Klamath County Leads the Way in Dental Care for Pregnant Women

February 4, 2010 -- A dental program in rural Oregon that focuses on pregnant women and infants has the potential to become a national model, according to a study to be published in Biomed Central Public Health within the next few months. 

 

Researchers have discovered that infants’ mouths soon become badly infected with Streptococcus mutans when their parents have poor dental hygiene, and found that a local Woman, Infants and Children program (WIC) could turn the situation around.

 

There’s a dual mythology in dentistry that these researchers debased which recommends that pregnant women only be treated for emergencies and children under age 30 months don’t need dental care. 

 

Before this program began, the average low-income pregnant woman in Klamath County had eight missing, decayed or filled teeth, and 90 percent had one or more untreated cavities.  

 

“Quite frankly we realized we were going to go broke if we continued on the same paradigm,” said study author Dr. Mike Shirtcliff, president and CEO of Advantage Community Dental Plan. “So the incentive was to look at something different from the drilling and filling. What I wanted to show is that by reducing the infection on the pregnant woman we’d break the cycle.”  

 

By using the WIC program, 55.8 percent of eligible pregnant women in Klamath County received dental care. There was a much lower rate of less than 10 percent in comparable counties, many of which have tried going through the schools and Head Start programs.

 

Timing was the key. “Head Start is too late to prevent decay in the baby teeth and too early to work on the six-year-old molars,” said the study’s lead author Dr. Peter Milgrom, professor of dental public health sciences at the University of Washington. “We’ve got this huge, out-of-control problem with tooth decay and kids, and the way we’ve been trying to fill and extract our way out of it isn’t working.”  

 

Because of the program’s success, Milgrom is replicating the project with a five-year $2.2 million grant from the National Institutes of Health. In part, that money will train WIC workers in Douglas, Josephine, Lincoln and Jefferson counties.  

 

“Although this work is only in a few counties, the effect will be much more widespread,” he said. “Dental care organizations might be able to invest in personnel out in the field because it would be more cost-effective than having to spend all that money putting kids in hospitals.”  He’s also the founder of the Abcd-dental.org program that encourages parents to take their children to the dentist early, and directs the Northwest/Alaska Center to Reduce Oral Health Disparities. 

 

Shirtcliff, who touted Milgrom’s program, said, “This is really a microcosm of how America could conserve precious resources in a lot of places. It’s actually a success story in the Oregon Health Plan because there aren’t enough funds to go around.” 

 

Advantage focuses on preventive care, so the insurer doesn’t offer crowns or periodontal surgery in some cases. 

 

“There’s no sense in doing those expensive procedures unless you’ve got the disease process under control,” Shirtcliff said. “Service prioritization requires somebody having some judgment based on some actual science. I’ve had families demand that I make grandma a new denture when she already has five she can’t wear, but what she really needs is a new blender.”