New AAPD Guidelines Urge Counseling and Oral Health Care for Moms, Infants

A call for all pregnant women to receive counseling and oral health care during pregnancy has been issued as part of the new oral health guidelines for expectant mothers and infants released by the American Academy of Pediatric Dentistry (AAPD). The guidelines extend the call for an oral health risk assessment and oral care for infants by their first birthdays.

The announcement was made following AAPD’s 62nd Annual Session in Honolulu, Hawaii, May 21 through May 24.

“There is evidence associating periodontal disease and increased risk of preterm birth and low-birth weight,” says Beverly Largent, DMD, AAPD’s immediate past-president.

A recently published study found significant differences between women treated for periodontal disease and those who were not treated, according to an AAPD statement. The findings suggest that incorporating periodontal care may result in improved pregnancy outcomes.

“Because premature births have become the number one obstetric problem in the United States, we felt the need to provide more guidance about necessary oral care for expectant moms, in addition to promoting oral health as a key part of pregnant women’s overall health,” Largent says.

The guidelines are based on studies that suggest proper dental care during the perinatal period may help prevent preterm and low-birth weight babies.

However, AAPD reports many women are unaware of the implications poor oral health can have on themselves and their babies and often don’t seek oral care during pregnancy.

Furthermore, mothers who have poor oral health may be at greater risk of infecting their children with the bacteria that causes caries, increasing their children’s risk of decay at an early age. Because caries in infants is preventable, determining which mothers are at the highest risk improves opportunities for preventive intervention.

“Every expectant mother should receive a comprehensive oral health evaluation and risk assessment,” Largent says. “Dental treatment is safe throughout pregnancy, and this is a time when expectant mothers need to be screened for oral risks, counseled on proper oral hygiene, and receive necessary dental treatment.”

The updated guidelines also address proper oral care for infants and toddlers, the age group most susceptible to early childhood caries (ECC), which is an infectious but preventable disease that causes tooth decay and potentially more serious health issues. When left untreated, ECC can affect speech and communication, eating and dietary nutrition, sleeping, learning, playing, and quality of life—even into adulthood. The guidelines explain how simple changes in a mother’s oral hygiene, diet, use of topical fluoride, and sharing of eating utensils can significantly reduce a child’s risk for ECC.

Additionally, because physicians, nurses, and other health care professionals see expectant or new mothers and their infants on a regular basis, the AAPD guidelines also encourage health care professionals to talk to their patients about proper oral care. In addition, the AAPD recommends that curriculum at medical, nursing, and allied health professional programs include education in perinatal and infant oral health.

Overview of the New AAPD Oral Health Guidelines for Expectant Mothers and Infants

— Oral health education: Early intervention and counseling during the perinatal period from all health care providers including physicians, dentists, and nurses.

— Oral Hygiene: Tooth brushing and flossing on a daily basis are important for the parent to reduce bacterial plaque, which research has linked to preterm, low-birth weight babies.

— Diet: Dietary education for the parents, including the potential effect of foods and beverages on their oral health, helps maintain good dental care.

— Fluoride: Using fluoridated toothpaste and rinsing every night with an alcohol-free, over-the-counter mouthrinse containing 0.05% sodium fluoride may help reduce plaque levels.

— Caries removal: Routine professional dental care for parents can help keep their oral health in optimal condition.

— Delay of colonization: Educating parents, especially mothers, about sharing utensils, food, and cups can help prevent transmission of caries-causing bacteria.

— Xylitol gum: Recent evidence suggests the use of xylitol chewing gum (four pieces per day by the mother) can decrease a child’s caries rate.

Photo: Courtesy of D. Sharon Pruitt
Source: American Academy of Pediatric Dentistry