Oral Health: Why It s Important and What Healthy Start Communities Can Do to Improve It

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Oral Health: Why It s Important and What Healthy Start Communities Can Do to Improve It Jolene Bertness, M.Ed., CHES Healthy Start EPIC Center April 7, 2015 3:00 p.m. to 4:00 p.m. ET Photo Source: Christiana Care Flickr CC BY-NC-SA 2.0 1

Overview During this presentation, you will be learning about the following: Importance of oral health during pregnancy and infancy Reasons pregnant women do not seek or receive oral health care Oral health issues faced during pregnancy Strategies for improving and maintaining oral health during pregnancy and infancy Photo Source: Thinkstock 2

Importance of Oral Health During Pregnancy and Infancy Healthy mother Oral health is important to mother s overall health and healthy pregnancy Healthy baby Bacteria that cause tooth decay can be passed from mother to baby Not enough evidence to support theory that gum disease causes premature births and/or lowbirthweight babies 3

Pregnant Women and Oral Health 4 out of 10 pregnant women have tooth decay and/or some form of gum disease Source: Azofeifa A, Yeung LF, Alverson CJ, Beltran-Agular E. 2014. Oral health conditions and dental visits among pregnant women and nonpregnant women of childbearing age in the United States, National Health and Nutrition Examination Survey, 1999 2004. Preventing Chronic Disease: Public Health Research, Practice, and Policy. 11(E163):1 10. Photos Source: Thinkstock 4

Percent of Pregnant Women Having a Dental Appointment in Previous Year By Age By Income 80% 75% 70% 66% 70% 60% 54% 59% 60% 51% 50% 50% 41% 40% 40% 30% 30% 20% 20% 10% 10% 0% 0% 15 24 25 34 35 44 <100 100-199 >199 Percent of Poverty Level Source: Azofeifa A, Yeung LF, Alverson CJ, Beltran-Agular E. 2014. Oral health conditions and dental visits among pregnant women and nonpregnant women of childbearing age in the United States, National Health and Nutrition Examination Survey, 1999 2004. Preventing Chronic Disease: Public Health Research, Practice, and Policy. 11(E163):1 10. 5

Percent of Pregnant Women Having Preventive Care as Main Reason for Dental By Age Visit 80% 80% 70% 69% 63% 70% 60% 56% 60% 50% 50% 40% 40% 30% 30% 20% 20% 10% 10% 0% 0% 15 24 25 34 35 44 By Income 70% 55% 41% <100 100 199 >199 Percent of Poverty Level Source: Azofeifa A, Yeung LF, Alverson CJ, Beltran-Agular E. 2014. Oral health conditions and dental visits among pregnant women and nonpregnant women of childbearing age in the United States, National Health and Nutrition Examination Survey, 1999 2004. Preventing Chronic Disease: Public Health Research, Practice, and Policy. 11(E163):1 10. 6

Reasons for Not Seeking or Receiving Oral Health Care During Pregnancy Do not understand that oral health is important to a healthy pregnancy Believe that poor oral health during pregnancy is normal Afraid that baby may be hurt by x- rays, local anesthesia, pain medications, or dental treatment Cannot find a dentist willing to treat pregnant women Photo source: Thinkstock 7

Common Oral Health Issues During Pregnancy Healthy mouth Periodontitis Pregnancy gingivitis Moderate Severe Photo sources: Dozenist Wikipedia CC BY-SA 3.0 (upper left), Parveen chopra Flickr CC BY-NC 2.0 (lower right) 8

Other Possible Oral Health Issues During Pregnancy Pregnancy tumor Tooth erosion Dry mouth Photo Sources: Medico @ www.medeco.de (left), Jeffrey Dorman Wikimedia Commons CC BY-SA 3.0 (upper right), Virginia Helena Quadrado @ https://fisioterapiapersonalizada.wordpress.com/2011/04/30/xerostomia-umsimples-significado-mas-quase-nunca-comentado (lower right) 9

Other Possible Oral Health Issues During Pregnancy Oral Health Effects of Iron Deficiency Anemia Burning sensation in the mouth and tongue Fungal infections in the mouth Tongue redness and swelling Sores and pale tissue in the mouth Photo source: Thinkstock 10

Lose a tooth for every pregnancy Baby takes calcium from mother s bones and teeth Others? Fact or Fiction Photo source: Thinkstock 11

Oral Health Messages to Share with Pregnant Women Get oral health care Practice good oral hygiene Eat healthy and nutritious food Practice other healthy behaviors Photo Source: Thinkstock 12

Get Oral Health Care Receiving oral health care during pregnancy is safe, including: X-rays Pain medication (e.g. aspirin) Local anesthesia (e.g. Novocain) Let dental office know you re pregnant and when you are due Get needed oral health care before baby is born 13

Practice Good Oral Hygiene Drink fluoridated water throughout the day Brush teeth using fluoridated toothpaste twice a day Floss teeth once a day Photos Source: Thinkstock 14

Practice Good Oral Hygiene Rinse nightly with an over-the-counter, alcoholfree, fluoride mouth rinse After eating, chew gum with Xylitol to reduce the amount of bacteria that cause tooth decay After vomiting, rinse mouth with a teaspoon of baking soda in a cup of water to neutralize stomach acids in mouth 15

Practice Good Oral Hygiene Dry Mouth: Sip on water or suck on ice chips Avoid alcohol, tobacco, and caffeine Chew sugar-free gum or suck on sugar-free mints Avoid salty or spicy foods Use a humidifier at night Consider using over-the-counter saliva substitutes Talk to dentist or dental hygienist Photo Source: U.S. Food and Drug Administration 16

Eat Healthy and Nutritious Meals Eat a variety of healthy foods Eat fewer foods high in sugar like candy, cookies, cake, and dried fruit Read labels to identify foods high in sugar Drink fewer beverages that contain sugar, like fruitflavored drinks or pop/soda Drink water throughout the day, especially between meals and snacks Photo Source: Pixabay 17

Practice Other Healthy Behaviors Attend prenatal classes Stop tobacco and recreational drug use Avoid secondhand smoke Stop alcohol use Photo Source: U.S. Department of Agriculture 18

Strategies to Help Pregnant Women Achieve and Maintain Good Oral Health Education Strategies: Include oral health in prenatal and perinatal home visits Host oral health baby showers Arrange Ask a Dentist/Dental Hygienist events for pregnant women Use informational interviewing strategies to educate and motivate pregnant women Photo Source: Thinkstock 19

Strategies to Help Pregnant Women Achieve and Maintain Good Oral Health Case Management Strategies: Identify local oral health providers willing to see pregnant women and make referrals Help pregnant women overcome emotional and physical barriers to receiving oral health care Photo Source: Thinkstock 20

Strategies to Help Pregnant Women Achieve and Maintain Good Oral Health Partnership/Collaboration Strategies: Partner with local WIC agencies Partner with local dental societies Partner with local obstetrics and gynecology societies Collaborate with perinatal programs Photo Source: Thinkstock 21

Resources for Healthy Start Staff Bright Futures in Practice: Oral Health Pocket Guide (2nd ed.) Oral Health Care During Pregnancy: A National Consensus Statement Module 5: Oral Health and the Pregnant Patient in Smiles for Life: A National Oral Health Curriculum Open Wide: Oral Health Training for Health Professionals 22

Resources for Pregnant Women English and Spanish Two Healthy Smiles: Tips to Keep You and Your Baby Healthy A Healthy Smile for Your Baby: Tips to Keep You and Your Baby Healthy A Healthy Smile for Your Young Child: Tips to Keep Your Child Healthy Tips for Good Oral Health During Pregnancy 23

Questions? Photo Source: Thinkstock 24

Contact Information Jolene Bertness, M.Ed., CHES Email: Jolene.Bertness@georgetown.edu Phone: (202) 784-9554 25

National Maternal and Child Oral Health Resource Center Contact Information Phone: (202) 784-9771 Email: OHRCinfo@georgetown.edu Website: http://mchoralhealth.org 26

Wrap Up and Reminders Upcoming Webinars: Care Coordination & the Healthy Start Community on April 14 from 3:00 4:30 PM EST Using Doulas As a Resource for Case Management on April 21 from 3:00 4:00 PM EST Reproductive Life Planning on April 28 from 3:00 4:00 PM EST Centering Pregnancy and Centering Parenting: Innovative models for prenatal, well-woman, and well-baby care on April 30 from 3:00 4:00 PM EST EPIC Center website: http://www.healthystartepic.org Includes all recorded webinars, transcripts, and slide presentations 27