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320166
Oral Health Intervention: A Multifaceted Approach to Improve Oral Health Care during Pregnancy


Monday, November 2, 2015

Sruthi Sakamuri, University of Vermont College of Medicine, Burlington, VT
Caleb Seufert, University of Vermont College of Medicine, Burlington, VT
Tabitha Ford, University of Vermont College of Medicine, Burlington, VT
Gregory Frechette, University of Vermont College of Medicine, Burlington, VT
Talia Kostick, University of Vermont College of Medicine, Burlington, VT
I-Hsiang Shu, University of Vermont College of Medicine, Burlington, VT
Patrick Silveira, University of Vermont College of Medicine, Burlington, VT
Kristin Fontaine, MPH, UVM Medical Center Community Health Improvement, Burlington, VT
Thomas V. Delaney, PhD, Pediatrics, UVM College of Medicine, Burlington, VT
Wendy Davis, MD, Pediatrics, University of Vermont College of Medicine, Burlington, VT
Jan K. Carney, MD, MPH, Medicine, Robert Larner MD College of Medicine at the University of Vermont, Burlington, VT
Introduction: In 2009, Vermont spent $2.7 million treating Early Childhood Caries (ECC) in children ages 0-5, a group whose oral health status is strongly associated with that of their mothers. In 2012, Vermont lifted the Medicaid dental care cap for women during pregnancy and for 60 days postpartum, but data indicates that the majority of maternity care providers are unaware of this change and are not using guidelines published by the American Congress of Obstetricians and Gynecologists (ACOG) to evaluate oral health during pregnancy.

Objective: The Oral Health Intervention (OHI) is designed to improve prenatal dental referral rates for pregnant women on Medicaid.

Methods: Obstetricians at the UVM Medical Center received a didactic session providing oral health education, guidelines, and local resources. Our Oral Health Referral Protocol (OHRP) provided patients with treatment authorization letters, dental kits with educational pamphlets, and opportunities to schedule dental appointments. Pre-and post-intervention surveys assessed physician’s attitude and knowledge. OHRP feasibility was assessed by total treatment authorization letters received and appointments scheduled at two local dental clinics.

Results: 13/47 patients receiving OHRP counseling requested treatment authorization letters, and 2 scheduled dental appointments. No surveyed physicians were aware of the Medicaid cap removal and none were using guidelines to assess oral health before the didactic session, compared to 100% and 29%, respectively, post-didactic.

Conclusions: Provider education increases awareness of important Medicaid payment policies. The OHI is a feasible model to improve prenatal dental referral rates. Future research is needed to reduce barriers to scheduling and keeping appointments.

Learning Areas:

Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Implementation of health education strategies, interventions and programs
Other professions or practice related to public health
Planning of health education strategies, interventions, and programs
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Explain how a mother's oral health is a strong predictor of the oral health status of their child Describe the 2012 Vermont Medicaid Reform and the impact on women's dental care during the peri- and post-natal period Identify the five key components of UVM COM's Oral health initiative Evaluate the Oral Health Initiative’s (OHI) impact on patient appointment referrals and provider knowledge and practice. Assess current barriers preventing medicaid eligible pregnant women from seeking, scheduling, and attending oral health care appointments.

Keyword(s): Oral Health, Prenatal Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was involved in the design, implementation, data collection, analysis, writing, and presentation of this project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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