Primary care physicians may feel underequipped to provide adequate oral health counseling to pregnant women, reports the University of North Carolina (UNC) at Chapel Hill School of Dentistry, even though poor maternal oral health can have significant effects on a woman’s overall health and the health of her children.
According to the school, this is the first study to provide national estimates and predictors of primary care prenatal oral health counseling. It used data from the 2013 Survey of Primary Care Physicians on Oral Health by the United States Department of Health and Human Services Office of Women’s Health.
More than 350 primary care physicians nationwide who treat pregnant women were surveyed. While many of them addressed prenatal oral health in the form of counseling and agreed that preventive dental care is very important, just 45% felt prepared to identify oral health issues and counsel pregnant patients about the importance of oral health, illustrating the disconnect between prenatal oral health practice guidelines and primary care physician preparedness.
“Pregnant women remain an underserved patient population, even after dentists from the ADA and physicians from the American College of Obstetrics and Gynecology came together on the national level to develop joint consensus practice guidelines for medical and dental providers that detail the safety of dental treatment in all trimesters,” said coauthor Gentry Byrd, DDS.
Previous studies suggest an increased risk of pre-term birth among pregnant women with periodontal disease. Also, mothers with untreated cavities and tooth decay have children with twice the likelihood of experiencing cavities and tooth decay with up to twice the severity. While many factors contribute to the development of diseases, the researchers said, mothers may model good oral health and nutritional practices for their children.
Fortunately, the researchers said, 69% of primary care physicians acknowledged their role in oral health and said they should be able to identify oral health issues in adult patients. The study also supported the results of a recent national survey that found a general lack of primary care physician training in oral health.
Furthermore, primary care physicians who received oral health continuing education were more likely to counsel pregnant women about oral health than those who did not, suggesting that oral health continuing education is key to improving prenatal care. The researchers say their work underscores the growing importance of interprofessional collaboration between healthcare providers, with a focus on oral health.
Oral health content has increased in medical school education over the past decade. For example, Smiles for Life, a national oral health curriculum, was designed to facilitate the integration of oral health into primary care provider training.
Also, the UNC-Chapel Hill School of Dentistry’s Department of Pediatric Dentistry and the UNC-Chapel Hill School of Medicine Department of Obstetrics and Gynecology collaborate in the Prenatal Oral Health Program to train medical and dental students in facilitating the delivery of essential dental services to pregnant women. Its goal is to improve the health of every woman, fetus, and child by educating and providing resources to providers.
“During pregnancy, some women may become eligible for insurance coverage for dental care that they may not get otherwise,” said Byrd. “This is an opportune time for medical and dental providers to collaborate in ensuring pregnant patients have a dental home.
The study additionally addressed areas of future research such as the quality of oral health counseling given by primary care providers and physicians and barriers to addressing prenatal oral health. New studies using their findings may be conducted to develop strategies to promote evidence-based practice, with more work needed to ensure equitable and quality prenatal care.
The study, Prenatal Oral Health Counseling by Primary Care Physicians: Results of a National Survey,” was published by the Maternal and Child Health Journal.
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