Primary care physicians report feeling unprepared for role in prenatal oral health

March 19, 2018, University of North Carolina at Chapel Hill

A new study from the University of North Carolina at Chapel Hill suggests that primary care physicians may feel underequipped to provide adequate oral health counseling to pregnant women. Poor maternal oral health can have significant impacts on a woman's overall health and the health of her children.

Dr. Gentry Byrd and Dr. Rocio Quinonez of the UNC-Chapel Hill School of Dentistry co-authored a paper, published in the Maternal and Child Health Journal on March 17, that investigates prenatal oral health counseling by primary care physicians. This is the first study to provide national estimates and predictors of their prenatal oral health counseling. The study used data from the 2013 Survey of Primary Care Physicians on Oral Health by the United States Department of Health and Human Services' (U.S. HHS) Office of Women's Health.

More than 350 primary care physicians across the country who treat pregnant women were surveyed. The authors found that while many primary care physicians addressed prenatal oral health in the form of counseling, and agreed that preventive dental care is very important, just 45 percent of respondents felt prepared to identify oral health issues and counsel pregnant patients on the importance of oral health.

With more than half of the surveyed primary care physicians saying they feel unprepared to address oral health issues with pregnant patients, this study illustrates the disconnect between prenatal oral health practice guidelines and workforce preparedness.

"Pregnant women remain an underserved patient population, even after dentists from the American Dental Association (ADA) and physicians from the American College of Obstetrics and Gynecology (ACOG) 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 Byrd.

Previous studies suggest there is an increased risk of pre-term birth among pregnant women with periodontal disease. We also know that 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 there are many factors that contribute to the development of diseases, good oral health and nutritional practices of mothers may be modeled to their children.

The findings of Byrd and Quinonez's study are promising. 69 percent of primary care physicians acknowledged their role in oral health and that they should be able to identify oral health issues in adult patients. The authors' research also supported the results of a recent national survey, which found a general lack of primary care training in oral health. The authors found that primary care physicians who received oral health continuing education had a higher likelihood of counseling pregnant women on oral health than those who did not, suggesting that oral health continuing education is a key component to improving prenatal care.

This research illustrates the growing importance of interprofessional collaboration between health care professions, with a focus on oral health. Oral health content has increased in medical school education within the last decade. For instance, Smiles for Life, a national oral health curriculum, was designed to facilitate the integration of oral health into primary care provider training.

Quinonez and Dr. Kim Boggess developed the Prenatal Oral Health Program (pOHP), a collaboration between the UNC-Chapel Hill School of Dentistry's department of pediatric dentistry and the UNC-Chapel Hill School of Medicine's department of obstetrics and gynecology, to train medical and dental students on facilitating the delivery of essential dental services to . The program's 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 authors address areas of future research, such as the quality of oral counseling given by primary care providers and physicians, and barriers to addressing prenatal . New studies using their findings may be done to help develop strategies to promote evidence-based practice, with more work needed to assure equitable and quality prenatal care.

Explore further: CDC: Oral health in young women needs improvement

More information: M. Gentry Byrd et al, Prenatal Oral Health Counseling by Primary Care Physicians: Results of a National Survey, Maternal and Child Health Journal (2018). DOI: 10.1007/s10995-018-2483-4

Related Stories

CDC: Oral health in young women needs improvement

September 22, 2014
(HealthDay)—Women of childbearing age in the United States should be encouraged to maintain better oral care and visit the dentist routinely, according to a study published Sept. 18 in the U.S. Centers for Disease Control ...

Oral care guidelines can improve quality of oral health care

December 20, 2017
(HealthDay)—Development and implementation of standardized oral care treatment and referral guidelines can improve the overall quality of oral health practice for older sub-acute patients, according to a study published ...

Better dental care needed for people living with MS

March 7, 2017
Many Australians living with multiple sclerosis (MS) do not receive adequate oral health care or access to dental services.

A head start against tooth decay

January 7, 2015
Massachusetts public health advocates have developed oral health guidelines to ensure the well-being of the 70,000 babies born in the state each year as well as that of their mothers.

Innovative oral health app helps with diagnosis, treatment

February 1, 2016
(HealthDay)—The Society of Teachers of Family Medicine (STFM) has released an innovative app as part of its national oral health curriculum, Smiles for Life, according to a report published by the American Academy of Family ...

Children's oral health disparities persist despite equal dental care access

December 14, 2016
Oral health of children who receive dental care through Medicaid lags behind their privately insured peers, even though the children receive the same amount of dental care, according to a study from the Columbia University ...

Recommended for you

Experts question benefits of fluoride-free toothpaste

August 7, 2018
Dental health experts worry that more people are using toothpaste that skips the most important ingredient—fluoride—and leaves them at a greater risk of cavities.

The starch risk to teeth

August 7, 2018
An examination of research on oral health, commissioned by the World Health Organisation, has indicated that for oral health we should stick to whole grain carbohydrates and avoid processed ones, especially if sweet.

Researchers discover cellular messengers communicate with bacteria in the mouth

May 8, 2018
A new UCLA-led study provides clear evidence that cellular messengers in saliva may be able to regulate the growth of oral bacteria responsible for diseases, such as periodontitis and meningitis.

Drug-filled, 3-D printed dentures could fight off infections

April 25, 2018
Nearly two-thirds of the U.S. denture-wearing population suffer frequent fungal infections that cause inflammation, redness and swelling in the mouth.

Bacteria boost antifungal drug resistance in severe childhood tooth decay

April 25, 2018
Early childhood caries, a form of severe tooth decay affecting toddlers and preschoolers, can set children up for a lifetime of dental and health problems. The problem can be significant enough that surgery is the only effective ...

Absence of a transcription factor halts tooth development in mid-stride

April 11, 2018
Amjad Javed, Ph.D., and University of Alabama at Birmingham colleagues have found a key role in tooth development for the transcription factor Specificity protein 7, or Sp7.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.