For several years, advocates have been calling for greater focus on disparities in health outcomes for Black women and their babies.
Although Minority Health Month was celebrated in April, it is still an opportune time to elevate the conversation and raise oral health care in particular as a birth equity issue.
In a recent federal report, data from the U.S. Department of Health and Human Services shows maternal mortality and other adverse outcomes associated with pregnancy or birth worsened significantly in 2020 and 2021, compared to the prior two years. Disparities also persisted, as the maternal mortality rate among Black or African American women was roughly 2.5 times greater than white women during these years, according to the analysis.
We’ve seen some progress, as government interest and action has intensified in the past several years. We need these big leaps and policy changes, but we can also utilize other beneficial approaches.
More:Maternal and mental health care are among the disparities 2024 equity report identified
Poor oral health can be dangerous for pregnant women
Part of a healthy pregnancy includes maintaining optimal oral health to protect against oral bacteria associated with pre-eclampsia/toxemia, eclampsia, premature birth, low birthweight babies and other adverse outcomes.
Yet, 60%–75% of pregnant women experience oral health issues, meaning they may be at greater risk for those dangerous outcomes. Poor oral health can also exacerbate underlying medical issues such as heart conditions – a leading cause of pregnancy-related deaths in the U.S., according to the Centers for Disease Control and Prevention.
Unfortunately, fewer than half of pregnant women nationally have their teeth cleaned during pregnancy. Black women are 14% less likely to get their teeth cleaned during pregnancy than white women, even though data shows no difference in dental visits prior to pregnancy for those groups.
During my years as a community health center dental administrator, I partnered with our obstetrician-gynecologists (OB/GYNs) to create an ongoing pregnancy clinic offering their patients priority dental appointments. As the DentaQuest Tennessee Chief Dental Officer, I played a major role in launching the state’s dental Medicaid pregnancy benefit. In these positions, I noticed many patients and dentists weren’t not aware of the current standard of care: prevention, diagnosis and treatment of oral diseases is safe throughout pregnancy and effective in decreasing adverse birth outcomes and maternal morbidity.
More:Why Tennessee lawmakers redirected $3M in maternal health funds to crisis pregnancy centers
More medical providers should promote oral health to patients
One study indicates 80% of OB/GYNs and certified nurse midwives acknowledge oral health is an important part of optimal prenatal care, yet just 53% report having oral health-related questions on their intake documents, 35% discuss oral health with their pregnant patients, 29% conduct an oral cavity exam, and 42% recommend their patients see a dentist. Elsewhere, 77% of surveyed OB/GYNs reported patients said their dentist “declined” to treat them.
More than 20 years of research confirms that the physicians and dentists could benefit from improved training and knowledge in caring for pregnant patients. Research shows pregnant women whose medical providers promoted oral health care were twice as likely to report having had a dental visit, even after adjusting for several potential confounders.
My call to action: consider how oral health fits into a healthy pregnancy. Addressing our country’s Black maternal health crisis requires more than one set of solutions. We can begin working toward equity now focusing on oral health care as one way to improve birth outcomes in the Black community.
Katrina Eagilen, DDS is the Tennessee dental director at DentaQuest, part of Sun Life U.S., and is active educating dental students across the state.