Can a prenatal dental public health program make a difference?

OBJECTIVE Some pregnant women may be at increased risk of poor oral health. A publicly funded prenatal dental program in Vancouver, British Columbia, called Healthiest Babies Possible (HBP), has been providing oral health education and limited clinical services for over 20 years to low-income women assessed to be at high risk of preterm or low-weight births. This report is an assessment of the initial outcomes. METHODS A prospective before-after evaluation of a non-probability convenience sample of women was undertaken over 1 year (2005-2006). Participants were seen at the customary 2 clinic visits, and were asked to return for a postnatal visit. Data collected by an inside evaluator, the program's dental hygienist, included questionnaires, semi-structured interviews, observations, clinical indices, appointment statistics and self-reports. Univariate and bivariate analyses (Student's t test and ANOVA) were performed. RESULTS Of the 67 women in the sample, 61 agreed to participate; 36 (59%) attended all 3 appointments at the clinic, and 40 (66%) completed all 3 interviews and questionnaires either at the clinic or by telephone. Clinical indices of gingival health improved significantly over the time of the evaluation. Improvements in tooth cleaning were demonstrated by a significant decrease in plaque (p < 0.001). The proportion of the women's other children receiving professional dental care increased significantly (p < 0.001). Oral health knowledge improved and, overall, women expressed satisfaction with the program. CONCLUSION Participants in this evaluation demonstrated improved gingival health, enhanced knowledge of oral health and positive tooth-cleaning behaviour. These women pursued infant oral care and sought professional dental visits for their children.