A few months ago, Rocio Quinonez and her pediatric dentistry students were volunteering at a clinic in Durham when Quinonez noticed a very pregnant patient awaiting care.
Quinonez, an associate professor at UNC’s School of Dentistry, offered the woman a pamphlet about caring for an infant’s oral health. The patient drew back the corner of her mouth, revealing a row of abscessed teeth. Her oral health had long been neglected, and the situation was dire.
“She told me she’d been repeatedly turned away by dentists who did not think it would be safe to treat a pregnant woman. Other clinics had refused to see her until the baby was born,” Quinonez said.
The idea that dental care should be postponed in pregnancy is an outdated one, she said, but in some dental practices, it still holds. And because of misinformation, this patient had been living unnecessarily in excruciating pain.
“I told her, ‘Don’t worry, we’ll help you,’” Quinonez said. “We stopped the clinic to get her triaged and come up with a plan.”
By that afternoon, the woman was seen in a clinic especially for pregnant patients where a UNC dental student treated her and extracted the problem teeth.
The clinic is a part of the Prenatal Oral Health Program (POHP) at UNC, a joint venture of the schools of Dentistry and Medicine that educates students and the public about oral health and pregnancy. Students at both schools are trained to include oral health in prenatal care and encouraged to carry that care forward into their professional practices.
“The mouth is the window to the body,” Quinonez said. “Education is the key to getting other health professionals to consider that dental health is a part of overall health.”
The diagnosis of a dental problem requires a dental professional, said Kim Boggess, professor of obstetrics and gynecology. Through POHP, medical students and residents learn what obstetricians can ask in an office visit to determine if a patient needs a referral.
“We can ask about loose teeth and tooth pain, previous periodontal disease, and most importantly,” she said, “we can ask, ‘Do you have a dentist? When did you last go?’”
Myths surrounding oral health and pregnancy abound: You lose a tooth for every pregnancy. X-rays are unsafe, and so is local anesthesia. You should postpone prophylactic care, like regular cleanings, until the baby is born. To visit the dentist, you need a note of approval from the obstetrician.
None of these is true, Boggess said. Worse, an oral infection can develop into something dangerous if untreated. If a dentist recommends delaying care, there can be negative consequences for both mother and baby.
“A pregnant woman in poor oral health with no access to care, or with nutritional habits that promote poor dental health, can pass bad bacteria, bad habits and the same lack of access to her children, who run the risk of passing them on,” Boggess said. “It’s a cycle.”
Published August 23, 2013.