Oral health diseases such as childhood caries and periodontal diseases are prevalent conditions that disproportionately affect racial/ethnic minorities and disadvantaged individuals. Periodontal disease has been associated with adverse pregnancy outcomes such as preterm birth, fetal growth restriction and preeclampsia, and dental caries is the most common chronic childhood disease. Effective preventive and treatment measures to reduce the morbidity of caries and periodontal diseases exist, and data suggest that treatment of periodontal disease among pregnant women reduces risk for adverse pregnancy outcome and improves the oral health of the offspring. However, despite the presence of these evidence-based interventions to prevent or reduce the burden of oral diseases among children and women, both caries and periodontal diseases remain prevalent, particularly among low-income women and members of racial and ethnic minorities. Our long-term goal is to reduce morbidity of oral diseases among pregnant women and their children, and to eliminate disparities in oral health. We hypothesize that maternal knowledge about and attitudes toward oral health, as well as lack of access to oral health services, greatly affect maternal behaviors that promote the oral health of both the mother and her offspring. The primary objective of this study is to identify barriers to oral health care among pregnant women, then develop intervention strategies for removing or lowering the barriers so that existing evidence-based interventions can be more effectively applied. We will pursue this objective by achieving the following specific aims:

1. Collect and analyze data to understand pregnant women’s current practices, attitudes, and perceived system barriers regarding optimal dental health.
2. Test the feasibility, acceptability, and likely use of four to eight potential interventions to remove and/or reduce barriers and encourage improved oral health practices.
3. Conduct pilot study of one or more interventions developed in aim 2.

This proposal brings together a multidisciplinary team with strength in oral health in pregnancy, public health programming, behavioral research, qualitative analysis and public policy. Findings from this research will provide the framework for development of innovative, culturally sensitive strategies and approaches to improve the health and well-being of mothers and their children by reducing barriers to oral health care.