Strategies for Providing Optimal Care

Screening

When screening patients follow these steps:

  1. Evaluate oral health risk history.
  2. Perform an oral exam.
  3. Document findings in prenatal record and share with dentist.
  4. Proactively reassure dentists of the safety of dental treatment during pregnancy.

Standardize Office Screening for all Pregnant Women

  1. Do you have any oral health issues currently?
    • If yes = > make urgent referral
  2. When was the last time you saw a dentist?
    • If > 6 months => make routine referral
    • If < 6 months = > advise to see dentist at 6 months

Anticipatory Guidance

Encourage patients to maintain the following good oral hygiene habits and healthy dietary practices:

  • Brush teeth with soft toothbrush twice daily with fluoridated toothpaste.
  • Floss daily.
  • Limit sugary snacks and drinks to meal times only.
  • Chew xylitol gum four to five times per day after eating (xylitol must be listed as first ingredient to be effective).
  • Establish a dental home for the family.

Discuss how to manage oral complications of vomiting:

  • Rinse with water and baking soda after vomiting.
  • Do not brush immediately after vomiting to  minimize erosion.

Standardize Office Processes

Implement the following procedures:

  • Modify prenatal chart to include dental screening, advice, and referral.
  • Develop a role for office staff in taking risk history, offering advice, and providing referral information.
  • Maintain an up-to-date list of local dental providers that see pregnant patients.
  • Use a referral form to improve communication with dental providers.
  • Follow up to ensure dental care has occurred.
  • Include oral handouts in prenatal informational packets.

References

American College of Obstetricians and Gynecologists. Planning your pregnancy and birth. (3rd ed.). Washington, DC, 2000.

Brambilla, E., Felloni, A., Gagliani, M., Malerba, A., García-Godoy, F., Strohmenger, L. Caries prevention during pregnancy: Results of a 30-month study. Journal of the American Dental Association 1998;129:871-877.

American Academy of Pediatric Dentistry. Guideline on Perinatal Oral Health Care. Revised 2011. 33(6): 118-123.