Roles of public health nurses to improve the dental health of low income urban mothers and their offspring

The disparate access to physical, mental and dental health for low income, urban minority groups is well documented. At risk populations for significant dental disease include underinsured mothers and their offspring who face significant challenges accessing and paying for routine and/or emergency dental care. All too frequently, dental practices have a cap on medical assistance patients and require the uninsured to “pay up front”. In addition, dental health education and screening is not a universal standard of care for all primary care providers. Therefore, lost opportunities to educate young mothers regarding 1) personal dental hygiene; 2) care of their infants' gums and “baby” teeth, 3) available, affordable dental health resources, and 4) routine six month dental check-ups abound. Consequently, too many mothers and their adult offspring face employment and social discrimination when their smiles reveal dental caries, misaligned and/or missing teeth. The Philadelphia Nurse-Family Partnership (NFP) team of public health nurses also notes that mothers with visible dental disease habitually cover their mouths to talk and are reluctant to give social “toothy” smiles. This paper provides an overview of the 2001- 2007 NFP program serving low income first time mothers-to-be and their offspring until the age of two years, and the 2006-2007 incorporation of a dental health questionnaire and teaching tool for NFP public health nurse home visitors to use at will with their NFP mothers. Emerging information and strategies to improve the dental health of NFP mothers and their babies are presented. Feedback from the nurses and participants is highlighted. The nurses have learned not to assume that 1) primary care providers (including prenatal providers) emphasis dental health; 2) families have toothbrushes; 3) mothers brush and floss their teeth daily; 3) mothers know how to access routine and emergency dental health resources for their families, and; 4) mothers value teeth as a natural resource. The role of public health nurses to improve the dental health of low income urban mothers and their offspring is emphasized. Discussion regarding the replication of the dental health questionnaire and teaching tool with other low income, at risk populations concludes the presentation.