Dentists Want Education, Guidance On Treating Pregnant Women
February 11, 2009

by Nancy Volkers
InteliHealth News Service

INTELIHEALTH - Dentists want to learn more about how to care for pregnant women, a survey shows.

Researchers from the University of Washington, Seattle, did the study. They surveyed 829 Oregon dentists. Nearly all -- 92% -- said that dental care was an important part of a pregnant woman's health. But most said they wanted to know more about treating and talking with pregnant women.

About 8 of 10 dentists in the study were male. Their average age was 47. Most had been in dentistry for more than a decade.

Just over half of dentists said it was never safe to give a pregnant woman a full-mouth X-ray. The American Dental Association (ADA) recommends that pregnant women delay elective dental X-rays until after delivery. Sometimes, X-rays are needed during pregnancy to diagnose and treat problems. A full-mouth X-ray would rarely be needed during pregnancy, however.

About 8 out of 10 dentists said it was never okay to give nitrous oxide to a pregnant woman. The American Academy of Pediatric Dentists (AAPD) says that women should not receive nitrous oxide in the first trimester. That's because nitrous oxide has been associated with miscarriage and spontaneous abortion in dental assistants and dental hygienists, who are frequently exposed to low levels of the gas. The AAPD does not make recommendations about giving nitrous oxide during the second and third trimesters. Nitrous oxide may be recommended for patients who are pregnant because it wears off quickly and does not stay in the body.

Most of the dentists in the study talked with their pregnant patients about periodontal disease. This disease affects the gums, bone and connective tissue around the teeth. Research suggests that pregnant women with periodontal disease may be more likely to give birth prematurely, or to have unusually small babies.

Just under half of the dentists said they talked with pregnant women about ways to prevent early childhood caries. This is a form of tooth decay that affects very young children. The bacteria that cause tooth decay are usually passed from mother to child. Dentists who had been in practice fewer than 10 years were more likely to think it was important to talk about early childhood caries than dentists who had been practicing longer.

Nearly all dentists said that it was important to counsel pregnant women about periodontal disease and birth risks. About two-thirds said they had the skills to counsel women this way.

There were some barriers to counseling and treating pregnant women. Most dentists said they had time for counseling. However, they said insurance companies did not pay enough for this service. About 4 out of 10 dentists were worried about legal action if something went wrong in a pregnancy.

Most dentists said they would like to take continuing education courses about treating pregnant patients. Dentists also were open to hearing examples of how to talk with pregnant women about their health care.

The study appears in the February issue of the Journal of the American Dental Association.