Dental Disease in Pregnant Women: A Screening and Referral Process

Abstract

Problem & Purpose: Adverse health outcomes increase with poor maternal oral health in pregnant women and their infants. Dental screenings and treatment during pregnancy are found safe and effective in improving women’s health in pregnancy. Adult women on Medicaid are only eligible for dental benefits while pregnant, but in 2016, only 26.1% of pregnant women in Maryland on Medicaid utilized the dental benefit, resulting in the lowest utilization in four years. The purpose of this Doctor of Nursing Practice (DNP) project was to implement and evaluate a screening tool and dental referral process at a local federally funded community organization. Methods: The dental screening used was the Maternal Oral Health Tool for pregnant women on Medicaid. The screening tool included two questions assessing if the woman 1) had seen a dentist in the last year or 2) has any current dental concerns and then when the screening indicated that a woman needed further dental treatment and evaluation, she was referred to the dental clinic. Once referrals were received, the dental clinic provided outreach to the women to educate and make appointments. Results: Over 12 weeks, 23% of all pregnant women seen at the community organization were referred to the dental clinic and 25% of pregnant women referred scheduled appointments at the clinic. 87% of all women screened required further dental evaluation, indicating the need and importance of dental care for pregnant women on Medicaid in this area. Conclusions: The overall recommendation is that staff continue to educate women about the importance of dental care, their benefits during pregnancy, and provide resources and information of dental clinics that accept Medicaid. To improve referral compliance, it’s recommended that the screening be embedded in the electronic intake system.