A Successful Dental Care Referral/Treatment Program for Low-Income Pregnant Women

Objective: To evaluate a unique dental care referral/treatment program for pregnant women. Methods: We performed a chart review of women referred for dental care to the Center for Maternal Oral Health (CMOH), a clinic for pregnant women. We recorded weeks gestation, periodontal status, number of visits and number of disappointments. We also asked women from the referring prenatal clinics to complete a survey exploring referral for dental care. Results: From 02/2007 to 04/2010, 989 women (median 18 wks gestation) were seen at the CMOH. The mean age was 28 (sd±6.1 years), 37.8% were married, and 26.8% spoke Spanish. Virtually all received public assistance (Medicaid, 96.2%). Almost one third (30.9%) had not seen a dentist for at least three years; 35.0% reported bleeding gingiva, 22.5% reported a toothache and 31.4% reported at least one carious tooth. Almost all women (93.0%) had at least one periodontal pocket depth (PPD) ≥5 mm; many had more severe PPD (39.2% ≥1 site PPD≥6; 14.1% ≥1 site PPD≥7). Care was completed in 2 visits or fewer for 55% of the women. Only 5.0% of the women missed appointments. Of the women approached in the prenatal clinics, 80.1% percent (n=298/368) completed the survey. The mean age was 26.4 (sd=5.5 years) and 49% were immigrants. Of the 72.5% who stated they had been referred for dental care, 63.4% reported having seen a dentist during their pregnancy. Of those who reported no referral, only 29.0% stated they had seen a dentist (Chi-Sq, p<0.01). Conclusion: Low-income pregnant women (who traditionally have low rates of dental care utilization but have high unmet needs) referred for dental care by their prenatal provider will indeed seek and utilize dental care when offered. This dental referral/treatment program may serve as a model for improving access to, and utilization of dental care.