Perinatal Oral Health Among Underserved Women: A Call to Action for North Carolina Patients, Providers and Policymakers

INTRODUCTION

Knowledge gaps exist among providers and pregnant women about the importance and safety of oral health care around pregnancy. This article describes the current state of perinatal oral health and healthcare among underserved women in North Carolina (NC) and provides policy recommendations to improve their access to and utilization of dental services.

METHODS

A descriptive analysis is provided using (a) 2016 oral health surveillance data of a convenience sample of 459 pregnant women across NC, (b) 2014-2016 Medicaid dental provider and dental services utilization data for the Medicaid for Pregnant Women (MPW) program, and (c) 2017 Medicaid dental benefits policy. Surveillance data was not linked to Medicaid dental services utilization data.

RESULTS

Less than 20% of pregnant women surveyed reported having a dental visit during pregnancy and oral screenings revealed 33% had untreated caries. Medicaid data showed a steady decline since 2014 in percentage of MPW beneficiaries utilizing any dental service-less than 10% as of 2016. MPW dental benefits lapse at delivery because dental care is not considered pregnancy-related in NC policy. Only 20% of practicing NC dentists provided care to MPW beneficiaries in 2015.

DISCUSSION

Inadequacies in oral health knowledge, beliefs and practices exist among pregnant women, health care professionals and policymakers. Statewide efforts are needed to promote a standard of perinatal care that emphasizes collaborative practice and addresses existing barriers at the patient, provider and policy levels.

Smiles over time: an older adult oral health survey in Illinois

PURPOSE

The purpose of the project was to identify the oral health status and needs of the older adult population ≥60 years old in Illinois for policy decisions and to help identify possible need for oral health interventions. No baseline data has previously been collected on this population in Illinois.

METHODS

A public/private collaboration was formed, which included the Illinois Department of Public Health, the IFLOSS Coalition and dental and dental hygiene schools in Illinois. The screening tool was developed based on methods outlined by Association of State and Territorial Dental Directors for Basic Screening Surveys. Questionnaires and in-mouth screenings were conducted at selected sites statewide. Data was collected by dental and dental hygiene students and faculty at onsite clinics and community outreach sites.

RESULTS

A total of 437 seniors were screened statewide. Of this population, 81% had no dental insurance, 13% were edentulous and 58% claimed to have had a dental visit in the last year.A total of 26% rated their oral health as fair or poor, while 29% had untreated caries. Suspicious oral lesions were present in 14% (n=308 for the oral lesions indicator), 19% needed immediate dental care and 41% required referral.

CONCLUSION

This study revealed that surveillance can be accomplished by the collaboration among entities with focus on a specific population. Additional surveillance efforts are warranted among older adults in Illinois in an effort to plan and to implement appropriate interventions for addressing the oral health needs of this population.