MCHbest. NPM 13.1: Preventive Dental Visit: Pregnancy
Strategy. Provider Education (Early Head Start, Home Visiting, WIC)
Approach. Collaborate with Early Head Start programs, home visiting programs, and/or Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics to train staff to conduct oral health risk assessments, provide preventive oral health care, and refer pregnant women for dental visits.
Overview. Provider education is an evidence-based strategy that has shown utility in increasing use of professional services including oral health by MCH population groups.1,2 Examples of topics focused on preventive oral health care include providing anticipatory guidance on feedback practices, providing tooth brush instruction, and conducting lift the lip screenings.
Evidence. Moderate Evidence. Provider education in Early Head Start, Home Visiting, and WIC appear to be effective in improving dental care for pregnant people. Programs based on this strategy are likely to work. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).. Also see Holt K, Louie R. 2019. Strengthening State and Jurisdiction Efforts Related to Title V Maternal and Child Health National Performance Measure 13 (Oral Health). Washington, DC: National Maternal and Child Oral Health Resource Center and other backtround resources.3
Target Audience. Providers.
Outcome. Proportion of pregnant people with a dental claim. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the “Intervention Results” for each study.
Examples from the Field. Access descriptions of ESMs from across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.
Sample ESMs. Using the approach “Collaborate with Early Head Start programs, home visiting programs, and/or Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics to train staff to provide preventive oral health care to pregnant women and referrals to oral health professionals for dental visits,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):
Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).
Possible Data Sources for ESMs:
- Training event data
- Early Head Start program data
- Home visiting program data
- WIC clinic data
- Dental clinic/office data
1 Lipper J. Advancing Oral Health through the Women, Infants, and Children Program: A New Hampshire Pilot Project. (2016). Center for Health Care Strategies.
2 Perkins, R. B., Zisblatt, L., Legler, A., Trucks, E., Hanchate, A., & Gorin, S. S. (2015). Effectiveness of a provider-focused intervention to improve HPV vaccination rates in boys and girls. Vaccine, 33(9), 1223-1229.
3 Additional Background Resources:
- Association of State and Territorial Dental Directors, Best Practice Committee. 2019. Best Practice Approach: Perinatal Oral Health. Reno, NV: Association of State and Territorial Dental Directors.
- Casamassimo P, Holt K, eds. 2016. Bright Futures in Practice: Oral Health—Pocket Guide(3rd ed.).Washington, DC: National Maternal and Child Oral Health Resource Center.
- Clark MB, Douglass AB, Maier R, Deutchman M, Gonsalves W, Silk H, Wrightson AS, Quinonez R, Dolce M, Dalal M, Rizzolo D. 2010. Smiles for Life: A National Oral Health Curriculum(3rd ed.).Leawood, KS: Society of Teachers of Family Medicine.
- Lorenzo S, Goodman H, Stemmler P, Holt K, Barzel R, eds. 2019.The Maternal and Child Health Bureau–Funded Perinatal and Infant Oral Health Quality Improvement (PIOHQI) Initiative 2013–2019: Final Report. Washington, DC: National Maternal and Child Oral Health Resource Center.
- Oral Health Care During Pregnancy Expert Workgroup. 2012. Oral Health Care During Pregnancy: A National Consensus Statement. Washington, DC: National Maternal and Child Oral Health Resource Center.
- Maternal and Child Oral Health Resource Center. 2010. Open Wide: Oral Health Training for Health Professionals. Washington, DC: National Maternal and Child Oral Health Resource Center.
- Wells J. 2019. Improving Oral Health Outcomes for Pregnant Women and Infants by Educating Home Visitors. Washington, DC: Association of Maternal and Child Health Programs.