A Prenatal Care Gap
Pregnant women are an important group for enhanced, targeted oral health promotion.    Pregnant women are at higher risk for oral disease because of hormonal changes that affect their gums and because many women do not access dental care during pregnancy.  
Many women mistakenly believe they should avoid dental visits during pregnancy and many dentists are reluctant to treat pregnant women because they are unaware of current guidelines in treating pregnant patients or fear of litigation.

 Also, many prenatal health professionals fail to discuss oral health with their patients.    

Benefitting the Overall Health of Women and Children
Good oral health is important not only for the health of pregnant women but also for their children.  
Pregnant women with periodontal (gum and bone) disease may have a higher risk of delivering a pre-term or low birth weight baby.  
Also, the oral health status of mothers is a strong predictor of the oral health status of their children in two main ways:

• Tooth decay in children begins when cavity-causing bacteria (mutans streptococci) are passed from caregivers to children (babies are not born with these bacteria).  Mothers are the most common source of bacteria transmission which can occur when sharing spoons or pacifiers. 
• Mothers’ dental attitudes and behaviours are strongly correlated with their children’s oral health. 

The Maternal Oral Health Project 
A Saskatchewan Oral Health Coalition project group formed in 2013 to initiate discussion, cross-disciplinary thinking, and collaboration to guide action and strategy development to enhance maternal oral health in Saskatchewan.  
The project group is facilitated by the Saskatchewan Prevention Institute.  Project partners include the Saskatoon Health Region, Saskatchewan Dental Hygienists Association, Ministry of Health, University of Saskatchewan College of Dentistry, and College of Dental Surgeons of Saskatchewan.   

The project’s goal
Oral health is increasingly viewed and included as a core component of routine prenatal care provided by maternal health and oral health professionals in Saskatchewan.

The project strategies 
Increasing oral health literacy:  The public and health care providers are largely unaware of the health impacts of oral disease, the basic risk factors and oral disease prevention.  Education aimed at individual pregnant women and health care professionals is a foundational strategy for maternal oral health. 

• Health system integration:  Family physicians, obstetricians, and midwives are more likely to see pregnant women than are oral health professionals and are therefore important partners in providing early risk assessment, anticipatory guidance and referrals for dental exams and treatment.  Also, oral health and maternal health professionals working together can enhance maternal oral health promotion and disease treatment by sharing information, providing basic diagnostic services, and consulting one another.
• Workforce development:  Continuing education for family physicians, obstetricians, midwives on the importance of oral health and its link to overall health and pregnancy outcomes, early risk assessment, and provision of anticipatory guidance.  Also, continuing education for oral health professionals on the implications of untreated oral conditions in pregnancy, encouraging regular visits during pregnancy, and interventions and precautions by trimester.
• Increase access:  Raise awareness of the inequities in access to care and support more effective and accessible services. 
• Funding: Target investment for oral public health programs for pregnant women and expand preventive dental public health programs among those with the greatest oral health disparities.
• Monitoring, research and evaluation:  Enhance surveillance, research and program evaluation related to maternal oral health. 

Oral Health - A Core Component of Routine Prenatal Care
Increasing understanding, skills, and motivation in oral health professionals, maternal health professionals (family physicians, obstetricians and midwives), and women themselves are all key in integrating oral health into routine prenatal care in Saskatchewan.