Prenatal teledentistry: because oral-systemic health links begin in the womb
Today’s emphasis on wellness extends throughout our lifespan. Recent research indicates that oral health is vital to overall health and wellness. This is especially important when it comes to prenatal care.
For example, pregnant women with undiagnosed and untreated periodontal disease are more likely to have preterm and low birth weight babies, leading to several other complications and conditions, such as delayed development and lags in growth.
The effects of the mother’s oral health on her unborn and growing child
Data about the connection between a mother’s oral health on her unborn child continues to emerge, with more recent meta-analyses affirming adverse birth outcomes for both mother and child when there is untreated gum disease. Preeclampsia, preterm delivery, and low birth weight are among the most severe outcomes. To put it simply, the poor health of a mother's oral cavity influences the mother's overall health and, therefore, her child's. Here are two examples:
Gingivitis is an inflammation of the gingiva or gums and is common among pregnant women. It can be easily prevented. Porphyromonas gingivalis, a bacteria associated with periodontal disease and other bacteria present in the subgingival plaque of pregnant women, was found to be more abundant in women with preterm birth, for example, than in women with near-term birth. More than two-thirds of pregnant women have gingivitis during pregnancy.
In addition, pregnant women may be more susceptible to caries due to hormonal changes and changes in eating habits. They can then transmit high counts of caries-causing bacteria in their mouths to the mouths of their infants. Mothers with high levels of untreated cavities are three times more likely to have children with cavities than mothers with good oral health.
Moreover, professional medical organizations recommend oral care during pregnancy; for example, The American College of Obstetrics and Gynecology recommends oral care during pregnancy to benefit both the mother and their unborn infants. This was affirmed in 2019, after its original guidance in 2011.
Also, since 2000, the American Academy of Pediatrics (AAP) guidance suggests that infants receive an oral examination by 6 months of age. Since there are not enough oral health professionals to provide care for young children, pediatricians and pediatric nurse practitioners are filling this void. So, how can we fill this gap? One word – teledentistry.
Teledentistry can link families to a dental home
Teledentistry, like telehealth, is now available to ensure that more children can easily access oral care from pediatricians and ensure connection to oral health professionals, and a dental home. With teledentistry, moms and babies can access care with a dentist, with the mom holding the baby on her lap without any downtime for transportation or additional time off from work, and without the risk of contagion of the latest COVID-19 variant. They can have face to face contact with a dental professional to meet their needs.
The AAP recommends that providers perform oral health risk assessments at all 6, 9, and 12-month visits. These can be conducted with teledentistry or when providing routine childhood vaccinations during well-baby checks.
There is no doubt that oral health impacts the overall quality of life. A healthy mouth, free of disease, ensures the ability to swallow, smile, eat, and feel confident, and improves basic quality of life issues. Furthermore, like a healthy body, prevention of oral disease begins in prenatal care and is especially important in early pediatric well-care.
Moreover, studies found that parents are mostly unable to accurately detect oral health issues in their children because they perceive it primarily based on assumptions. Therefore, teledentistry consultations are paramount in catching and treating problems before they develop in severity.
Teledentistry links pregnant patients and newborns to pediatricians and pediatricians to oral health professionals
While some areas may lack oral health professionals to treat infants and young children, teledentistry can easily link oral health professionals and the regional pediatric practice schedule. According to a recent report, oral health should be integrated into primary care. In fact, teledentistry is the only proven technology that can bridge the prenatal and pediatric care gap.
Teledentistry visits can co-occur as the patient attends another health professional or, if necessary, be pre-recorded for later viewing. Teledentistry can also link pediatric patients to a dental home by age 1, as recommended by the AAP.
The following provides some guideposts for the standard teledentistry virtual consultation, with the mom holding a baby on her lap:
Medical history: including any history of gestational diabetes, preeclampsia, pregnancy hypertension, preterm labor, and any other issues.
Chief complaint, if any.
Oral health risk assessment.
Summary of oral health findings from observation.
Additional information: including any relevant information from OBGYN, oral professional, or another health professional.
Assessment of oral findings and any impact on function such as feeding, speech, expressions, or other difficulties.
Summary of recommended treatment and/or prevention: for example, fluoride varnish, not putting a baby to bed with formula, avoiding high-sugar drinks, and other recommendations.
Summary of treatment
Recommended next visit (time period).