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Oral Health Policy and Practice Guidelines

One of nine priority areas for the 2021–2025 Illinois Maternal and Child Health (MCH) Title V Action Plan is to support an intergenerational and life course approach to oral health promotion and disease prevention. The information presented here can be used to expand oral health outreach to the most at-risk maternal populations by engaging WIC programs; supporting and assisting school personnel and families across Illinois to access oral health education, dental sealants, fluoride varnish, Illinois All Kids (Medicaid) enrollment, and dental home referrals; assessing the burden of oral diseases and barriers to access care for individuals during their pregnancy period; and supporting projects to integrate the interprofessional oral health core clinical competencies into primary care practice, particularly for pregnant women and adolescents.

In many Illinois communities, oral health care services are provided through standalone clinics. Referrals to and from these facilities pose additional challenges to accessing timely oral health services. All health care providers for pregnant women can prioritize effective use of social service and care coordination to help facilitate delivery of prevention and treatment services.

The practice guidelines included in the following sections are consistent with guidance from many professional organizations and state health departments. The guidelines provide detailed information about the provision of dental care, including advice and education for pregnant women. Where possible, Illinois-specific information has been added and is contained in the Tools section of the guide.

Oral health practice guidelines for prenatal providers include instructions on how to assess oral health status, advise and educate patients, and collaborate with oral health care providers. Similarly, specific recommendations for oral health care providers include assessment (health history, dental history, comprehensive examination, including blood pressure and radiographs as appropriate), advice and education, and the provision of all necessary treatment. Pregnancy generally should not affect the type or quality of oral health care provided. However, oral health care providers must be aware of medications that are acceptable for use during pregnancy.

Management of oral infections, disease control, and providing corrective treatments are essential to maintaining health and well-being during pregnancy. Routine dental care, including dental radiography, is safe and acceptable during all trimesters and should be provided when clinically indicated. Oral health providers should develop a plan to address immediate issues and comprehensive management during and after pregnancy. Working towards establishing a regular source of oral health care is essential for a healthy pregnancy and postpartum period. In addition, an oral health provider can take this opportunity to provide anticipatory guidance for the newly born.

The first dental visit should occur within six months of the eruption of the first tooth or by age 1 year, whichever comes first. Deciduous or primary teeth are important for eating and speaking, and they play an essential role in socialization, nutrition, and appearance. They also hold the space for the adult teeth. Childhood oral health problems, including dental caries, may have immediate complications as well as cause a lifetime of oral health issues including pain, local and systemic infections, poor eating and growth, poor self-esteem, financial costs, missed school days, and missed work for parents.

This section supports the early assessment of risk and oral health status to provide anticipatory guidance to increase home prevention and promotion efforts. The use of a knee-to-knee examination positioning is beneficial and reassuring to the child as he/she can see their parent. Through this process, the provider can intervene early with prevention services, assess growth and development, eruption sequence, hard and soft tissue (extra-oral and intra-oral) injuries, and signs of child abuse or neglect.

Parents and other primary caregivers play a critical role in good oral health practices and the prevention of tooth decay (dental cavities), a common and preventable condition. The best protection against tooth decay is brushing with fluoridated toothpaste, flossing, regular access to professional care, a healthy diet of low sugar food and beverages, dental sealants, and a visit with a dentist when their first tooth erupts, or at age 1, whichever comes first.

Untreated tooth decay can cause pain and infections that may lead to problems with eating, speaking, playing, and learning. Compared with children who have good oral health, those who have poor oral health often miss more school and receive lower grades.