Oral Health Care During Pregnancy - Practice Guidance for Maryland's Prenatal and Dental Providers - Maryland.gov
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Oral
Health Care
During Pregnancy
Practice Guidance for Maryland’s
Prenatal and Dental Providers
2022
ACKNOWLEDGEMENTS
Debony Hughes, DDS
Director, Office of Oral Health
Stacy Costello, MPH, CHES Maryland Office of Oral Health
Office of Oral Health Department Shelly Choo, MD
John Welby, MS Maternal and Child Health Bureau
Office of Oral Health of Health Colleen Wilburn, MPA
Olivia Polkuzio, MPP Maternal and Child Health Bureau
Office of Oral Health
Giselle Gonzalez, MPH, CHEP
Marianna Wysong, MSN, RN, IBCLC Reviewers, Angeline Bell, BS, RN, CCE
Holy Cross Health 2021 Montgomery County Department of Health
and Human Services; Holy Cross Health
Greg Buckler, IOM, MBA, MSM Steering Katrina Holt, MPH, MS, RD, FAND
Maryland State Dental Association Committee, National Maternal and Child Oral
Health Resource Center
Ann Burke, MD 2018 Alice M. Horowitz, RDH, MA, PhD
The Maryland Section: American
College of Obstetricians and University of Maryland College Park,
Gynecologists School of Public Health
Richelle Cricks, CNM, MSN Susan Scherr, CRNP
Maryland Affiliate: American College University of Maryland, Baltimore
of Nurse Midwives School of Nursing
Christina Drostin, MD Norman Tinanoff, DDS, MS
Sandra Garbely-Kerkovich, DMD University of Maryland, Baltimore
Choptank Community Health System School of Dentistry
Kristen Blair, RDH
Maryland Dental Hygienists’
Association
Special Thanks for Initial Publication
Greg McClure, DMD, MPH Katy Battani, RDH, MS
Director, Office of Oral Health Project Director
In memoriam Office of Oral Health
Please contact the Maryland Office of Oral Health for additional information at mdh.oralhealth@maryland.gov.
Citation & Support
Cite as: Maryland Department of Health (2022). Oral Health Care During Pregnancy: Practice Guidance for
Maryland’s Prenatal and Dental Providers. Baltimore, MD: Maryland Department of Health, Office of Oral Health.
health.maryland.gov/oral-health.
This project was supported in 2018 by the Health Resources and Services Administration (HRSA) of the U.S.
Department of Health and Human Services (HHS), Grant Number: H47MC28476*. Information/content and
conclusions are those of the author and should not be construed as the official position or policy of, nor should any
endorsements be inferred by HRSA, HHS or the U.S. Government.
Selected content adapted, with permission, from Oral Health Care During Pregnancy Expert Work Group. 2012.
Oral Health Care During Pregnancy: A National Consensus Statement. Washington, DC: National Maternal and
Child Oral Health Resource Center.
TABLE OF CONTENTS
Oral Health During Pregnancy Infographic 4
Letter from the Deputy Secretary for Public Health Services 5
Introduction 6
Myths vs. Facts 7
Guidance for Prenatal Providers 8
Oral Conditions During Pregnancy 10
Guidance for Dental Providers 12
Dental Pharmacological Considerations for Pregnant Women 14
Resources 15
Tips for Good Oral Health During Pregnancy/Infancy (English)
Tips for Good Oral Health During Pregnancy/Infancy (Spanish)
Dental Referral Form for Pregnant Women
Additional Resources: Brochures, Posters, Links, Maryland Medicaid
Citations
Permission is given to photocopy this publication or to forward it, in its entirety, to others.
Requests for permission to use all or part of the information contained in this publication in other
ways should be sent to: Maryland Department of Health, Office of Oral Health 201 W. Preston
Street, Baltimore, MD 21201.
3
In Maryland,
only 15%
of pregnant women
with an oral health problem see a dentist.
Data Source: Maryland PRAMS Annual Report, 2015 Births
fe
d e n tist sa
the ? a
ng to d my baby see
Is goi ea n ul d I
for m sho ist?
e n t
Can I af
ford car ? Wh den
e?
n I find
a ?? Do I
ca den
tal i have
ere t?
Wh dentis nsu
ran
ce?
Let women know that
oral health care during pregnancy is
Safe
Important
Covered
by Maryland Medicaid
4
April 1, 2022
Dear Colleagues,
The health of a woman’s mouth is an essential part of a healthy pregnancy. It is also an important indicator of
her future child’s risk for developing dental caries (i.e., tooth decay) - the most common chronic childhood
disease in the United States. Pregnancy provides a key opportunity to provide oral health care services to
women, as well as to provide education on good oral health practices and preventive strategies. Yet, half of
pregnant women in Maryland do not have an oral prophylaxis (i.e., teeth cleaning) during pregnancy, and
19 percent of pregnant women report untreated oral health problems. With support from the U.S. Health
Resources and Services Administration (HRSA), the Maryland Department of Health’s Office of Oral Health
launched its Perinatal and Infant Oral Health Quality Improvement (PIOHQI) Project in 2015 to address
these issues. This updated version is being reprinted with support from the Maryland Department of Health,
Maternal and Child Health Bureau.
As part of this PIOHQI Project, an inter-professional steering committee of Maryland experts was formed to
review existing guidelines and current research related to oral health care during pregnancy. Based on this
review, the steering committee developed state-specific guidance for health care providers who serve pregnant
women. The culmination of their work is this new document: Oral Health Care During Pregnancy: Practice
Guidance for Maryland’s Prenatal and Dental Providers that includes the following to assist providers:
1) state statistics on oral health care utilization during pregnancy; 2) practice guidance for prenatal and dental
providers; 3) a visual guide of oral conditions that can occur during pregnancy; 4) a dental pharmacological
chart; 5) a sample dental referral form; and 6) educational resources to share with pregnant women.
I am grateful for the steering committee’s expertise and passion that brought this initiative to fruition and look
forward to working together to ensure optimal oral health for all women and children in Maryland.
Sincerely,
Jinlene Chan, MD, MPH, FAAP
Deputy Secretary for Public Health Services
Maryland Department of Health
5
Early is Key
Pregnant women should make
a dental appointment early in
pregnancy. Oral health care
is safe during all trimesters
and should not be postponed
or avoided during pregnancy.
Women should visit the dentist
Introduction for cleanings, exams, and any
treatment needed to maintain
or improve their oral health
during pregnancy.
Women experience multiple physiologic Professional oral prophylaxis (i.e.,
changes during pregnancy, including teeth cleaning) is a vital component of
changes in the oral cavity that may preventive and therapeutic oral health
adversely affect their oral health. care; however, almost half of mothers
Therefore, it is paramount that do not have their teeth cleaned during
prenatal and dental providers discuss pregnancy. Additionally, only 15 percent
oral changes with pregnant women, of women with a dental problem during
reinforce positive oral health practices, pregnancy see a dentist.3 Barriers for
and assure women that oral health not seeking care include cost, safety
care during pregnancy is safe and concerns, and difficulty finding a dentist
important. Physicians, nurses, and other who accepts pregnant patients or
medical providers are more likely to see Medicaid.
pregnant women and infants than are
dental providers, making it essential It is critical that prenatal and dental
that they address oral health with these providers assure women that oral health
patients and make referrals to dentists, care during the entire pregnancy is
as necessary. safe for both them and their developing
fetus. Providers should also inform
Children born to women with poor oral women that Maryland Medicaid covers
health and high levels of caries-causing oral health care services during
bacteria are at high risk for developing pregnancy.
dental caries (i.e., tooth decay).
According to the Centers for Disease In 2012, the American College of
Control and Prevention, dental caries Obstetricians and Gynecologists, the
remains one of the most prevalent American Dental Association, and other
chronic diseases among children in organizations issued Oral Health Care
the United States, despite it being During Pregnancy: A National Consensus
preventable.1 Additionally, periodontitis Statement, which included practice
has been linked to negative pregnancy guidance for both prenatal and dental
outcomes, including preterm birth, low providers. The Maryland Department of
birth weight, and preeclampsia.2 This Health’s Office of Oral Health is pleased
underscores the prenatal period as an to contribute to this vital conversation
opportune time to educate pregnant with the release of this state-specific
women on oral health and to deliver oral guidance, as the health and safety of
health care services. These interventions pregnant women and children is a top
may significantly change the trajectory priority.
of oral health for both the woman and
her future child.
6
Myths vs. Facts
Myth: Pr
eg
do with o nancy has nothing
ral health to
.
Fact: Du
tal X-rays
ring preg
nancy, p
changes hysiolog ver get den
Myth: Ne
occur tha ical
affect or t may ad
al health versely ant.
pregnan
cy gingiv
, such as
dental ca while pregn
it is, period ries, lding
disease)
, pregna ontitis (g - ra y s w it h lead shie
ncy tumo um tal X gnancy
granulom
a), and t r (pyoge
n Fact: Den s a fe during pre
ooth ero ic e re d iation.
4
condition
s can be sion. The are consid ta l A s s o c
prevente se erican Den from
treated,
so wome d and by the Am d ia ti o n exposure
n g h ra ision to
dentist d
uring pre
should v
isit the Even thou lo w , o nce a dec
gnancy. ys is e dental
dental X-ra m a de, it is th
y s is e
obtain X-ra n s ib il ity to follow th
resp o asonably
provider’s ( A s Low as Re
n c ip le ent’s
ALARA Pri in im ize the pati
l m
d denta ow if a
) to
a n Achievable
s t s
Denti d to kn exposure.
Myth: ts do not nee includes:
is ic practice
hygien is pregnant. Bes t ra d io lo g
fa s te s t image re
ceptor
s k
woman ers e ta
provid º Use of th with the diagnostic
dental t for compatible ital);
portan nant film or dig rons and th
yroid
is preg
i m (F -s p e e d a p
t i s n l le a d
I ain ora
t : m a rotectiv e
Fac h a t a wo r c e r t e º Use of p
wt fo orm th of the
to kno b e a t risk l d i n f collars; b e a m to the size
n shou
may on of th e
as she her º Collimati
A woma n a nt, of henever fe
asible;
ion s .
e is pr
e g ancy receptor w s; and
condit i f s h f h e r pregn c e s s in g technique the
team and i º Proper p
ro images to
dental o f
u e date, the nu m b e r
ted d º Limiting .
expec minimu m necessary
risk.
is high
Myth: Mater Myt
nal oral healt h
future child’s h does not aff tooth : Gain a
health. ect the . ch ild, lo
se a
Fact: Childre Fact
n born to w :
high levels o omen with p
oor oral hea calci The fetu
f caries-cau lth and um f s do
developing si ng bacteria teeth rom es n
dental carie are at high . Thi i t s m ot ta
linked to ne s. Also, peri ri sk of origi s my othe ke
gative pregn odontitis ha nate th lik r ’s
a ncy outcom s b e en wom db el
birth, low b
irth weight, es, including en m ecause y
and preecla preterm for d a pr
carious lesio
ns before de mpsia. Rest
o ri enta y be at h egnant
outcomes a li very may re n g active l car i gher
nd the child duce negati ies. risk
is an opport ’s risk of de v e birth
une time to ntal caries.
of their own e ducate wom P re g nancy
oral health a en on the im
child. Poor p nd the healt portance
renatal nutr h of their fu
developmen it ion may als tu re
t. o affect a ch
ild’s tooth
7
Oral Health Questions
1
to Ask Pregnant Women
Do you have any dental problems or
concerns?
Do you have swollen or bleeding
Guidance for
gums, a toothache (pain), problems
eating or chewing food, or other
problems in your mouth?
Prenatal Providers Since becoming pregnant, have you
been vomiting? If so, how often?
Do you have any questions or
concerns about getting oral health
Assess Pregnant Women’s Oral Health Status care while you are pregnant?
During the first prenatal visit: When was your last dental visit? Do
you need help finding a dentist?
º Take an oral health history (see Box 1).
º Assess frequency of consuming foods, beverages, and medications that contain
sugar and use of tobacco, alcohol, and recreational drugs.
º Check the mouth for problems such as swollen or bleeding gums, untreated dental
caries, mucosal lesions, signs of infection (e.g., abscess), or trauma.
º Document findings in woman’s medical record.
Advise Pregnant Women About Oral Health
º Assure women that there is no need to postpone
or avoid oral health care during pregnancy. Oral Health Tips to Share
Oral health care, including the use of X-rays,
2 with Pregnant Women
pain medication, and local anesthesia, is
safe, important, and covered by Medicaid
throughout pregnancy. See a dentist as early in your
pregnancy as possible.
º Advise women to schedule an appointment with
a dentist as early in the pregnancy as possible. Brush teeth twice a day with
If urgent care is needed or if the woman does fluoridated toothpaste.
not have a dentist, write and facilitate a formal
referral to a dentist with whom you maintain a Floss once a day.
collaborative relationship. See sample dental Choose healthy snacks and avoid
referral form in the Additional Resources foods and drinks containing sugar.
section.
Drink water with fluoride. About
º Encourage good oral health behaviors during 94% of Marylanders served by a
pregnancy (see Box 2). community water system (as opposed
to a private well) receive fluoridated
º Explain to women that caries-causing bacteria water from their tap. Most water
can be passed from mother to child after birth, filters do not remove fluoride.
and periodontal disease may increase the risk
of negative birth outcomes. Restoring active If you vomit, rinse your mouth with
a teaspoon of baking soda in a cup
carious lesions before delivery may reduce the
of water and delay toothbrushing for
child’s risk of dental caries. about an hour.
88
SAFE Prenatal providers are often the “first line” in assessing
pregnant women’s oral health. They have the
Important
opportunity to identify problems, provide referrals to
Covered
dentists, and reinforce good oral health practices.
Collaborate with Dental Providers
º Establish relationships and a 3 To Find a Dentist
referral process with dentists in the
community. See sample dental
referral form in the Additional For a list of dentists who accept
Resources section. Medicaid, visit:
health.maryland.gov/oral-health
º Maintain a list of dentists in the
community (see Box 3). For a list of public health dental
services, visit: https://phpa.health.
º Share pertinent patient information maryland.gov/oralhealth/documents/
and coordinate care with dentists. OralHealthResourceGuide.pdf
Provide Support Services (Case Management) to Pregnant Women
º If the woman does not have a º Help pregnant women complete
dentist, help her obtain care by applications for insurance or other
facilitating referrals to dentists in sources of coverage, social services
the community, including those who (e.g., domestic violence services),
serve pregnant women enrolled or other needs (e.g., transportation,
in Medicaid and those who are translation, tobacco cessation).
uninsured (see Box 3).
Improve Health Services in the Community
º On your patient-intake form, record º Provide a referral to a nutrition
the name and contact information of professional if counseling on food
the woman’s dentist, reason for and choices or nutrition-related health
date of last dental visit, and previous problems would be beneficial
dental procedures. (available at WIC programs).
º Establish partnerships with º Provide culturally and linguistically
community-based programs that appropriate care. Ensure that women
serve pregnant women (e.g., Special understand information shared with
Supplemental Nutrition Program for them by asking them to explain what
Women, Infants, and Children (WIC); they heard (i.e., “teach back”).
Early Head Start; Home Visiting).
º Integrate oral health topics into
prenatal classes.
99
Oral Conditions
During Pregnancy
Increased acidity in the
mouth from morning
sickness or gastric reflux;
increased intake and
Dental frequency of sugary
foods and beverages; not
Caries drinking fluoridated water;
and decreased attention to
oral hygiene practices will
result in an elevated risk
of dental caries.
An increased
inflammatory response
to plaque while
pregnant can result in
Pregnancy gums that swell and
Gingivitis bleed more easily.
Thorough toothbrushing
and flossing can
prevent or reduce
gingivitis.
10Untreated gingivitis can
result in periodontitis
Periodontitis - infection of the gums
and surrounding bone.
This can result in
“Gum Disease” loosening teeth and
bone loss.
Occurs in approximately
Pyogenic 5% of pregnancies.
These lesions may result
Granuloma from a heightened
inflammatory response
to oral pathogens and
“Pregnancy usually regress after
Tumor” pregnancy without
treatment.
Vomiting from morning
sickness and gastric
reflux may lead to
Tooth tooth erosion. Rinsing
with one teaspoon of
Erosion baking soda dissolved
in a cup of water
following vomiting helps
neutralize acid.
11Questions to Ask
1 Pregnant Women
How many weeks pregnant are you?
(When is your due date?)
Do you have any questions or
concerns about getting oral health
care while you are pregnant?
Guidance for Have there been any changes in
your diet?
Dental Providers Since becoming pregnant, have you
been vomiting? If so, how often?
Have you received prenatal care?
Do you need help finding a prenatal
Assess Pregnant Women’s Oral Health Status provider?
º Ask questions about pregnancy when taking a
medical and oral health history (see Box 1).
º Assess frequency of consuming foods, beverages, and medications that contain sugar
and use of tobacco, alcohol, and recreational drugs.
º Perform a comprehensive oral examination, which includes risk assessments for
dental caries, periodontal disease, and oral and oropharyngeal cancer.
º Take X-rays to diagnose oral diseases, as needed.
Advise Pregnant Women About Oral Health Oral Health Tips to Share
2
º Assure women that there is no need to postpone with Pregnant Women
or avoid oral health care during pregnancy.
Oral health care, including the use of X-rays,
Brush teeth twice a day with
pain medication, and local anesthesia, is safe,
fluoridated toothpaste.
important, and covered by Medicaid throughout
pregnancy. Floss once a day.
º Encourage good oral health behaviors during Choose healthy snacks and avoid
pregnancy (see Box 2). foods and drinks containing sugar.
Drink water with fluoride. About
º Explain to women that caries-causing bacteria
94% of Marylanders served by
can be passed from mother to child after birth. a community water system (as
Restoring active carious lesions before delivery opposed to a private well) get
may reduce the child’s risk of dental caries. fluoridated water from their tap.
Most water filters do not remove
fluoride.
Collaborate with Prenatal Providers
If you vomit, rinse your mouth with
º Establish relationships and a referral process with a teaspoon of baking soda in a cup
prenatal providers in the community. of water and delay toothbrushing for
º Share pertinent patient information and coordinate about an hour.
care with prenatal providers.
º Provide oral health training and resources to prenatal providers.
º Consult with prenatal providers, as necessary – for example, when considering:
• Co-morbid conditions that may affect management of oral health problems (e.g., diabetes,
hypertension, pulmonary or cardiac disease, bleeding disorders);
• The use of intravenous sedation or general anesthesia; and
• The use of nitrous oxide as an adjunctive analgesic to local anesthetics.
123 Positioning Pregnant Women in the Dental Chair
Keep the woman’s head at a higher level
than her feet.
Place the woman in a semi-reclining
position, as tolerated, and allow frequent
position changes.
Place a small pillow under the right hip or
have the woman turn slightly to the left
as needed to avoid dizziness or nausea
resulting from hypotension.
Provide Oral Disease Management and Treatment to Pregnant Women
º Provide emergency and routine º Use standard practice when placing
oral health care at any time during restorative materials such as amalgam
pregnancy. and and composite. Although data
º Position women appropriately in the are limited, the U.S. Food and Drug
dental chair (see Box 3). Administration concluded in 2008 that
fetuses are not at risk for adverse
º Develop, discuss, and provide women health effects from amalgam placement
with a comprehensive care plan that or removal during pregnancy.5
includes prevention, treatment, and
maintenance throughout pregnancy. º Use a rubber dam and high speed
evacuation during endodontic and
restorative procedures.
Provide Support Services (Case Management) to Pregnant Women
º If the woman does not have a prenatal º Help pregnant women complete
provider, explain the importance of applications for insurance or other
prenatal care. Assist the pregnant sources of coverage, social services
woman with finding a prenatal provider (e.g., domestic violence services),
in the community, especially those or other needs (e.g., transportation,
who accept Medicaid and other public translation, tobacco cessation).
insurance programs.
Improve Health Services in the Community
º On the patient-intake form, record the º Provide a referral to a nutrition
name and contact information of the professional if counseling on food
woman’s prenatal provider. choices or nutrition-related health
º Accept pregnant women enrolled in problems would be beneficial (available
Medicaid. Medicaid’s Maryland Healthy at WIC programs).
Smiles Dental Program covers oral º Provide culturally and linguistically
health care services during pregnancy. appropriate care. Ensure that women
º Establish partnerships with community- understand the information shared with
based programs that serve pregnant them by asking them to explain what
women (e.g., WIC, Early Head Start, they heard (i.e., “teach back”).
Home Visiting).
13Dental Pharmacological Considerations
for Pregnant Women
MAY MAY BE USED AVOID
BE IN SHORT OR
USED DURATION NEVER USE
Analgesics*
48 to 72 hrs, avoid
º Acetaminophen during 1st and 3rd
º Acetaminophen trimesters
with Codeine, º Aspirin
Hydrocodone, or º Ibuprofen
Oxycodone
º Naproxen
Avoid!
º Ciprofloxacin
Amoxicillin
Antibiotics
º º Clarithromycin
º Cephalosporins º Levofloxacin
º Clindamycin º Moxifloxacin
º Metronidazole
º Penicillin Never Use!
º Tetracycline
º Local Anesthetics
with Epinephrine
Anesthetics
(e.g., Lidocaine)
º Nitrous Oxide
Consult with a prenatal
provider before using
nitrous oxide, intravenous
sedation, or general
anesthesia.
Therapeutic Agents
º Chlorhexidine
mouth rinse
º Professionally-
applied topical
fluorides
Use alcohol-free products
during pregnancy.
*Oral pain can often be managed with non-opioid medication. If opioids are used,
prescribe the lowest dose for the shortest duration (usually less than 3 days) and
avoid issuing refills to reduce risk for dependency.
14Tips for Good Oral Health During Pregnancy
The health of your teeth and gums is important because it affects the health of you
and your child. Getting dental care while you are pregnant is safe and covered by
Maryland Medicaid during pregnancy. If your mouth is healthy, you will be giving your
baby a healthy start! Doing the following will help keep you and your baby healthy.
Practice Good Oral Hygiene Eat Healthy Foods
º Brush teeth twice a day with fluoride º Eat a balanced and nutritious diet.
toothpaste. º Avoid foods high in sugar.
º Floss once a day to Also avoid beverages high
prevent red, puffy in sugar like juice, fruit-
gums. flavored drinks, and soda.
º If you vomit, rinse your º If you have problems
mouth with a teaspoon with nausea, eat small
of baking soda in a amounts of healthy foods
cup of water to stop throughout the day.
acid from attacking º Drink fluoridated water
your teeth. Delay throughout the day,
toothbrushing for about an hour. especially between meals. Most tap
water in Maryland contains fluoride
Get Dental Care which prevents cavities. Most water
filters do not remove fluoride.
º Tell the dentist and dental hygienist
that you are pregnant and your due Practice Other Healthy Behaviors
date.
º All dental treatment should be º Attend prenatal classes.
completed before delivery. º Stop use of all tobacco products and
º Dental care, including the use of X-rays, recreational drugs. Avoid secondhand
most pain medications, and local smoke.
anesthesia, is safe during pregnancy. º Do not drink alcohol.
º Changes to your body when you º Take folic acid and iron supplements as
are pregnant may make your gums recommended by your prenatal doctor
sore or puffy and may make them or nurse.
bleed. This problem is called gingivitis
(inflammation of the gums). If
gingivitis is not treated, it may lead to
periodontal (gum) disease, which can
cause tooth loss.
To find a Medicaid dentist, visit: health.maryland.gov/oral-healthTips for Good Oral Health During Infancy
To Keep Child Cavity Free:
Tips on How to Brush a
º Beginning soon after birth, clean your
child’s gums daily with a clean, wet Young Child’s Teeth
washcloth.
º Use a small, child-sized toothbrush.
º Lay child down on a comfortable
surface (changing table).
º Position yourself behind child’s
head.
º Give child a toy to hold.
º Brush 2 - 3 teeth at a time.
º Do not put your child to bed with a LIFT THE LIP
bottle. Children should be weaned LIFT THE LIP
from a bottle between 12 and 14
LIFT THE LIP
º Lift the child’s lip
months. once a month to
º Avoid saliva-sharing activities (sharing look for cavities. Early
EarlyCavities
Decay
The child should
Chalky white lines at the gum line
utensils, cleaning pacifier in your Chalky
can bewhite
healed lines
– See aatdentist
the atgum line
once.
Early Decay
that canlines
beathealed.
Use fluoride toothpaste.
see a dentist
Chalky white the gum line
mouth) as cavity-causing bacteria can
can be healed – See
Early a dentist at once.
Decay
Use
Chalky fluoride
white toothpaste.
lines at the gum line
be passed from mother to child. immediately if can be healed – See a dentist at once.
Use fluoride toothpaste.
there are signs of
º Once teeth come in, start brushing cavities. Moderate Decay
Looks like teeth are “melting or chipping.”
See a dentist at once.
Moderate
ModerateCavities
twice a day with a smear of fluoride
Decay
Looks like teeth are “melting or chipping.”
toothpaste for children under age 3. º At one year well- Looks likeSee teeth
a dentistare
Moderate
chipping.
Looks like teeth
melting or
at once.
Decay
are “melting or chipping.”
child visit, ask
See a dentist at once.
For children ages 3 and above, a pea-
size amount should be used. doctor about child’s Severe Decay
Must see a dentist to avoid damage
oral health and Must
to permanent teeth.
Brought to you
see
Severe Decay
a by the Officeto
dentist of Oral
avoidHealth, Maryland
damage
fluoride.
Department of Health and Mental Hygiene
Must
Brought
Severe Cavities
see
toSevere
to you
permanent
a by
dentist
Decay
the Officeto
teeth.
Adapted from Alberta Health Services – Oral Health
avoid
of Oral damage
Health, Maryland
Department of Health and Mental Hygiene
to permanent teeth.
Brown/black
Adapted from in color; may be chipped
http://phpa.dhmh.maryland.gov/oralhealth/
Alberta Health Services
09/16– Oral Health
º Children should
Brought to you by the Office of Oral Health, Maryland
or broken.
Department of Health and Mental Hygiene
http://phpa.dhmh.maryland.gov/oralhealth/
Adapted from Alberta 09/16
Health Services – Oral Health
have their first Lip Pamphlet.indd 1
http://phpa.dhmh.maryland.gov/oralhealth/
09/16
1/28/14 1:38 PM
smear pea-size dental visit by age 1. Lip Pamphlet.indd 1 1/28/14 1:38 PM
under age 3 age 3 and older
Lip Pamphlet.indd 1 1/28/14 1:38 PM
º Avoid giving your child foods and How to Relieve
drinks containing sugar. Children
should not have fruit juice during their Teething Pain
first year.
º Use over-the-counter pain medicine
(acetaminophen, ibuprofen) and/or
chilled teething rings.
º Do not use teething gels.Consejos para tener una buena salud bucal durante el embarazo
La salud de sus dientes y encías es importante ya que afecta su salud y la de su hijo.
Obtener atención odontológica mientras está embarazada es seguro y está cubierto
por Medicaid de Maryland durante el embarazo. Si su boca está sana, ¡le estará dando
a su bebé un comienzo saludable! Hacer lo siguiente les ayudará a usted y a su bebé a
mantenerse saludables.
Tenga buenos hábitos de higiene Coma alimentos saludables
bucal
º Tenga una dieta balanceada y nutritiva.
º Cepíllese los dientes dos º Evite alimentos con alto
veces al día con pasta contenido de azúcares.
dental con flúor. También evite bebidas
º Use hilo dental una vez al con alto contenido de
día para prevenir encías azúcares, como jugos,
rojas e inflamadas. bebidas con sabor a frutas
º Si vomita, enjuáguese la y gaseosas.
boca con una cucharadita º Si tiene náuseas, coma
de bicarbonato de sodio pequeñas cantidades
disuelto en una taza de de alimentos saludables
agua para evitar que el durante el día.
ácido le haga daño a los dientes. Retrase
º Beba agua con fluoruro durante el día,
el cepillado por cerca de una hora.
especialmente entre comidas. La mayoría
Obtenga atención odontológica del agua de grifo de Maryland contiene
fluoruro, lo cual previene las caries. La
º Dígale al odontólogo y al higienista mayoría de los filtros de agua no eliminan
odontológico que está embarazada y la el fluoruro.
fecha del parto.
º Todos los tratamientos odontológicos se Tenga otros buenos hábitos
deben completar antes del parto. saludables
º La atención odontológica, lo que incluye º Asista a clases prenatales.
uso de rayos X, la mayoría de los
º No consuma tabaco ni drogas recreativas.
medicamentos para el dolor y la anestesia
Evite ser fumadora pasiva.
local, son seguros durante el embarazo.
º Los cambios en su cuerpo cuando está º No consuma alcohol.
embarazada pueden ocasionar dolor e º Tome ácido fólico y suplementos de hierro
inflamación en sus encías, lo que puede según lo recomendado por su médico o
hacerlas sangrar. Este problema se llama personal de enfermería prenatal.
gingivitis (inflamación de las encías). Si no
se trata la gingivitis, puede provocar una
enfermedad periodontal (en las encías)
que puede ocasionar pérdida de dientes.
Para encontrar un odontólogo de Medicaid, visite:
health.maryland.gov/oral-healthConsejos para tener una buena salud bucal durante la infancia
Para mantener a su hijo libre de caries:
Consejos para cepillar los
º Al poco tiempo del parto, limpie las º
encías de su bebé a diario con un pañito dientes de un niño pequeño
mojado limpio.
º Use un cepillo de dientes pequeño
para niños.
º Acueste al niño en una superficie
cómoda (cambiador).
º Ubíquese detrás de la cabeza del
niño.
º Dele un juguete para que lo
º No acueste a su hijo con un biberón. Los sostenga.
niños deben ser destetados del biberón º Cepille de 2 a 3 dientes al mismo
entre los 12 y 14 meses. tiempo. LIFT THE LIP
Evite actividades en la cuales comparta
º
LIFT THE LIP
saliva (compartir utensilios o limpiar
LIFT THE LIP
º Cumplido el primer
el chupón con su boca), ya que las
año, en la visita
bacterias que ocasionan caries pueden
para el bienestar del Caries en la primera infancia
ser transmitidas de madre a hijo.
Early Decay
Chalky white lines at the gum line
niño, pregúntele al Lascan
líneas blanquecinas
Use
Early Decay en la línea
be healed – See a dentist at once.
fluoride toothpaste.
Chalky white lines at the gum line
de la healed
encía –se pueden curar.
º Una vez que le salgan dientes, empiece odontólogo sobre la can be
Use
Chalky
See
Early a dentist at
Decay
fluoride
white
once.
toothpaste.
lines at the gum line
salud bucal y el flúor.
can be healed – See a dentist at once.
a cepillarlos dos veces al día con una Use fluoride toothpaste.
pequeña cantidad de pasta dental con º Los niños Moderate Decay
flúor para niños menores de 3 años. Para deben tener su
Looks like teeth are “melting or chipping.”
See a dentist at once.
Caries moderadas
Moderate Decay
niños de 3 años de edad o más, se debe primera consulta
Looks like teeth are “melting or chipping.”
See a dentistDecay
at once.
Los dientes parecen derretirse
Moderate
usar una cantidad del tamaño de un odontológica al
Looks like teeth are “melting or chipping.”
o astillarse.
See a dentist at once.
guisante. cumplir 1 año de Severe Decay
edad.
Must see a dentist to avoid damage
to permanent teeth.
Severe Decay
Brought
Must see Caries graves
to you
a by the Officeto
dentist of Oral
avoidHealth, Maryland
damage
Department of Health and Mental Hygiene
toSevere
permanent Decay teeth.
Adapted from Alberta Health Services – Oral Health
De color marrón o negro; pueden
Must see
Brought a by
to you dentist
the Officeto avoid
of Oral damage
Health,
Department of Health and Mental Hygiene
Maryland
to permanent teeth.
estarfromastilladas o rotas.
http://phpa.dhmh.maryland.gov/oralhealth/
Adapted Alberta Health Services
09/16 – Oral Health
Brought to you by the Office of Oral Health, Maryland
Department of Health and Mental Hygiene
http://phpa.dhmh.maryland.gov/oralhealth/
Adapted from Alberta 09/16
Health Services – Oral Health
pequeña cantidad tamaño de un guisante
http://phpa.dhmh.maryland.gov/oralhealth/
Lip Pamphlet.indd 1 1/28/14 1:38 PM
09/16
menores de 3 años 3 años de edad y mayores
Lip Pamphlet.indd 1 1/28/14 1:38 PM
Lip Pamphlet.indd 1 1/28/14 1:38 PM
Cómo aliviar el
º Evite darle a su hijo alimentos y bebidas
que contengan azúcares. Los niños no dolor de la dentición
deben beber jugo de frutas durante su
primer año.
º Use analgésicos de venta libre
º Levante los labios del niño una vez al (acetaminofén, ibuprofeno) o anillos
mes para ver si tiene caries. El niño debe de dentición fríos.
tener una consulta con un odontólogo º No use geles para la dentición.
inmediatamente si hay señales de caries.Dental Referral Form for Pregnant Women
SECTION A: PRENATAL PROVIDER TO COMPLETE (SEND TO DENTAL PROVIDER)
Patient Referred to: Referral Date:
(Dentist Name | Practice)
Patient Information:
Name:
(Last) (First)
DOB: ____ / ____ / _______ Estimated Delivery Date: ____ / ____ / ______
mm dd yyyy mm dd yyyy
Known Allergies and Precautions: (Specify, if any)
The following are considered safe during pregnancy:
Dental Procedures: Medications:
Oral Examination Amoxicillin
Dental Prophylaxis Cephalosporins
Scaling and Root Planing Clindamycin
Extraction Metronidazole
Dental X-ray with Lead Shielding Penicillin
Local Anesthetic with Epinephrine Acetaminophen
Root Canal Acetaminophen with Codeine, Hydrocodone, or
Restorations | Fillings Oxycodone
Patient may NOT have: (Specify)
REFERRING PRENATAL PROVIDER
Name: Signature:
(Please Print)
Date: Phone #: ( ) -
Email: Fax #: ( ) -
SECTION B: DENTAL PROVIDER TO COMPLETE (RETURN TO PRENATAL PROVIDER)
Diagnosis:
Treatment Plan:
DENTAL PROVIDER
Name: Signature:
(Please Print)
Date: Phone #: ( ) -
Published: February 2018
Oral health care is covered by Medicaid for pregnant women in Maryland. Provided By:
To find a dentist who accepts Medicaid, visit: OralHealth4BetterHealth.com
Permission is given to use this form, which can be found at: OralHealth4BetterHealth.comSection
SectionC:C:Poster
PosterChoices
Choices
Additional Resources
ENGLISH
ENGLISH——
Posters
Posters
The Maryland Department of Health and its partners offer printed materials free of
charge (subject to availability). Use the link reference number beneath each resource to
Enero 2019 Enero 2019 Enero 2019
January 2019 January 2019 January 2019
Adaptado de los Servicios de Salud de Alberta - Salud Bucal. Adaptado de los Servicios de Salud de Alberta - Salud Bucal. Adaptado de los Servicios de Salud de Alberta - Salud Bucal.
Adapted from Alberta Health Services — Oral Health. Adapted from Alberta Health Services — Oral Health. Adapted from Alberta Health Services — Oral Health.
may be chipped or broken. may be o
pueden estar agrietado deteriorado.
chipped or broken. pueden may beoo
estar agrietado
pueden estar agrietado deteriorado.
deteriorado.
chipped or broken. pueden estar agrietado o deteriorado.
preview and request materials from the organizations listed in the links section.
Severe Cavities Brown/Black in color; Caries graves De
Severe marrón/negro,
color Cavities Caries graves
Caries
Brown/Black in color; graves- De
Severe marrón/negro,
colorCavities
De color marrón/negro,
Brown/Black in color; Caries graves De color marrón/negro,
melting or chipping. se están deshaciendo o agrietando.
melting or chipping. se están deshaciendo o agrietando.
melting or chipping. se están deshaciendo o agrietando.
Moderate Cavities Looks like teeth are Caries moderadas Parece que
Moderate Cavities are moderadas
Looks like teethCaries
los dientes Parece que
Moderate los dientes
Cavities Looks like teeth are Caries moderadas Parece que los dientes
gum line that can be healed. gum
en la línea gingival queline that can
pueden be healed.
curarse. gum
en la línea gingival line
que that can
pueden be healed.
curarse. en la línea gingival que pueden curarse.
Early Cavities Chalky white lines at the Early
Caries incipientes Cavities
Líneas Chalky white lines atCaries
blanquecinas the Early
incipientes Cavities
Líneas Chalky white lines at the
blanquecinas Caries incipientes Líneas blanquecinas
Every Month Healthy Teeth No cavities.
Lift baby’s lip to look
Month EveryMensualmente
EveryMensualmente
Levante
Lift baby’s
Month
Dientes
lip toellook
Mensualmente
Dientes saludables
saludables- SinSin
Healthy
labio del bebé
Lift baby’s
caries.
caries.
Teeth
Levante
No cavities.
lip toel labio del bebé
look
Brochures
Dientes saludables Sin
Healthy caries.
Teeth No cavities. Dientes saludables Sin caries.
Levante el labio del bebé
for early cavities that for earlypara revisar
cavities si tiene for earlypara
that revisar
cavities si tiene
that para revisar si tiene
1 1 2 2 3 3 4 4
if there are any signs of cavities. si presenta algúnifindicio
there are signs of cavities. si presenta algún ifindicio
caries.
de any de caries.
there are any signs of cavities. si presenta algún indicio de caries.
look like white lines look likecaries,
whiteestas look likecaries,
lines se ven como white estas
lines se ven como caries, estas se ven como
Take your child to the dentist immediately Lleve de inmediato
Takea su
yourhijo
child odontólogo
al to Lleve de inmediato
the dentist immediately Take a su hijo
your al odontólogo
child to the dentist immediately Lleve de inmediato a su hijo al odontólogo
Oral Health is near the gum line. near thelíneas
gum blancas
line. cercanas
nearalthelíneas blancas cercanas al
gum line. líneas blancas cercanas al
Important During
¿Sabía Usted? La Salud Oral es
LIFT THE LIP LIFT LEVANTE
THE
area de laLIP EL LABIO
encia. LIFT LEVANTE
THE
area de laLIP EL LABIO
encia. LEVANTE
area EL LABIO
de la encia.
Importante Durante
Pregnancy Buena salud oral es importante
para su salud en general y la el Embarazo
Ӷ salud de su bebé. Ӷ
Free dental care is
available to pregnant Durante el embarazo, cambios Give
Atención dental gratuita
para mujeres embarazadas Cuide
Section C: Poster Choices
women through Medicaid. en su cuerpo pueden yourself
causarle a healthy se encuentra disponible la salud de su
dolores, enrojecimiento, por medio de Medicaid.
Find a dentist at: hinchazón en las encías mouth during
y que boca durante
sangren fácilmente. Si detecta Encuentre un dentista en:
HealthyTeethHealthyKids.org pregnancy.
estas condiciones, consulte el embarazo.
DientesSanosNinosSanos.org
If you do not qualify for
a un dentista de inmediato.
Medicaid, contact your Si usted no califica
county’s health department
PregNancy
Haga una cita para ver a su para Medicaid, póngase en à Soon after birth, begin wiping baby’s à Soon after birth, begin wiping baby’s à Soon after birth, begin wiping baby’s
ENGLISH —
to find a dentist. dentista tan pronto como
Maryland Oral Health
contacto con el Departamento gums daily with a clean, wet washcloth. à Inmediatamente
gums daily with después del nacimiento,
a clean, wet washcloth. à Inmediatamente
gums daily with después del
a clean, wet washcloth. nacimiento,
DENTAL REFERRAL àFORM Inmediatamente
FOR PREGNANT después del nacimiento,
WOMEN
de Salud de su condado para comience a limpiar a diario las encías de su comience a limpiar a diario las encías de su comience a limpiar a diario las encías de su
sepa que está embarazada.
Together
Take care of your teeth and gums à Never put baby to bed with a bottle. à Never put baby to bed with a bottle. à Never put baby bebéto bedcon
with
unaaPatient
bottle.
toallaReferred to:
limpia y húmeda. bebé con una toallaReferredlimpia Date:
y húmeda.
encontrar un dentista. bebé con una toalla limpia y húmeda. ™
Resource Guide
(Dentist Name | Practice)
and go to the dentist during
Es importante tener dientes à Once teeth come in, brush twice a day à Once teeth come in, brush
à Nunca twice
acueste a day
a un à Once teeth come
bebé con un biberón. in, brush
à Nunca twice
acueste a una day
bebé con un biberón. Patient
à Nunca Information
acueste a un bebé con un biberón.
pregnancy. Do your best to keep
y encías sanos antes de que with a rice-sized amount of fluoride with a rice-sized amount of fluoride with a rice-sized amount of fluoride
Name: Date of Birth:
à Una vez que broten los dientes, cepíllelos dos à Una vez que broten los dientes, cepíllelos dos à Una(First) vez que broten los dientes, cepíllelos dos The importance of
Cuide sus dientes y sus
2019 Edition
(Last) Estimated Delivery Date:
you and your baby healthy! dé a luz para así prevenir que toothpaste. toothpaste. toothpaste.
Posters
veces al día con una cantidad pequeña (del veces al día con una cantidad pequeña (del veces al día con una cantidad pequeña (del
encías, y visite al dentista tamañoandde un
Known Allergies and Precautions: (Specify, if any)
grano de arroz) de crema dental tamaño de un grano de arroz) de crema dental
maintaining the health
gérmenes pasen de su boca Avoid sharing utensils and cleaning tamañoand
Avoid sharing utensils de un grano de arroz) de crema
cleaning à dental
Healthy Teeth
à à Avoid sharing utensils cleaning
a la boca de su bebé. durante el embarazo. Dientes Sanos the pacifier in your mouth. Germs that con flúor.
the pacifier in your mouth. Germs that con flúor.
the pacifier in your mouth. Germs that con flúor.
The following are considered safe during pregnancy:
The Maryland of your mouth and teeth
during pregnancy
This project was supported by the Health Resources and Services
Administration (HRSA) of the U.S. Department of Health and Human
Services (HHS), Grant Number: H47MC28476*. Information/content
Healthy Kidspara
¡Haga todo lo posible
mantener su salud
Niños Sanos cause cavities can spread. cause cavitiesà can spread.
Evite compartir cubiertos y limpiar el cause cavities
chupete con su boca. ¡Los gérmenes que
Evite
à can compartir
spread. cubiertos
Dental
chupete con su Oral
Procedures:
boca.
y limpiar el
Examination
¡Los gérmenes que
à EviteMedications:
compartir cubiertos y limpiar el
chupeteAmoxicillin
con su boca. ¡Los gérmenes que Tobacco Quitline
à Avoid foods and drinks containing à Avoid foods and drinks containing à Avoid foods andproducen
drinks containing
helps you help
Dental Prophylaxis Cephalosporins
and conclusions are those of the author and should not be construed as the producen las caries pueden transmitirse! las caries pueden transmitirse! producen las caries pueden transmitirse!
official position or policy of, nor should any endorsements be inferred by y la salud de su bebé! sugar. No juice during the first year. sugar. No juice during the first year. sugar. No juice during the first Scaling
year. and Root Planing Clindamycin
à Evite alimentos yExtraction
your patients.
bebidas que contengan azúcar. Metronidazole
Evite alimentos y bebidas que contengan azúcar.
HRSA, HHS or the U.S. Government. à Evite alimentos y bebidas que contengan azúcar. Dental X-ray with Lead Shielding
à
Penicillin DEVELOPED BY
The Department of Health and Mental Hygiene (DHMH) complies with à Wean baby from bottle by 12-14 à Wean baby fromNobottle by 12-14
le ofrezca à Wean
jugos durante el primer año. baby fromNo bottle by 12-14
le ofrezca jugos durante withel primer año. No le ofrezca jugos durante el primer año. The Children’s Oral Health Institute
Local Anesthetic Epinephrine Acetaminophen with content contributed by
applicable Federal civil rights laws and does not discriminate on the basis months. months. months. à DesacostumbreRoot a suCanal
bebé del biberón entre Acetaminophen
Desacostumbre a suwith
bebéCodeine, Hydrocodone,
del biberón or
entre national health care experts
of race, color, national origin, age, disability in its health programs and à Desacostumbre a su bebé del biberón entre Restorations | Fillings
à
Oxycodone SPONSORED BY
activities.
At well-baby visits, ask about oral At well-baby visits,
los 12aska about oralde edad.
14 meses los 12
à At well-baby visits, aska about
14 meses
oral de edad. los 12 a 14 meses de edad.
Dientes Sanos
à à
Help is available in your language: 410-767-5300 (TTY: 1-800-735-2258). Patient may NOT have: (Specify)
health and fluoride. health and fluoride. health and fluoride. Office of Oral Health
SectionR C:
C:Poster
PosterChoices
These services are available for free.
à En las consultas de bebé sano, pregunte à En las consultas de bebé sano, pregunte à En las consultas de bebé sano, pregunte
Section Choices
www.HealthyTeethHealthyKids.org www.DientesSanosNinosSanos.org
Niños Sanos
Este proyecto fue apoyado por la Administración de Recursos y Servicios de Salud
Hay ayuda disponible en su idioma: 410-767-5300 (TTY: 1-800-735-2258). Cancer and Chronic Disease Bureau
sobrebylaage
salud
1. bucal y el flúor. sobre la salud bucal y el flúor.
(HRSA por sus siglas en inglés) del Departamento de Salud y Servicios Humanos de
Estos servicios están disponibles gratis. los EE.UU. (HHS por sus siglas en inglés), Número de subvención: H47MC28476*. La
à First visit to dentist by age 1. à sobrebylaage
First visit to dentist salud
1. bucal y el flúor. à First visit to dentist
用您的语言为您提供帮助：410-767-5300 (TTY: 1-800-735-2258). 这些
información/contenido y conclusiones son los del autor y no deben ser interpretados Referring Prenatal Provider Prevention and Health Promotion Administration
服务都是免费的
como la posición o política oficial de HRSA, HHS o el gobierno de los EE.UU., ni debe
inferirse ningún respaldo por estos. à Primera consulta con el odontólogo en el 1° año. à Primera consulta con el odontólogo en el 1° año. à Primera consulta con el odontólogo en el 1° año. Maryland Department of Health
TABLE OF CONTENTS >
health.maryland.gov/oral-health health.maryland.gov/oral-health health.maryland.gov/oral-healthName: (Please Print)
Signature: Department of Health
and Mental Hygiene
health.maryland.gov/oral-health health.maryland.gov/oral-health
Date: Contact: ( health.maryland.gov/oral-health
) - Provided by: 1
Give Yourself Give Yourself Lift the Lip Lift the Lip Referral Pad Oral Health Tobacco Toolkit PregNancy
a Healthy a Healthy (Eng.) (Sp.) 5 5 ENGLISH
ENGLISH — — Resource
6 6 Guide 7 7 8 8
Mouth During Mouth During
Pregnancy Pregnancy Posters
PostersSPANISH
SPANISH— —Posters
Posters
(Eng.) (Sp.)
1 Link
2 Reference
3 Number
4
1 1 1 1 1 1 3 6
Posters
Section C:
5
Poster Choices
11
6
11 11 2 2
7 8
12312
3 413
4 13 14 14
ENGLISH — SPANISH — Posters
Posters
The Health of Your Mouth is
Important During Pregnancy
The health of your teeth and
gums can affect the health
of you and your baby.
It is safe to get dental
care during pregnancy.
Make an appointment
to see your dentist
as soon as you know
you are pregnant.
In Maryland, Medicaid covers dental care
during pregnancy. For more information or to find
a dentist, visit: HealthyTeethHealthyKids.org.
This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS), Grant Number:
H47MC28476*. Information/content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be
inferred by HRSA, HHS or the U.S. Government.
Oral Health Wipe Baby’s
11 5 5 Baby’s
Wipe 12 66
Fluoride
13 Fluoride
14 77 88
Lift the Lip Lift the Lip
During
1
Pregnancy
Mouth (Eng.)
2
Mouth (Sp.)
3 SPANISH
Prevents — Posters
SPANISH
4
Cavities (Eng.)
Prevents
— Posters
Cavities (Sp.)
(Eng.) (Sp.)
Link Reference Number
1 2 2 2 2 2 2
5 6 7 8
SPANISH — Posters Links
1111 1212 1313 1414
1. Office of Oral Health Educational Resources: https://phpa.health.maryland.gov/oralhealth/Pages/materials.aspx
2. University of Maryland College Park, School of Public Health: http://sph.umd.edu/center/hchl/oral-health-and-health-literacy
3. Maryland’s 1-800-Quit Now: http://smokingstopshere.com/
4. Healthy Teeth Healthy Kids Program: www.HealthyTeethHealthyKids.org
5. National Maternal and Child Oral Health Resource Center: https://www.mchoralhealth.org/
11 12 13 14
6. The Children’s Oral Health Institute: http://www.mycohi.org/pregnancy-together.htmlMedicaid’s Maryland Healthy Smiles Dental Program
Medicaid’s Maryland Healthy Smiles Dental Program provides coverage for children
under the age of 21, former foster care recipients under the age of 26, pregnant
women ages 21 and over, and adults enrolled in the Rare and Expensive Case
Management (REM) program. The federal American Rescue Plan Act, passed into law
on March 11, 2021, establishes a new state option to expand Medicaid coverage for
expectant women from 60 days to 12 months postpartum. This expansion is granted
through a State Plan Amendment (SPA) and will be effective beginning April 1, 2022.
SKYGEN USA
Skygen USA handles the coordination of all dental-related customer service for
Maryland Medicaid enrollees participating in the Healthy Smiles Dental Program.
Provider Services Member Services
Phone: 844-275-8753 Phone: 855-934-9812
Email: providerservices@skygenusa.com TDD: 855-934-9816
Web: www.provider.MDhealthysmiles.com Web: www.member.MDhealthysmiles.comCitations
1
Centers for Disease Control and Prevention. 2017. Children’s Oral Health.
https://www.cdc.gov/oralhealth/basics/childrens-oral-health/index.html
2
Oral Care in Pregnancy. NIH. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6883753/ ;
Pregnancy and Oral Health Feature. CDC. https://www.cdc.gov/oralhealth/publications/features/
pregnancy-and-oral-health.html
3
Maryland Department of Health. 2017. Maryland PRAMS Report: 2015 Births. Baltimore, MD:
Maryland Department of Health.
https://phpa.health.maryland.gov/mch/Documents/MD%20PRAMS%20Report%202015%20Births.
pdf
4
American Dental Association, Council on Scientific Affairs, U.S. Food and Drug Administration.
2012. Dental Radiographic Examiniations: Recommendations for Patient Selection and Limiting
Radiation Exposure (rev.). Chicago, IL: American Dental Association. http://www.ada.org/~/
media/ADA/Member%20Center/FIles/Dental_Radiographic_Examinations_2012.ashx
5
Federal Register. 2009. Guidance for Industry and Food and Drug Administration Staff; Class II
Special Controls Guidance Document: Dental Amalgam, Mercury, and Amalgam Alloy; Availability.
74:148. https://www.gpo.gov/fdsys/pkg/FR-2009-08-04/pdf/E9-18445.pdf
Photographs Contributed By
Page 10, top image: dentalcare.com
Page 10, bottom image: http://www.perioimplant.gr/en/periodontal-disease/133-gingivitis.html#
Page 11, top image: dentalcare.com
Page 11, middle image: dentalcare.com
Page 11, bottom image: dentalcare.com
Page 12, image on top left: BCBSNC Foundation
Page 13, top image: Wilkins, E. 2009. Clinical Practice of the Dental Hygienist, 10th ed.
Philadelphia: Lippincott Williams & Wilkins.
Pages 15 & 17, image on left: Maternal and Child Health Access
Pages 16 & 18, image on top left: National Maternal and Child Oral Health Resource
Center
Pages 16 & 18, images on right: Alberta Health Services - Oral Healthn
he de
g o i n g to t my baby? I se
ea
Is e a n d l d
for m u
sho ?
h en entist
Can I aff W d
ord car
e?
?
an I
fin da ?? Do I
c den
er e t? tal i have
Wh dentis nsu
ran
ce?
Let women know that
oral health care during pregnancy is
Safe
Important
Covered
by Maryland MedicaidYou can also read
