Promoting Oral Health During Pregnancy
Update on Activities: May 2020
For at least three decades, federal agencies and organizations have launched programs, advanced policy, produced resources, and provided education and training to ensure that health professionals and pregnant women are aware of the importance and safety of receiving oral health care during pregnancy. The goal of these efforts is to improve oral health for pregnant women and their children.
The May 2020 update presents a timeline of national and state activities related to oral health during pregnancy that took place between 1996 and 2020. The timeline highlights efforts to raise awareness of the importance of oral health during pregnancy and to increase access to and utilization of oral health care for pregnant women. The timeline is by no means an exhaustive list, but it illustrates the abundance of activitiesthat have been conducted during this period.
- Browse the series of Promoting Oral Health During Pregnancy: Update on Activities
1996
Bright Futures in Practice: Oral Health
This guide offers health professionals an overview of preventive oral health supervision during five developmental periods: prenatal, infancy, early childhood, middle childhood, and adolescence. It provides oral health supervision guidelines, risk assessment, measurement of outcomes, steps to make oral health supervision accessible, and essentials of oral health. [Funded by the Maternal and Child Health Bureau] The guide was produced by the National Center for Education in Maternal and Child Health.
2006
Oral Health Care During Pregnancy and Early Childhood: Practice Guidelines
These practice guidelines provide an overview of oral health during pregnancy and early childhood and recommendations for prenatal care professionals, oral health professionals, and pediatric health professionals. The recommendations include background and offer guidance on the role of the health professional, what should happen at the visit, and other topics specific to the type of health professional. The guide was produced by the New York State Department of Health.
2008
Access to Oral Health Care During the Perinatal Period: A Policy Brief
This policy brief provides an overview of the major barriers to addressing women’s oral health needs during the perinatal period. The brief provides examples of strategies to promote the use of guidelines during the perinatal period, expand opportunities for professional and consumer education, increase dental insurance coverage, and integrate oral health care as a part of routine perinatal care. [Funded by the Maternal and Child Health Bureau] The brief was produced by the National Maternal and Child Oral Health Resource Center.
Oral Health Care During Pregnancy: A Summary of Practice Guidelines
This document (now archived) summarized the New York State Department of Health publication Oral Health Care During Pregnancy and Early Childhood: Practice Guidelines, which is geared toward prenatal care health professionals and oral health professionals. The guidelines intended to bring about changes in the health care delivery system and to improve the
overall standard of care for pregnant women. [Funded by the Maternal and Child Health Bureau] The document was produced by the National Maternal and Child Oral Health Resource Center.
2010
Oral Health During Pregnancy and Early Childhood: Evidence-Based Guidelines for Health Professionals
These guidelines are designed to help health professionals deliver oral health services to pregnant women and young children. Topics include the importance of oral health; maternal physiological considerations related to oral health; pregnancy, oral conditions, and oral health care; oral health and early childhood; access to care; and systems improvement and public policy changes. Sample forms and websites for parents are included as appendices. A policy brief is also available. The guidelines were produced by the California Dental Association Foundation.
Smiles for Life: A National Oral Health Curriculum
This curriculum for health professionals and educators comprises eight courses addressing oral health. Course 5 focuses on pregnancy and women’s oral health. Topics include the importance of oral health before and during pregnancy, the prevalence of oral disease during pregnancy and its consequences for both mothers
and children, and treatment guidelines for pregnant women. The curriculum was produced by the Society of Teachers of Family Medicine.
2012
Oral Health Care During Pregnancy: A National Consensus Statement
This resource includes a consensus statement that resulted from an expert workgroup meeting held on October 18, 2011, in Washington, DC, convened by the Health Resources and Services Administration in collaboration with the American College of Obstetricians and Gynecologists and the American Dental Association. It contains guidance on oral health care for pregnant women for both prenatal care health professionals and oral health professionals, pharmacological considerations for pregnant women, and guidance for health professionals to share with pregnant women. [Funded by the Maternal and Child Health Bureau] The resource was produced by the National Maternal and Child Oral Health Resource Center
Tips for Good Oral Health During Pregnancy
This tip sheet provides information and resources to help women take care of their oral health during pregnancy. Topics include getting oral health care, practicing good oral hygiene, eating healthy foods, and practicing other healthy behaviors. The tip sheet also encourages women to take care of their infant’s gums and teeth and ask their pediatric health professional to check their infant’s mouth starting at age 6 months. The tip sheet is available in Arabic, Chinese, Chuukese, English, German, Korean, Portuguese, Russian, Samoan, Spanish, and Vietnamese. [Funded by the Maternal and Child Health Bureau] The tip sheet was produced by the National Maternal and Child Oral Health Resource Center .
2013
Considerations for the Dental Treatment of Pregnant Women: A Resource for Connecticut Dentists
This document is designed to help dentists and other health professionals understand the importance of providing oral health services to pregnant women. The document also assists health professionals in making appropriate decisions about pregnant women’s care. Contents include answers to basic questions related to providing oral health services to pregnant women and pharmacological considerations for pregnant women. The document was produced by Connecticut State Dental Association.
Oral Health Care During Pregnancy and Through the Lifespan
This paper presents information and recommendations for obstetricians, gynecologists, and others about oral health care during pregnancy and through the lifespan. Topics include general health, common oral health conditions during pregnancy, periodontal disease and pregnancy outcomes, oral health assessment and counseling during pregnancy, and access to oral health care. The paper was reaffirmed in 2017. The paper was produced by the American College of Obstetricians and Gynecologists.
Perinatal and Infant Oral Health Quality Improvement (PIOHQI) Initiative Pilot Phase
The Health Resources and Services Administration’s Maternal and Child Health Bureau launched the Perinatal and Infant Oral Health Quality Improvement (PIOHQI) national initiative in 2013. (See the 2015 description of the PIOHQI Initiative expansion phase for more information about that phase.) This initiative began with the PIOHQI pilot grant program. The purpose of the program was to expand the number of targeted demonstrations for replicable integration of high quality oral health care (i.e., preventive services, restorative treatment, education) into perinatal and infant primary care delivery systems with statewide reach. Three projects—Connecticut, New York, and West Virginia—were funded through 2018.
Prenatal Oral Health Program (pOHP)
These resources are designed to help prenatal primary care professionals and oral health care teams implement and deliver preventive oral health services to women, including those who are pregnant. Contents include videos, guidelines, a referral form and followup report card, and a periodicity table. Additional resources for new mothers and pregnant women— including videos on oral health care for pregnant women and infants, a self evaluation, and a provider locator—are also available in English and in Spanish. The resources were produced by the University of North Carolina at Chapel Hill School of Dentistry and School of Medicine.
Promoting Oral Health in Pregnancy
This brief describes a study on factors that affect the ability and inclination of pregnant women with low incomes in Connecticut to seek oral health care. The brief outlines reasons for seeking oral health care during pregnancy as well as several barriers related to obtaining care, and it provides recommendations for overcoming barriers. The brief was produced by the Connecticut Health Foundation.
2014
American Dental Association
The American Dental Association’s (ADA’s) Council on Access, Prevention, and Interprofessional Relations submitted two resolutions to the House of Delegates and both were approved. These resolutions are now ADA policy and read as follows:
Resolved, that the ADA urges all pregnant women and women of child bearing age to have a regular dental examination. Resolved, that the ADA acknowledges that preventive, diagnostic, and restorative dental treatmentis safe throughout pregnancy and is effective in improving and maintaining the oral health of the mother and her child.
2015
During Pregnancy, The Mouth Matters: A Guide to
Michigan Perinatal Oral Health
This guide provides information about reducing infant
mortality and promoting perinatal oral health in
Michigan. It discusses a statewide perinatal oral health
initiative, an infant-mortality-reduction plan, the
national and local landscapes, and transmission of cariogenic
bacteria. It also includes guidance for perinatal
care health professionals and oral health professionals,
a visual guide for common oral health conditions, and
referral resources to assist in facilitating oral health care
for pregnant women. The guide was produced by the
Michigan Department of Health and Human Services.
Healthy Smiles for Mom and Baby: Insights into Expecting and New Mothers’ Oral Health Habits
This report summarizes findings from a survey to explore the oral health attitudes and behaviors of expectant and new mothers. Topics include women’s
self rating of oral health before and during pregnancy and oral health problems reported during pregnancy; dental checkup participation and coverage, frequency, and cost concerns; routines impacting oral health; participation in healthy pregnancy programs; and the impact of pediatricians’ and other health professionals’ discussions of oral hygiene habits. The report was produced by Cigna.
Perinatal and Infant Oral Health Quality Improvement(PIOHQI) Initiative Expansion Phase
The second phase of the Perinatal and Infant Oral Health Quality Improvement national initiative was an expansion grant program (2015–2019), which continued the work of the national initiative. (See the description of the PIOHQI initiative pilot phase in 2013 for information about the pilot program.) The purpose of the program was to expand the number of targeted demonstrations for replicable integration of high quality oral health care (i.e., preventive services, restorative treatment, education) into perinatal and infant primary care delivery systems with statewide reach. Thirteen expansion projects—Arizona, California, Colorado, Maine, Maryland, Massachusetts, Minnesota, New Mexico, Rhode Island, South Carolina, Texas, Virginia, and Wisconsin—were funded through 2019.
Title V National Performance Measure 13 (Oral Health)
The Maternal and Child Health Bureau revised the process that states use for the Title V maternal and child health block grant needs assessment, grant application, and reporting in 2015. Under the process, there are fewer performance measures, but those remaining are more closely tied to Title V activities, and evidence based or evidence informed strategy measures are state identified. In addition, data prepopulates from federal sources, wherever possible. The two oral health related performance measures (NPMs) are NPM 13.1: Percent of women who had a preventive dental visit during pregnancy and NMP 13.2: Percent of children and adolescents, ages 1 through 17, who had a preventive dental visit in the past year.
2016
2015 Wisconsin Perinatal-Infant Oral Health Summit: Summary Report and Statewide Plan
This report summarizes information from a summit held on September 9, 2015, to brainstorm strategies for improving oral health for pregnant women and infants in Wisconsin. The report describes five themes
supported by both oral health communities and overall health communities: reimbursements and insurance availability, coordination and integration, training, awareness, and practice settings. Contents include a statewide plan (objectives and activities) to reduce the prevalence of oral disease among pregnant women and infants who are underserved by integrating highquality oral health care into the health care delivery system. [Funded by the Maternal and Child Health Bureau] The report was produced by the Children’s Health Alliance of Wisconsin.
Bright Futures: Oral Health—Pocket Guide (3rd ed.)
This pocket guide offers health professionals an overview of preventive oral health supervision during five developmental periods: prenatal, infancy, early childhood, middle childhood, and adolescence. The pocket guide is designed to help health professionals implement specific oral health guidelines during these periods. For each period, information about family preparation, risk assessment, interview questions, screening, examination, preventive procedures, anticipatory guidance, measurable outcomes, and referrals is discussed. [Funded by the Maternal and Child Health Bureau] The pocket guide was produced by the National Maternal and Child Oral Health Resource Center.
Massachusetts Oral Health Practice Guidelines for Pregnancy and Early Childhood
These guidelines provide oral health care recommendations and resources for health professionals caring for pregnant women and young children. Contents include background information about oral diseases; the status of oral health among pregnant women and children in Massachusetts and national and state efforts to improve it; and the role of prenatal care health professionals, oral health professionals, and pediatric care health professionals in improving pregnant women’s and children’s oral health. Topics include assessing, advising, educating, referring, collaborating, and providing treatment and management. Resources on medication use during pregnancy, sample referral forms, and reproducible handouts on healthy portion sizes and healthy eating during pregnancy are also provided. The guidelines were produced by the Massachusetts Department of Public Health.
Oral Health Care and Coverage During Pregnancy
This brief for policymakers provides information about the effects of oral disease on pregnant women and infants and state actions to prevent disease and reduce costs. The brief examines insurance coverage for care, including publicly funded coverage and reimbursement rates; dental expenditures; and where to find statespecific statistics on health status and coverage rates.
The brief also discusses state strategies to help pregnant women receive care and provisions in the Affordable Care Act, such as public education and tobaccocessation services. The brief was produced by the National Conference of State Legislatures.
2017
Connecticut’s Perinatal and Infant Oral Health Quality Improvement Project: Pregnancy Risk Assessment Monitoring System Data for Evaluation
This report describes the Pregnancy Risk Assessment Monitoring System (PRAMS) and how PRAMS data can be used for evaluating the Perinatal and Infant Oral Health Quality Improvement project in Connecticut. Topics include births and maternal oral health and health care in Connecticut. Other topics include PRAMS questions on maternal oral health, oral health care for mothers by health insurance status, and implications and alternatives for project evaluation. [Funded by the Maternal and Child Health Bureau] The report was produced by Connecticut Voices for Children.
Oral Health Care for Pregnant Women
This document presents clinical practice guidelines for the oral health care of pregnant women in South Carolina. It contains data on infant mortality and preterm birth, oral health care and counseling utilization, and key findings from the SC Pregnancy Risk Assessment Monitoring Systems (PRAMS) for 2012–2013. It also includes recommendations for health professionals and for oral health professionals, referral forms for oral health care, and dentists’ reports for prenatal care professionals. [Funded by the Maternal and Child Health Bureau] The document was produced by the South Car olina Department of Health and Environmental Control.
2018
Oral Health Care During Pregnancy: North Carolina Collaborative Practice Framework
This document provides guidance on oral health care during pregnancy for prenatal care health professionals and oral health professionals in North Carolina, pharmacological considerations for pregnant women, and guidance for health professionals to share with pregnant women. Selected topics include assessing women’s oral health status, advising pregnant women about oral health care, working in collaboration with other health professionals, providing support services to pregnant women, improving health services in the community, and advising women about oral health care. The document was adapted from Oral Health Care During Pregnancy: A National Consensus Statement. The document was produced by the North Carolina Division of Public Health, Oral Health Section.
2019
Best Practice Approach: Perinatal Oral Health
This report provides a description of perinatal oral health, including its significance and background, barriers to accessing oral health care for this population, and a strategic framework for improving perinatal oral health. The report also includes guidelines and recommendations, research evidence, best practice criteria, state practice examples, and a logic model. [Partially funded by the Maternal and Child Health Bureau] The report was produced by the Association of State and Territorial Dental Directors.
Coverage Brief: Improving Access to Oral Health Care in Pregnancy
This brief provides an overview of the status of dental coverage during pregnancy, using data related to Medicaid dental coverage available to pregnant women in each state as of September 2019. Topics include the impact of a woman’s oral health during pregnancy and after birth, barriers to accessing oral health care during pregnancy, oral health coverage for pregnant wom en through state Medicaid programs, and available data about oral health coverage for pregnant women through Medicaid. The brief was produced by the Children’s Dental Health Project.
The Maternal and Child Health Bureau-funded Perinatal and Infant Oral Health Quality Improvement (PIOHQI) Initiative 2013-2019: Final Report
This report describes the achievements of 16 projects funded though the PIOHQI initiative to improve oral health for pregnant women and infants, lessons the projects learned, and resources they produced. It provides examples of project achievements and successes in seven strategy areas: network development; workforce enhancement; community outreach; process and procedure development; program development; state practice guidance development; and data collection, evaluation, and reporting. Also presented are examples of PIOHQI projects included in Best Practice Approach: Perinatal Oral Health and selected resources produced by the projects. [Funded by the Maternal and Child Health Bureau] The report was produced by the National Maternal and Child Oral Health Resource Center.
Oral Health Care During Pregnancy: Practice Guidance for Maryland’s Prenatal and Dental Providers
This document presents practice guidance for oral health professionals and prenatal care professionals in Maryland. It provides information about the oral health of pregnant women and their infants in the state, state statistics on oral health care utilization during pregnancy, clinical practice guidance, a visual guide of oral conditions that can occur during pregnancy, a pharmacological considerations chart, a sample dental referral form, and educational resources to share with pregnant women. [Funded by the Maternal and Child Health Bureau] The document was produced by the Maryland Department of Health.
This document provides guidance on oral health care during pregnancy for prenatal care health professionals and oral health professionals in Texas. Topics include myths vs. facts, guidance for health professionals, oral conditions during pregnancy, and oral health pharmacological considerations for pregnant women. It also includes resources for consumers, available in English and in Spanish, about good oral health during pregnancy and during infancy as well as a dental referral form for pregnant women. The document was adapted from Oral Health Care During Pregnancy: A National Consensus Statement. [Funded by the Maternal and Child Health Bureau] The document was produced by Texas Department of State Health Services.
Oral Health During Pregnancy: Practice Guidance for Virginia’s Prenatal and Dental Providers
These clinical practice guidelines for oral health professionals and prenatal care professionals in Virginia provides information about the oral health of pregnant women and their infants in the state, state statistics on oral health care utilization during pregnancy, practice guidance, a visual guide of oral conditions that can occur during pregnancy, a pharmacological considerations chart, a sample dental referral form, and educational resources to share with pregnant women. [Funded by the Maternal and Child Health Bureau] The guidelines were produced by the Virginia Department of Health, Dental Health Program.
2020
AMCHP’s Implementation Toolkit for National Performance Measure 13
This toolkit for Title V program staff and relevant partners and other stakeholders provides information to help address national performance measure 13.1 (preventive dental visits for pregnant women) and 13.2 (preventive dental visits for children and adolescents ages 1–17). The strategic approaches described in the toolkit are informed by evidence and include resources from national and state organizations. The approaches are divided into categories, with relevant resources listed for each. [Partially funded by the Maternal and Child Health Bureau] The toolkit was produced by the Association of Maternal and Child Health Programs and the National Maternal and Child Oral Health Resource Center.
Improving Pregnancy-Related Oral Health Coverage Would Bolster Maternal Health, Reduce Health Care Costs
This document provides information about the importance of oral health to women’s and children’s overall health and discusses the benefits of making comprehensive oral health coverage a guaranteed part of pregnancy related Medicaid coverage. Other topics include the importance of oral health coverage to mothers’ and children’s well being, the contribution of oral health disparities to disparities in maternal health outcomes, and variations in pregnancy related oral health coverage by state. The document was produced by Families USA.
Oral Health Tips
This series of videos offers information about oral health during pregnancy and during infancy.
Pregnancy related topics include visiting the dentist during pregnancy, the importance of brushing
with fluoride toothpaste and flossing every day, the relationship between a pregnant woman’s oral health and her future child’s oral health, and oral health problems that can occur during pregnancy. The video series was produced by Georgia Department of Oral Health.
Perinatal Oral Health Policy Statement
This Association of State and Territorial Dental Directors (ASTDD) policy statement provides information about oral health during the perinatal period, including barriers to achieving and maintaining good oral health during this period for both women and their infants and efforts to improve access to and utilization of oral health care for this population. The document presents a strategic framework for improving perinatal oral health. A concluding statement indicating what ASTDD endorses is included. [Partially funded by the Maternal and Child Health Bureau] The policy statement was produced by ASTDD.
Title V National Performance Measure 13 (OralHealth): Strategies for Success
This paper provides detailed information to help state Title V maternal and child health programs in their implementation of national performance measure 13 (NPM 13) and oral health related state performance measures. It provides sample strategies for addressing NPM 13.1 and 13.2. The resource also provides sample evidence based or evidence informed strategy measures (ESMs); possible data sources for ESMs; and a selection of resources, including best practice reports, curricula, guides, and risk assessments, and contacts for more assistance. [Funded by the Maternal and Child Health Bureau] The paper was produced by the National Maternal and Child Oral Health Resource Center.
Cite as
National Maternal and Child Oral Health Resource Center. 2020. Promoting Oral Health During Pregnancy: Update on Activities— May 2020. Washington, DC: National Maternal and Child Oral Health Resource Center.
Promoting Oral Health During Pregnancy: Update on Activities— May 2020 © by National Maternal and Child Oral Health Resource Center, Georgetown University.
This publication was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an annual award totaling $1,000,000 with no funding from nongovernmental sources. This information or content and conclusions are those of the author(s) and should not be construed as the official policy of HRSA, HHS, or the U.S. government, nor should any endorsements be inferred.