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by Sarah Vidrine 

 

We’ve long understood the connection between a mother’s health and her child’s health. The science backs up what we can understand intuitively: a woman’s health during pregnancy has a huge impact on whether her baby will survive and thrive. More recently, researchers have helped us begin to understand that moms and babies health continue to be deeply intertwined throughout early childhood (and beyond!). While this may seem less intuitive, dental health is a key part of that picture.  

Oral health is key to overall health 

Oral health care and medical care have separate rules, separate educational institutions and trade associations, and separate care delivery systems. This historical separation between dentists and doctors does us all a disservice. The health of our mouths and teeth are integral to our overall health and well-being. Poor dental health is strongly associated with heart disease, diabetes, and other health problems. 

There is a severe shortage of dental care in particular in rural and low-wealth communities. This means that women and children of color in particular are more likely to suffer from a wide range of health outcomes that go way beyond tooth decay.   

Pregnancy and childbirth are not exempt from this unfortunate dynamic. There is a very clear link between a mother’s oral health and her baby’s health. For example, women with poor oral health are more likely to suffer pre-eclampsia, putting both mother and child at serious risk during pregnancy and birth. Periodontal disease is associated with low birth weight, one of the biggest factors in a baby’s survivalThe risks continue into early childhood: Cavity-causing bacteria are transmitted between mother and child, contributing to early childhood tooth decay.  

Medicaid for Pregnant Women 

In some aspects, North Carolina is ahead of the game. Women who earn too much to be eligible for full Medicaid may be able to access coverage during pregnancy through the state’s Medicaid for Pregnant Women (MPW) program. Medicaid for Pregnant Women provides care related to pregnancy, including dental. But there are some challenges to this short-term coverage option: 

  • Unfortunately, for some women MPW is the first access to dental coverage that they’ve ever had. Often their treatment needs are extensive.  
  • Even when women begin a treatment plan during pregnancy, her coverage may end before her treatment is complete. The coverage they get through Medicaid for Pregnant Women ends shortly after the baby’s birth 
  • Although most care is proven to be safe, some dentists are still reluctant to treat pregnant women, making it even harder to find care. And some women may be nervous about the impact of treatment on their pregnancy.  

While we still don’t have all the answers, we know that woman’s health before she becomes pregnant is vital to a healthy pregnancy, safe delivery, and a thriving baby. Access to oral health care before pregnancy, throughout pregnancy, and throughout life is really the ticket to improving health of both moms and babies. 

Women need coverage throughout their child-bearing years 

One way to ensure that women and children can get the dental care they need is by closing the “coverage gap.” If North Carolina chose to accept the federal funds for Medicaid expansion, it would have a huge impact on oral health for women and children. Many women who now qualify for the Medicaid for Pregnant Women program would finally be able to get health coverage before, during, and after pregnancy. If we want babies to survive and thrive in North Carolina, we must care for their moms too.  

Sarah Vidrine is NC Child’s Health Policy Analyst 

 

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