Meanwhile, many people hear stories from family, friends, and even some doctors that make them question dental care while they’re pregnant.
“We know today that these myths are false, that some of the advice from friends and family is untrue, and that some medical and dental health care professionals may be misguided,” Horan says. Even dental X-rays, still sometimes considered harmful to a fetus, are known to be safe.
“These persisting misconceptions are likely contributing to the ongoing challenge of poorer overall maternal health outcomes,” Horan says.
Encouraging Partnership
In fact, Leader urges people to tend to their oral health before getting pregnant, if possible. If it’s not, Horan says, “I would encourage pregnant people to make an appointment with an oral health professional as soon as possible and share their pregnancy status when scheduling.”
Pregnancy keeps the human body busy over the course of nine months. That activity includes the many hormonal shifts that increase a person’s risk of developing oral disease, including gingivitis and benign pyogenic granulomas, also known as pregnancy tumors. “There is a correlation between periodontal disease and early-term birth and low birth weight” Leader says. That means that what affects the mother also affects the baby.
These problems don’t affect everyone equally. “Pregnant people from racial and ethnic minoritized groups and those insured by Medicaid have higher rates of [cavities] and periodontal disease (and are more likely to enter pregnancy with oral disease) but report lower rates of prenatal oral health care,” according to a guest editorial in JADA co-written by Chloe Bird, the Sara Murray Jordan Professor of Medicine at TUSM.
“Adults who are low-income, non-Hispanic Black, and have no health insurance coverage are twice as likely to have untreated cavities or gum disease with bone loss than comparison groups,” Horan adds. Some of the reasons include a lack of available dentists, living in a remote area, fear of the dentist, and financial concerns. These differences primarily exist because of structural racism within our society and systems and can ultimately shape health outcomes such as maternal health indicators, he adds.
One solution was proposed in 2013, when the American Dental Association endorsed the American College of Obstetrics and Gynecology’s call for increased attention to prenatal oral health. Massachusetts has developed oral health guidelines for pregnancy and early childhood to foster collaboration between dentists and physicians. Leader was part of the group that created the original guidelines in 2014—they were updated in 2024—and four other states have undertaken similar steps.
Bird and her coauthors urge doctors and dentists to promote oral health care for their pregnant patients. They hope prenatal care providers will include oral health questions in their patient screening questionnaires. Such questions “should be as integrated into prenatal health as HIV testing, smoking cessation, and nutritional counseling,” they write.
More collaboration among healthcare professionals improves maternal health outcomes by keeping people healthy and efficiently connecting people to care and information, Horan says. “It’s all about prevention,” he says.
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