A new study published in the journal Maternal and Child Health suggests that primary care physicians may feel under-challenged to provide pregnant women with proper oral health advice. A bad oral health of the mother can have a significant impact on the overall health of a woman and the health of her children.

Dr. Gentry Byrd and Dr. Rocio Quinonez of the UNC-Chapel Hill School of Dentistry, investigate prenatal oral health counseling by primary care physicians. This is the first study to provide national estimates and predictors of their prenatal oral health counseling. The study used data from the 2013 Survey of Primary Care Physicians on Oral Health by the United States Department of Health and Human Services' (U.S. HHS) Office of Women's Health.

More than 350 primary care physicians across the country who treat pregnant women were surveyed. The authors found that while many primary care physicians addressed prenatal oral health in the form of counseling, and agreed that preventive dental care is very important, just 45% of respondents felt prepared to identify oral health issues and counsel pregnant patients on the importance of oral health.

With more than half of the surveyed primary care physicians saying they feel unprepared to address oral health issues with pregnant patients, this study illustrates the disconnect between prenatal oral health practice guidelines and primary care physician workforce preparedness.

"Pregnant women remain an underserved patient population, even after dentists from the American Dental Association (ADA) and physicians from the American College of Obstetrics and Gynecology (ACOG) came together on the national level to develop joint consensus practice guidelines for medical and dental providers that detail the safety of dental treatment in all trimesters," said Byrd.

Previous studies suggest there is an increased risk of preterm birth among pregnant women with periodontal disease. We also know that mothers with untreated cavities and tooth decay have children with twice the likelihood of experiencing cavities and tooth decay with up to twice the severity. While there are many factors that contribute to the development of diseases, good oral health and nutritional practices of mothers may be modeled to their children.

About 69% of primary care physicians acknowledged their role in oral health and that they should be able to identify oral health issues in adult patients. The authors found that primary care physicians who received oral health continuing education had a higher likelihood of counseling pregnant women on oral health than those who did not, suggesting that oral health continuing education is a key component to improving prenatal care.

Quinonez, Dr. Kim Boggess, and their collaborators developed the Prenatal Oral Health Program (pOHP), to train medical and dental students on facilitating the delivery of essential dental services to pregnant women. The program's goal is to improve the health of every woman, fetus and child by educating and providing resources to providers.

The authors address areas of future research, such as the quality of oral health counseling given by primary care providers and physicians, and barriers to addressing prenatal oral health. New studies using their findings may be done to help develop strategies to promote evidence-based practice, with more work needed to assure equitable and quality prenatal care.