2013
- Oral Health Literacy—Workshop Summary released
Background
This report summarizes the Institute of Medicine’s Roundtable on Health Literacy workshop held on March 29, 2012, in Washington, DC. The purpose of the workshop was to explore findings from oral health literacy research and how these findings are being translated into oral health practice, as well as the intersection between oral health literacy and health literacy. The report includes information on the importance of health literacy, the role of health literacy in addressing oral health problems, how oral health literacy can be assessed within health care systems and within the environment, the experiences of several oral health literacy programs, three state-based initiatives, and an overview of national oral health literacy activities.
Impact
This report should serve to increase awareness of the importance of oral health literacy.
Source
Hewitt M. 2013. Oral Health Literacy—Workshop Summary. Washington, DC: National Academies Press.
- Perinatal and Infant Oral Health Quality Improvement Initiative established
Background
To reduce the prevalence of oral disease in pregnant women and infants at high risk for oral disease through improved access to and utilization of high-quality oral health care, the Maternal and Child Health Bureau (MCHB), Health Resources and Services Administration, funded the Perinatal and Infant Oral Health Quality Improvement (PIOHQI) Initiative from 2013 through 2019.
MCHB funded 16 projects. Three pilot projects—Connecticut, New York, and West Virginia—were funded through 2018, and 13 expansion projects—Arizona, California, Colorado, Maine, Maryland, Massachusetts, Minnesota, New Mexico, Rhode Island, South Carolina, Texas, Virginia, and Wisconsin—were funded through 2019.
Technical assistance was provided to the PIOHQI projects by the Children’s Dental Health Project (CDHP) from 2013 through 2018 and the National Maternal and Child Oral Health Resource Center in partnership with the Association of State and Territorial Dental Directors in 2018 and 2019. CDHP shepherded the initiative through its transformation to become the first oral health learning collaborative funded by MCHB, providing education and training on quality-improvement theory and practice.
The PIOHQI projects worked toward:
- Increasing pregnant women’s utilization of preventive oral health care.
- Increasing the percentage of children who have dental homes by age 1.
- Reducing the prevalence of oral disease in pregnant women and infants, ultimately reducing dental caries throughout early childhood.
- Reducing oral health care expenditures.
Impact
Throughout the PIOHQI initiative, projects engaged in numerous wide-ranging activities to reduce the prevalence of oral disease in pregnant women and infants at high risk for oral disease through improved access to and utilization of oral health care. While robust evidence for PIOHQI effectiveness is not yet available, project findings provide promising evidence for the efficacy of PIOHQI interventions and a final report was produced.
One key area of success was increasing preventive oral health care utilization among pregnant women. Projects successfully integrated oral health screenings, education, and referrals into prenatal care programs and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). For instance, Wisconsin’s PIOHQI project built these components into its WIC and prenatal care coordination efforts. This led to more pregnant women receiving dental cleanings, a trend observed in several states, including New York, where one site saw 66 percent of referred pregnant women complete their dental appointments. Furthermore, projects developed and shared practice guidelines for both prenatal care health professionals and oral health professionals, emphasizing the safety and importance of oral care during pregnancy. Maryland’s PIOHQI project created specific guidance for health professionals.
Another significant finding was an increase in the percentage of children establishing a dental home by age 1. These initiatives aimed to identify infants in need of oral health care early on. Massachusetts’s PIOHQI project partnered with early intervention sites to develop an oral health screening form and staff training, resulting in a notable increase in children seeing a dentist in just 4 months. The broader goal was to use existing health care touchpoints, like well-child visits, to promote infant oral health and help families establish a crucial early relationship with an oral health professional.
PIOHQI also significantly enhanced workforce capacity and fostered interprofessional collaboration. Projects delivered extensive in-person and online training to a wide range of professionals and providers, including oral health professionals, medical professionals, and social services providers, boosting their ability to provide care to pregnant women and infants. Some projects developed oral health curricula for professional schools. These initiatives also cultivated stronger networks among health professionals and community organizations. South Carolina’s PIOHQI project collaborated with community systems directors to expand regional oral health networks, reporting a threefold increase in network size and greater confidence in creating inter-organizational connections. Some projects’ efforts led to a cultural shift in how oral health was viewed within tribal communities, attributed to strong partnerships and public-awareness campaigns.
In addition, PIOHQI projects brought about important policy and systems-level changes. Some projects used data from their analyses of barriers to accessing oral health care to advocate for policy shifts, leading to tangible results like the addition of an adult emergency dental benefit and the reintroduction of a pregnant women’s benefit in one state. Massachusetts’ PIOHQI project successfully encouraged the inclusion of oral health questions on the state’s early-intervention-program intake form and the integration of an oral health training module for new staff.
Sources
Barzel R, Association of State and Territorial Dental Directors. 2020. Perinatal Oral Health Policy Statement. Reno, NV: Association of State and Territorial Dental Directors.
Holt K, Barzel R. 2023. Improving oral health and overall health for pregnant people and infants. Journal of the California Dental Association 50(4):211–216.
Lorenzo S, Goodman H, Stemmler P, Holt K, Barzel R, eds. 2019. The Maternal and Child Health Bureau– Funded Perinatal and Infant Oral Health Quality Improvement (PIOHQI) Initiative 2013–2019: Final Report. Washington, DC: National Maternal and Child Oral Health Resource Center.
National Maternal and Child Oral Health Resource Center. 2019. Perinatal and Infant Oral Health Quality Improvement Initiative [webpage].
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