Data to Action Success Story: Rhode Island

Continuing Education for Rhode Island Oral Health Professionals to Promote Optimal Care Among Pregnant Women

Problem Overview

Hormonal and immunologic changes during pregnancy predispose women to various oral health problems. Half of all women experience during pregnancy gingivitis, a milder form of and precursor to more severe periodontal disease. The American Academy of Pediatric Dentistry (AAPD) recommends that women have periodontal evaluation performed by a dentist before becoming pregnant and they maintain oral hygiene during pregnancy [PDF - 559KB].

Furthermore, the receipt of preventive and therapeutic oral health services may prevent further complications of dental diseases during pregnancy and the postpartum period. The prenatal period is a valuable opportunity for receiving oral health services. During prenatal care, women should be advised by health care providers to maintain optimal oral health and receive a comprehensive oral evaluation, preventive services, and necessary treatment through appropriate and timely referral.

Program Activity Description

In December 2010, the Rhode Island Oral Health Program (OHP) submitted a data request to Rhode Island PRAMS to analyze and summarize Rhode Island women’s oral health practices during pregnancy. Rhode Island PRAMS provided OHP with data from 2009 births that showed  approximately half of Rhode Island women reported having had a dental visit during their pregnancy. Disparities in using dental services during pregnancy were found by type of prenatal care coverage and maternal characteristics, such as age, marital status, education, household income, and residential area. Challenges and barriers that keep women from obtaining oral health care during their pregnancy, such as financial barriers, lack of oral health care information during pregnancy, lack of appropriate counseling on oral health care needs from prenatal care providers (obstetricians, family physicians, and other prenatal care providers), and misperceptions of dental care providers on treating pregnant women, were discussed in “Less Than Optimal Oral Health Care During Pregnancy in Rhode Island Women: Oral Health Care as a Part of Prenatal Care.”. Written by the Rhode Island oral health epidemiologist and other oral health staff, this article was published on May 2011, in the Medicine and Health Rhode Island journal [PDF - 3MB].

In February 2011, OHP shared the 2009 PRAMS oral health findings at the Oral Health Professionals Advisory Council (OHPAC) meeting. The gaps in continuing education opportunities for the Rhode Island Oral Health workforce were discussed. Providing additional education on safety and importance of oral health care during pregnancy may address identified issues such as dentists postponing oral health care for pregnant women because they may not fully understand the physiological changes that occur during pregnancy and fetal development, or having misconceptions about the effect of dental treatments on pregnant women and their fetuses.

In collaboration with the Oral Health Professionals Advisory Council, Rhode Island Dental Association, Rhode Island Dental Hygienists' Association, and the Rhode Island Dental Assistants Association, The Rhode Island Oral Health Program planned the 2011 Continuation Education Sessions for community-based dental professionals at private or public health care settings in Rhode Island.

Program Activity Outcomes

The 2011 Rhode Island Prenatal and Pediatric Dentistry Mini-Residency was held on June 17-18, 2011. One of the sessions was devoted to Oral Health Care During Pregnancy, which included discussions of dental practice modifications and using dental X-rays and local anesthesia for the pregnant woman. In total, 116 Rhode Island oral health professionals attended the session, and most reported they “anticipate practice changes because of the session.”

Increased knowledge of oral health care considerations among special populations and expanded clinical competency and skills of the oral health workforce are expected to improve dental care use and meet the oral health needs of the Rhode Island’s pregnant women. The 2011-2016 Rhode Island Oral Health Plan identifies goals and priority activities that support optimal dental care for all Rhode Island pregnant women. The Rhode Island Oral Health Program is monitoring progress toward meeting the 2011-2016 Rhode Island Oral Health Plan objectives using PRAMS data.

As a continuing outreach effort to oral health professionals and pregnant women, the TeethFIRST! campaign was launched in 2013. The campaign is aninitiative of the Rhode Island Oral Health Commission, a statewide oral health coalition, to promote early dental visits for very young children in Rhode Island, and emphasizes the importance of good oral health and healthy oral health behaviors of pregnant women and mothers and its relationship with baby’s healthy teeth.