh the potential of periodontal treatments to reduce adverse birth outcomes, according a meta-analysis of studies.
Low-income women who depend upon Medicaid for their health care may face additional challenges obtaining dental care, particularly during pregnancy.
As the Kaiser Family Foundation observed in this 2017 survey of Medicaid pregnancy coverage, “states have considerable discretion to determine the specific scope of maternity care benefits.”
Adult dental services are not mandated under Medicaid, and benefits vary from state to state. The program’s patchwork approach to adult dental benefits has particular relevance during pregnancy because “roughly two in three women of reproductive age are enrolled in the Medicaid program,” noted Meg Booth, executive director of the nonprofit Children’s Dental Health Project (CDHP) in a blog accompanying her organization’s September 2018 issue brief Oral Health During Pregnancy.
In spite of ongoing challenges, Booth notes that some states have made “laudable progress” in prioritizing oral health during pregnancy.
The CDHP package highlights advances made in Virginia since 2015 when the state instituted a comprehensive Medicaid dental benefit for pregnant women.
How is your state tackling this issue?