May 1st 2013

1. Maternal Oral Health Project
presented by
Christine Thompson
Project Facilitator
www.skprevention.ca
© 2013, Saskatchewan Prevention Institute

2. Our mission
• Our mission is to reduce the
occurrence of disabling
conditions in children
• Our focus is on Primary
Prevention:
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Education
Information Services
Community Development
Research and Evaluation
Communications

3. Partners in prevention
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Government of Saskatchewan
Kinsmen Telemiracle Foundation
Saskatchewan Abilities Council
University of Saskatchewan
Community‐at‐Large
History
The Saskatchewan Prevention Institute was formed in 1980 as a non‐
profit, provincial organization.

4. Program areas
• Alcohol, Tobacco, and Other Drugs
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Child Injury Prevention
Early Childhood Mental Health
Maternal and Infant Health
Parenting Education
Program Partners
Reproductive Health

5. Examining link
between poor oral
health and adverse
pregnancy outcomes

6. Pregnant women are at higher risk for oral conditions
such as tooth erosion and periodontal disease
… due to physiologic changes in the mouth that occur during
pregnancy combined with the lack of routine exams and
delays in treatment for oral disease

7. Health consequences:
– For a pregnant woman: associated with diabetes,
cardiovascular disease and some respiratory
diseases
– For a fetus/infant: linked to preterm birth and low
birth weight
Transmission of caries‐causing bacteria from
mothers to infants

8. “A sizable number of women…enter pregnancy
with active oral disease, or pregnancy may
trigger the progression of the disease process.”
‐ Association of State & Territorial Dental Directors

9. “Studies suggest that only about one‐quarter to
one‐half of women receive any dental care
during their pregnancies.
The likelihood of low‐income and uninsured
women receiving such care is even lower.”
‐ California Dental Association

10. Pregnant women cited as key
oral health target group by:
•U.S. Dept. of Health & Human Services,
Health Resources & Services
Administration, Maternal and Child
Health Bureau
•American College of Obstetricians and
Gynecologists
•American Dental Association
•Association of State & Territorial Dental
Directors
•U.S. State Departments of Health
•American Academy of Pediatric
Dentistry

11. Maternal Oral Health Strategy Framework

12. “The degree to which individuals have the capacity
to obtain, process and understand basic health information and
services needed to make appropriate oral health decisions.”
‐ U.S. Dept. of Health and Human Services
•Foundational strategy
•Low oral health literacy among pregnant women,
communities and health care professionals

13. “Care to maintain oral health is not dental care per se.
Oral health care is a subset of primary care.
After all, the mouth is part of the body.”
– William Maas (Grantmakers in Health)

14. Oral health as an integral,
routine part of prenatal care:
• oral health screening
• anticipatory guidance
• referral to oral health
professional
Image source:
Washington Dental Service Foundation

15. Continuing education • Interdisciplinary training
Updating curricula • Workforce review
Focus on both oral health and
maternal health professionals

20. Barriers to access:
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Financial
Geographic
Social/Cultural
Policy
Workforce
Literacy
Lack of health system integration

23. Maternal Oral Health Strategy Framework

24. Image source:
http://groups.itu.int/wsis‐
forum2012/Agenda/KnowledgeExchanges.aspx

25. Current initiatives ‐ Saskatchewan
• SK Ministry of Health Enhanced Preventive Dental
Services
– pre/post natal services targeting at risk mothers
– Northern Saskatchewan Prenatal/Preschool Dental Program
• Children’s Oral Health Initiative (COHI) ‐ Health
Canada
• No provincial oral public health program for
pregnant women; efforts in individual health regions

26. Next steps
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Linkage with SK Oral Health Coalition
Key Informant meetings
Look for integration opportunities
Possible initial strategies:
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Partnership
Education/social marketing campaign
Continuing education & training for professionals
Collaboration projects

27. References
ASTDD (Association of State & Territorial Dental Directors) (2012). Best Practice Approaches for State and Community
Oral Health Programs. Retrieved from: http://www.astdd.org/bestpractices/BPAPernatalOralHhealth.pdf
California Dental Association (2010). Oral health during pregnancy & early childhood: Evidence‐based guidelines for
health professionals. Retrieved from: http://www.cdafoundation.org/library/docs/poh_guidelines.pdf
Grantmakers in Health (2012). Returning the Mouth to the Body: Integrating Oral Health and Primary Care. Retrieved
from: http://www.gih.org/files/FileDownloads/Returning_the_Mouth_to_the_Body_no40_September_2012.pdf
HHS (U.S. Dept. of Health and Human Services) (2010). Healthy People 2020. Office of Disease Prevention and Health
Promotion. Retrieved from: www.cdc.gov/nchs/healthy_people/hp2020.htm (accessed May 31, 2012).
IOM (Institute of Medicine). 2013. Oral health literacy: Workshop summary. Washington, DC: The National Academies
Press. Retrieved from: http://iom.edu/Reports/2013/Oral‐Health‐Literacy.aspx
Saskatchewan Prevention Institute (2011). Maternal Oral Health and Pregnancy Outcomes Literature Review.

29. Table discussions
• Each table assigned one
of the strategies outlined
in the framework
• Brainstorm ideas for
action on maternal oral
health in Saskatchewan
• Record each idea on a
sticky note
• Post notes on flip chart
• Choose one idea to
present to group