Gingivitis and periodontal disease are common in women of reproductive age. While estimates of periodontal disease in pregnant women range as high as 30%, nearly two-thirds do not receive dental care during pregnancy.
Nurses, NPs, and nurse midwives "can play an important role in educating pregnant women on oral health," according to an article by epidemiologist Ananda Dasanayake and his colleagues at New York University, the only university combining the College of Nursing and the College of Dentistry. However, Dasanayake told AJN, "neither nurses nor other prenatal care providers currently emphasize the importance of good oral health during pregnancy."
Many studies link poor oral health in pregnancy to a higher incidence of low-birth-weight, preterm, or preterm low-birth-weight infants. A few have found that treating periodontal disease in pregnant women improves birth outcomes. Additionally, infants exposed in the womb to chronic inflammation, such as that caused by periodontal disease, may be at higher risk for heart disease later in life or for neonatal neurologic disorders such as cerebral palsy.
Dasanayake and colleagues call for routine prenatal care to include an examination of the teeth and mouth. Pregnant women with oral problems&-such as bleeding gums, loose teeth, toothaches, tooth sensitivity, bad breath, inflammation, purulent drainage, or signs of infection&-should be referred to dentists. Pregnant women should be told to brush their gumline, tongue, and all sides of teeth with a soft toothbrush that they replace every three months. They should also floss twice daily to remove plaque buildup.
Pregnancy is an ideal time to educate women and to detect and treat oral problems: it may be the only time some low-income women have medical and dental coverage. Pregnant women can be treated safely and effectively for dental problems at any time during pregnancy.
Carol Potera