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Dentists Can Help Improve Maternal and Fetal Health

The release of a U.S. Centers for Disease Control and Prevention (CDC) report revealing racial disparities in pregnancy-related maternal deaths has reenergized calls to address health care disparities, particularly for non-Hispanic black women.

The release of a U.S. Centers for Disease Control and Prevention (CDC) report revealing racial disparities in pregnancy-related maternal deaths has reenergized calls to address health care disparities, particularly for non-Hispanic black women — a group with the highest risk of dying from pregnancy in the United States.1 Furthermore, CDC data also demonstrate black women have the highest risk of stillbirth2 and preterm birth.3

While many factors come into play, an important reason that is sometimes overlooked is access to oral health care, both before and during pregnancy. A 2019 study found that women who went into labor early were 1.5 times more likely (45%) to have periodontal disease than women who had a complication-free, full-term pregnancy (29%). The women who experienced preterm labor also had more untreated dental caries and restorations.4

Due to hormonal changes during pregnancy, periodontal disease and other oral conditions tend to worsen during pregnancy. Since 2014, the American Dental Association has maintained a policy urging all pregnant women and women of childbearing age to have regular dental examinations due to the risk poor oral health may pose to a healthy pregnancy. The racial disparities seen in oral health and use of preventive dental care certainly correlate with the worse outcomes noted in the CDC data.5

As policymakers look for solutions to reduce the disparities in pregnancy outcomes among various ethnicities, oral health care access should be an important consideration. Although not always recognized as such, dental teams are valuable allies in improving U.S. maternal and fetal health outcomes, which currently rank among the worst in Western industrialized nations.6

REFERENCES

  1. Petersen EE, Davis NL, Goodman D, et al. Vital signs: pregnancy-related deaths, United States, 2011–2015, and strategies for prevention, 13 states, 2013–2017. MMWR Morb Mortal Wkly Rep. 2019;68:423–429.
  2. U.S. Centers for Disease Control and Prevention. Stillbirth (fetal death) rates, by race and Hispanic origin of mother: United States, 2013. Available at: https:/​/​www.cdc.gov/​ncbddd/​stillbirth/​data-stillbirth-race-text.html. Accessed May 20, 2019.
  3. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion. Preterm Birth. Available at: https://www.cdc.gov/ reproductivehealth/ maternalinfanthealth/ pretermbirth.htm. Accessed May 20, 2019.
  4. Radochova V, Stepan M, Kacerovska Musilova I, et al. Association between periodontal disease and preterm prelabour rupture of membranes. J Clin Periodontol. 2019;46:189–196.
  5. Azofeifa A, Yeung LF, Alverson CJ, Beltrán-Aguilar E. Oral health conditions and dental visits among pregnant and nonpregnant women of childbearing age in the United States, National Health and Nutrition Examination Survey, 1999–2004. Prev Chronic Dis. 2014;11:140212.
  6. Gunja MZ, Seervai S, Colins S. What Is the Status of Women’s Health and Health Care in the U.S. Compared to Ten Other Countries? Available at: https:/ / doi.org/ 10.26099/ wy8a-7w13. Accessed May 20, 2019.

 

From Decisions in Dentistry. June 2019;5(6):52.

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