Pregnancy and Oral Health Case Study

OHNEP GOLD STANDARD CLINICAL CASE

“For increasing the interprofessional approach to patient care. ”

Teeth for Two: A Model Midwifery and Nursing Curriculum

THE NEED

TO LEARN MORE

Meetings and Webcasts

  • Several state chapters of the Nurse Family Partnership are requesting  presentations of the NYU oral health curriculum for its members. Check its website to see if one is scheduled for your state. The national Partnership provides home visits from registered nurses to low-income first-time moms and their babies. 

Online Resources

Diligent oral health care is especially important during pregnancy, both for mother and child.

Yet health professionals seldom learn as part of their health education how to conduct a prenatal oral assessment, or have the facts about why it is important.  

  • Pregnancy gingivitis— bacterial infection caused by physiological changes that can lead to inflammation of the gum tissue— affects 60-75% of pregnant women.

  • Periodontis resulting from unattended gingivitis, leading to tooth loss, affects 15% of pregnant women.

  • A serious tooth infection can spread throughout the body, affecting both mother and fetus.

These prenatal oral health problems can also affect the newborn child if left untreated. Dental caries (the infectious process that leads to cavities) is the most common chronic disease of children under 72 months of age. Research suggests that most infants are exposed to these caries-causing bacteria from the person with whom they have the most physical contact—usually their mothers.

Midwives in the Vanguard

Midwives are positioned to be frontline educators for pregnant women about the importance of oral health care during pregnancy and for their newborns.

Yet, as a result of its traditional absence from most health care education, attention to oral health during pregnancy is often not a routine part of prenatal care for many midwives as well as for ob-gyns, other physicians, physician assistants, and nurses.

Now, as recent midwifery and nursing graduates are being educated on oral health care and entering the field, this is beginning to change.

NYU graduate student midwife Kristen Gomes, who is doing her midwifery clinical experience in a private practice at Women and Infant’s Hospital of Rhode Island, says that the health care providers she works with “are grateful for the new evidence that I bring to them—making them aware of the importance of treating simple caries and any oral health discrepancies during pregnancy, since it can have potentially detrimental effects on the fetus.”

You can lead this change in your institution. Here’s how.

THE SOLUTION: NYU’S MODEL NURSE-MIDWIFERY CURRICULUM

When the NYU College of Nursing decided to add the missing oral health piece to its Nurse-Midwifery Master’s Program, it decided to infuse it into every aspect of the curriculum.

The college even renamed the basic head exam familiar to every doctor, midwife and nurse practitioner—called HEENT (head, eyes, ears, nose, throat) to HEENOT (pronounced he-not)—to include the oral cavity.

Midwives learn how to conduct an oral exam as part of their midwifery education at NYU College of Nursing. The program is part of two national oral health initiatives directed by the college: OHNEP, (Oral Health Nursing Education and Practice), and TOSH program (Teaching Oral Systemic Health) program. OHNEP is funded by: DentaQuest Foundation, Washington Dental Service Foundation, and Connecticut Health Foundation. TOSH is funded by the Health Services and Resources Administration.

Teaching Oral Health Literacy

All courses in primary and gynecologic health, antepartum, and postpartum care now include oral health, and students learn how to practice oral health care and teach oral health literacy as part of a mother and child’s health care. Each year student midwives provide more than 1,080 clinical hours to patients in birth centers, community hospitals, home settings, and medical centers.

During those hours, midwifery students get approximately 150 opportunities to perform an oral assessment as part of annual exams, new ob-gyn exams, and postpartum exams.

Oral health is now embedded as well into the Family Nurse Practitioner program—giving the nursing college end-to-end integration of oral health education for its graduate students.