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Perinatal Oral Health Among Underserved Women: A Call to Action for North Carolina Patients, Providers and Policymakers

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Knowledge gaps exist among providers and pregnant women about the importance and safety of oral health care around pregnancy. This article describes the current state of perinatal oral health and healthcare among underserved women in North Carolina (NC) and provides policy recommendations to improve their access to and utilization of dental services.


A descriptive analysis is provided using (a) 2016 oral health surveillance data of a convenience sample of 459 pregnant women across NC, (b) 2014–2016 Medicaid dental provider and dental services utilization data for the Medicaid for Pregnant Women (MPW) program, and (c) 2017 Medicaid dental benefits policy. Surveillance data was not linked to Medicaid dental services utilization data.


Less than 20% of pregnant women surveyed reported having a dental visit during pregnancy and oral screenings revealed 33% had untreated caries. Medicaid data showed a steady decline since 2014 in percentage of MPW beneficiaries utilizing any dental service—less than 10% as of 2016. MPW dental benefits lapse at delivery because dental care is not considered pregnancy-related in NC policy. Only 20% of practicing NC dentists provided care to MPW beneficiaries in 2015.


Inadequacies in oral health knowledge, beliefs and practices exist among pregnant women, health care professionals and policymakers. Statewide efforts are needed to promote a standard of perinatal care that emphasizes collaborative practice and addresses existing barriers at the patient, provider and policy levels.

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Data Availability

Raw data used in this study may be accessed from the following agencies: NC perinatal oral health assessment data—NC Oral Health Section (; NC Medicaid provider and dental services utilization data—NC Division of Health Benefits (; NC dentist licensure data—NC Board of Dental Examiners (


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The authors would like to thank the NC Oral Health Section and its staff for conducting the 2016 prenatal oral health assessment and the local health departments that allowed access to their patients and facilities. Thank you to the NC Division of Health Benefits for providing Medicaid data, the NC Board of Dental Examiners for licensure data, and our team of reviewers, Drs. Mark Casey, Sarah Tomlinson, and Kelly Kimple. We also want to acknowledge the NC Perinatal Oral Health Task Force for its ongoing efforts to improve the health and well-being of pregnant women in the state.


The 2016 perinatal oral health assessment was supported by the Division of Public Health, North Carolina Department of Health and Human Services.

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Correspondence to Rhonda Stephens.

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All authors have no relevant conflicts of interest.

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Stephens, R., Quinonez, R., Boggess, K. et al. Perinatal Oral Health Among Underserved Women: A Call to Action for North Carolina Patients, Providers and Policymakers. Matern Child Health J 24, 351–359 (2020).

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