Teeth for Two: The Importance of Oral Health for Parents and Babies

By |Published On: December 10th, 2024|

Jessamin Cipollina, MA, GoMo Health
Dr. Judith Haber, PhD, APRN, FAAN

Everybody wants to be a good parent, and parents’ oral health status is a predictor of the oral health of their children. Parents who practice good oral care at home and keep up with regular dental check-ups have a positive influence on their children’s oral health throughout early childhood and throughout their lifespan.

Awareness of the importance of oral health during pregnancy has grown exponentially over the past 20 years, influencing policymakers and health agencies across the US and worldwide.1-2 Despite widespread recognition, many pregnant people experience oral health problems during pregnancy that, if left untreated, can lead to more severe oral and overall health problems for both parent and child. Establishing healthy oral and dental health practices during pregnancy is an essential part of prenatal care that needs to be included as a standard component across the health care continuum.

The mouth is the gateway to the rest of the body. As the body changes during pregnancy, parents may be more susceptible to oral health problems, such as gum disease and tooth decay. Hormonal changes during pregnancy increase gum inflammation, increasing the risk for developing periodontal disease and tooth decay.3 Adjusted eating habits and morning sickness can cause acid erosion of the tooth enamel, which also increases the risk for tooth decay.3 Keeping up with regular oral hygiene practices can reduce the risk for more serious oral health issues.

If needed, treatment for oral health problems during pregnancy is safe and effective in preventing serious oral and overall health problems.3 Preventive, restorative and emergency dental treatments are safe at any stage of pregnancy. Addressing dental concerns as soon as possible can prevent serious oral and overall health problems later on, and it is key to promoting positive oral health and pregnancy outcomes.3,4

Understanding How Poor Oral Health Increases Risks for Adverse Pregnancy Outcomes

Periodontal disease in some form occurs in approximately 40% of pregnant people.2 found that pregnant persons with periodontitis were about six times more likely to give birth prematurely compared to those without periodontitis.5 Multiple studies have also shown an association between periodontitis and increased risk for low-birth weight. Pregnant persons with periodontitis have more than three times the odds of developing preeclampsia compared to those without periodontitis.7

Tooth decay can occur as cavities or other kinds of oral infections. But in the US, only about 46% of pregnant adults receive dental cleanings during their pregnancy.8 Pregnant persons may not access dental care during pregnancy due to several reasons including misconceptions about the safety of dental care during pregnancy. Teeth cleanings, x-rays, local anesthetics and pharmacological agents are completely safe and highly recommended if needed during pregnancy.3

Logistical Barriers to Proper Oral Health Care During Pregnancy

Prenatal care consists of numerous medical appointments with a maternity provider, physician, midwife or nurse practitioner, that make it difficult to find time to get to the dentist. For many patients, the costs of dental care and/or lack of dental insurance presents an additional barrier to care.2 Medicaid coverage for dental care for pregnant persons varies from state to state, and low-cost dental care is limited in many areas across the US.2 With Medicaid, pregnancy may be the only time a person has a dental benefit, and this benefit ends at varying times post-delivery. Primary care providers should emphasize the importance of consistent oral hygiene practices at home in preventing serious oral health problems. They should also be aware of their pregnant patients’ dental coverage options in their state when making referrals for dental care.2

Role of Prenatal Providers

Obstetricians, nurse practitioners, midwives, physician assistants and other prenatal care providers are well-positioned to educate their pregnant patients on the importance and safety of proper oral care and dental care to prevent serious oral health problems. A recent report showed that only 4% of pregnant adults received a referral to their dentist during their pregnancy.9 Pregnancy also presents an opportunity for prenatal providers to perform quick oral examinations to assess for any oral health issues and make referrals for dental treatment as needed. It is important for the prenatal care team to establish a network of dental providers in the community to promote a collaborative approach to prenatal care that incorporates oral health as a key component of overall health.

Conclusion

Oral health is an integral part of overall preventive health care for pregnant persons and their children. Poor oral health during pregnancy can have serious consequences for parent and baby. Good oral hygiene at home and regular dental check-ups are fundamental to protecting oral health and overall health for the whole family. Prenatal and pediatric providers can incorporate oral health education and screening into prenatal, postpartum and well-child visits and provide tools and resources to their pregnant patients. Parents are role models for their children, and starting good oral health habits during pregnancy sets up families for lifelong good oral health.

Oral Health Checklists (Callouts)

For Pregnant Patients: Brushing for Two

  • Keep up with daily oral hygiene:
    • Brush twice per day with fluoride toothpaste
    • Floss once per day
  • Eat healthy foods to protect oral health:
    • Limit sugary foods and beverages
    • Stay hydrated with water; avoid juices, fruit flavored drinks and soda
  • Visit the dentist for regular dental check-ups and treatment for oral health problems as needed.
  • Learn more about how to promote good oral health for parent, baby and the whole family.

For Providers: How To Support Your Pregnant Patients’ Oral Health

  • Address dental hygiene as an important part of keeping parent and baby healthy.
  • Include oral health history and risk assessment on intake form or during initial visit.
  • Perform an oral exam in each trimester.
  • Discuss a healthy diet and provide ongoing nutritional support.
  • Encourage regular dental check-ups and make referrals for dental treatment for any oral health issues during pregnancy.
  • Establish relationships and community partnerships with dental providers.
  • Reassure women that prevention, diagnosis and dental treatment and procedures are safe during pregnancy.
  • Explore additional resources for integrating oral and dental health care into prenatal care.

References:

  1. National Institutes of Health. “Oral Health in America: Advances and Challenges.” Bethesda, MD: US Department of Health and Human Services, National Institutes of Health, National Institute of Dental and Craniofacial Research, 2021. https://www.nidcr.nih.gov/research/oralhealthinamerica.
  2. American College of Obstetricians and Gynecologists Women’s Health Care Physicians Committee on Health Care for Underserved Women. “Committee opinion no. 569: Oral health care during pregnancy and through the lifespan.” Obstetrics and Gynecology, vol. 122, issue 2 Pt. 1, 2013, pp. 417–422. doi:10.1097/01.AOG.0000433007.16843.10.
  3. American Dental Association. “Pregnancy”. Research Services and Scientific Information, ADA Library & Archives. https://www.ada.org/resources/ada-library/oral-health-topics/pregnancy
  4. López, N.J., Smith, P.C., & Gutierrez, J. “Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomized controlled trial.” Journal of Periodontology, vol. 73, issue 8, 2002, pp. 911-924. doi:10.1902/jop.2002.73.8.911.
  5. Uwambaye, P., Munyanshongore, C., Rulisa, S. et al. “Assessing the association between periodontitis and premature birth: a case-control study.” BMC Pregnancy Childbirth, vol. 21, issue 204, 2021. doi:10.1186/s12884-021-03700-0.
  6. Padilla-Cáceres, T., Arbildo-Vega, H.I., Caballero-Apaza, L., et al. “Association between the Risk of Preterm Birth and Low Birth Weight with Periodontal Disease in Pregnant Women: An Umbrella Review.” Dentistry Journal (Basel), vol. 11, issue 3, 2023. doi:10.3390/dj11030074.
  7. Le, QA., Akhter, R., Coulton, K.M. et al. “Periodontitis and Preeclampsia in Pregnancy: A Systematic Review and Meta-Analysis”. Maternal and Child Health Journal, vol. 26, 2022, pp. 2419–2443. doi:10.1007/s10995-022-03556-6.
  8. American Public Health Association. “Improving Access to Dental Care for Pregnant Women through Education, Integration of Health Services, Insurance Coverage, an Appropriate Dental Workforce, and Research.” 2020. https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2021/01/12/improving-access-to-dental-care-for-pregnant-women.
  9. CareQuest Institute for Oral Health. “Oral and Mental Health During and After Pregnancy.” 2024. https://www.carequest.org/resource-library/oral-and-mental-health-during-and-after-pregnancy.