According to the Surgeon General’s report, Oral Health in America, perceptions must change to improve oral health and to make it an accepted component of general health (1). A follow-up report titled A National Call to Action to Promote Oral Health urges actions to reduce health disparities (2). Strategies to change the perceptions of health care professionals include updating health curricula and continuing education courses, training health care providers to conduct oral screenings as part of routine physical examinations and to make appropriate referrals and promoting interdisciplinary training in counseling patients about how to reduce risk factors common to oral and general health. Two population groups that can benefit immensely from these changes are pregnant women and young children (3).
Pregnancy and early childhood are particularly important times to access oral health care because the consequences of poor oral health can have a lifelong impact (1;2;4-9). Several national organizations have provided recommendations for improving oral health during pregnancy and early childhood. The National Center for Maternal and Child Health published Bright Futures in Practice: Oral Health to promote and improve the health and well being of infants, children and adolescents (5). The Community Preventive Services Task Force, the American Dental Association, the American Academy of Pediatric Dentistry, the American Academy of Periodontology and the American Academy of Pediatrics have issued statements and recommendations for improving oral health (10-14). Improving the oral health of pregnant women prevents complications of dental diseases during pregnancy, has the potential to decrease early childhood caries and may reduce preterm and low birth weight deliveries. Assessment of oral health risks in infants and young children, along with anticipatory guidance, has the potential to prevent early childhood caries. No comprehensive guidelines exist that address the oral health needs of pregnant women. The Institute of Medicine suggests that it is appropriate to develop guidelines when a problem is common or expensive, great variation exists in practice patterns, and sufficient scientific evidence exists to determine appropriate and/or optimal practice (15). Guidelines are, therefore, needed to assist health care professionals in improving clinical practice and to promote oral health in pregnant women and children.
For many women, pregnancy is the only time they have medical and dental insurance and thus provides a unique opportunity to access care (16). It is also a time when women are more receptive to changing behaviors that have been associated with an increased risk of poor pregnancy outcomes. Once the pregnancy is completed, some women may have difficulty accessing dental care due to loss of insurance coverage and preoccupation with childcare (17;18). In addition, children have multiple preventive health care visits during the first year of life,