LOCAL ANESTHETICS AND PREGNANCY. A REVIEW OF THE EVIDENCE AND WHY DENTISTS SHOULD FEEL SAFE TO TREAT PREGNANT PEOPLE.

Oral health and dental treatment are essential during pregnancy. Despite dental treatment being safe during pregnancy for mother and baby, many dentists are reluctant to treat pregnant people. Previously published FDA and ADA recommendations for the treatment of pregnant people exist. Consensus statements and injectable local anesthetic manufacturers' information exist as well. Yet many dentists continue to demonstrate reluctance and hesitancy to treat pregnant people during all stages of pregnancy and for all routine comprehensive care such as exams, diagnostic radiographs, scaling and root planning, restorative, endodontic, and oral surgical procedures. Local anesthetics are most widely used in dental treatment, and many dental procedures necessitate their use when treating pregnant people. To facilitate dentists... comfort and clinical decision-making in the use of local anesthetics in improving the pregnant population's receipt of dental treatment and care outcomes and to calibrate practices to the current standard of practice aligning with contemporary evidence, this paper will review essential published evidence-based studies, guidelines, resources, and information from national organizations responsible for protecting the public's health.

Perinatal Oral Health: A Novel Collaborative Initiative to Improve Access, Attitudes, Comfort Level, and Knowledge of Pregnant Women and Dental Providers.

Objectives The objectives of this program were to increase access to dental care among pregnant women and to improve dental students' exposure, comfort level, and knowledge of the potential impact of poor oral health on pregnancy outcomes. Study Design Through collaborative efforts of a School of Dentistry and a School of Medicine, the Oral Health Pregnancy Day Initiative (OHPDI) was developed. Dental students were educated on the impact poor oral health may have on pregnancy outcomes and the importance of access to care. Pregnant women received perinatal oral health education and needed dental care. Results Thirty-four pregnant women presented for the OHPDI. Thirty-nine dental students participated. Eighty-five percent of students reported they learned how poor oral health may have a negative impact on pregnancy and birth outcomes; 79% agreed as a result of the event they were more likely to treat pregnant women. Ninety-four percent of pregnant women reported not having a dentist and 100% received perinatal oral health education and needed dental care. Eighty-eight pregnant women were seen subsequent to the OHPDI. Conclusion This initiative resulted in increased students' knowledge, exposure, and comfort level to treating pregnant women and pregnant women received needed oral health care education and dental treatment.

Exposure of Seventh and Eighth Grade Urban Youth to Dentistry and Oral Health Careers.

While pipeline programs for students from underrepresented minority groups have been established at the high school and college levels, fewer programs have been developed for middle school students. In an effort to reach this cohort, the University of Detroit Mercy School of Dentistry embarked on a grassroots collaborative pipeline program with two distinct segments: Urban Impressions and Dental Imprint. Their purpose is to expose Detroit-area seventh and eighth grade students to careers in dentistry, provide oral health education, and introduce role models. The aim of this pilot study was to determine outcomes for the middle school participants in Urban Impressions (n=86) and Dental Imprint (n=68). Both segments featured hands-on dental activities at the dental school. Outcomes were assessed by pretest-posttest surveys. Across the three cohorts, a total of 86 students participated in one or more sessions, with 57 completing the pre- and post-program surveys, for a 66% response rate. The results showed that the Dental Imprint respondents' knowledge of oral health, dental admissions, and specialties increased by an average 26% over three years. The gain in knowledge for each cohort was statistically significant (p<0.001). Overall, 91% of Urban Impressions and 95% of Dental Imprint respondents were positive about the value of the program. Thirty-one of 57 Urban Impressions respondents indicated interest in dentistry as a career following the program. These results suggest that the two segments of this program are meeting their goals of increasing middle grade students' awareness of oral health professions including dentistry and providing access to role models. Institutions may benefit from the description of strategies used by this program to address challenges related to establishing early pipeline programs.

Accountable Care Organizations and Oral Health Accountability.

Accountable care organizations agree to be accountable for the cost and outcomes of an attributed population. However, in many, no provisions have been made to account for oral health. There are several social, medical, and financial implications for health care provider and payer systems and health care outcomes when oral health is not accounted for in patient management. How can an organization strive to improve population health without including the oral health system? Total systemic health for a population must include oral health. Accountable care organizations are positioned to change the course of oral health in the United States and close the disparities that exist among vulnerable populations, including seniors. Such efforts will reduce health care costs. Opportunities abound to expand points of entry into the health care system via dental or medical care. Closing the great divide between 2 historically isolated professions will position the United States to make gains in true population health. I provide evidence of the need to mandate access to oral health care services for all Americans-specifically adults, because legislation currently exists for pediatric dental coverage.

MDA Dentists and Pregnant Patients: A Survey of Attitudes and Practice.

Objectives There are dental and medical consensus statements stating oral health care is safe throughout pregnancy. This survey seeks to assess the attitudes and practice of Michigan Dental Association dentists regarding the oral health and treatment of pregnant patients as a preliminary assessment to facilitate state perinatal oral health initiatives. Methods Surveys were sent to all 4,494 Michigan Dental Association (MDA) members via the Michigan Dental Association List Serv between July and September of 2013 using an online survey instrument. There were 347 respondents, a response rate of 7.72 percent. Results Of the respondents, 91 percent strongly agree that oral health care is an important part of prenatal care, but only 37 percent indicate they provide restorative procedures and periodontal scaling and root planning procedures throughout all stages of pregnancy. Conclusions MDA dentists believe oral health care is important for pregnant patients. There is a need to provide continuing education in the management of pregnant patients.