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Closing the Gap in Oral Health Equity Before Birth

As part of National Minority Health Month — a time in which we also recognize Black Maternal Health Week (April 11 – 17) — it’s important to elevate awareness about maternal health disparities and the role oral health providers can play in mitigating our nation’s maternal health crisis. Along with highlighting a collection of issues, stories and providers, DentaQuest joins a diverse group of national business and health leaders invested in the health and longevity of Black mothers as the sole oral health sponsor of the Black Maternal Health Conference (BMHC). We proudly add our voice to the discussions that elevate maternal health and celebrate Black women.

There is no shortage of thoughts and emotions that run through the minds of expecting parents: joy, anticipation, fear and anxiety are just a few. For many, access to health care, including oral care, is a big factor in that mix of fear and anxiety.

And for those who already disproportionately lack access to care, those fears are often compounded.

Lack of dental care during pregnancy is a significant concern when considering the impact poor oral health can have on pregnancy outcomes. Pregnancy can increase the likelihood of getting periodontal (gum) disease and cavities. And poor oral health during pregnancy may increase risk of poor birth outcomes, such as low birth weight or premature birth.

These gaps in access around oral health care contribute to long-standing inequities in our health system. The same populations that face the highest rates of maternal mortality and poor birth outcomes also face higher rates of oral disease — and are the least likely to be able to access dental care.

State Medicaid programs typically have an additional dental benefit for those who are pregnant. But in states with limited or no adult Medicaid dental benefits, that’s when dental coverage for the new mother ends. Many dental providers prefer to see patients after the pregnancy due to outdated concerns about dental care risks during pregnancy. This creates an additional barrier to dental care when expecting a child.

Enter Smiling Stork and Healthy Beginnings, two DentaQuest outreach programs that are working to increase awareness and utilization of oral care among Medicaid families, especially those who are pregnant and young children.

Smiling Stork and Healthy Beginnings

DentaQuest launched the Smiling Stork and Healthy Beginnings programs in 2006 and 2012, respectively, after data showed that those who are pregnant and children ages 0-2 years were underutilizing oral health care.

“When we look at data and compare oral health of Medicaid populations to commercial insurance, historically their rate of dental caries is higher due to lower rates of access and utilization,” says DentaQuest outreach supervisor Ivy Beville, RDH, BASDH. “If we can get ahead, reaching out to these families early on, it will be better for children's long-term health.”

The Smiling Stork program provides oral health materials specific to pregnancy and newborn oral health care. Healthy Beginnings provides age-specific oral health education at each birthday for DentaQuest’s youngest members, ages 0 to 2.

  • The Smiling Stork materials include oral health issues to watch for during pregnancy — such as swollen or bleeding gums. They ensure members who are pregnant that dental care is safe and encourage them to see a dental provider at least once during pregnancy. The materials also share tips for how to gently clean an infant’s gums as they start teething.
  • The Healthy Beginnings materials outline important advice on topics from pacifier use and baby bottle dental decay, to how to engage young toddlers in brushing their own teeth.
  • Both programs encourage finding and visiting a dental home provider. Early visits to a dental provider help providers and families to build relationships. This also offers opportunities for dental providers to offer age appropriate oral health education.

“We pair these programs because we know that a mother's oral health is a great predictor of a child's oral health,” Beville says. “If we can start by taking care of the mom and getting her regular dental care, she's more likely to bring her child to the dentist.”

Improving the Health of the Entire Family

Kelly Schroeder, RDH, MS, senior national outreach specialist at DentaQuest, hopes that this outreach will lead families to a better understanding of the role oral health plays in their lives — from little things they do every day to the larger connections between oral health and chronic diseases.

“A lot of people don’t realize, for example, that the type of bacteria that causes dental caries is communicable,” Schroeder says. “If a caregiver has active dental caries bacteria in their mouth, they can transfer the bacteria to the child when doing simple things like kissing or sharing food. We try to provide this kind of education to our members.”

As the Smiling Stork and Healthy Beginnings programs have shown, when awareness and education around oral health increases, so do better oral health habits.

“A mother who has good oral health habits and visits the dentist regularly is more likely to teach the children good oral health habits and take them to the dentist regularly,” Schroeder says. “Modeling that behavior sets up the whole family for better oral health habits and a healthy, pain-free smile for life.”