The National Healthy Mothers, Healthy Babies Coalition (HMHB), issued a position statement asserting that “oral health care during pregnancy is crucial and should be available to all women, regardless of income level”. HMHB is committed to “working with dental and other health care providers to increase awareness of, and support research on, the possible link between periodontal disease and pre-term, low birth-weight babies” (18)

The American Academy of Periodontology has developed a draft policy statement that recommends pregnant women have a periodontal examination performed and appropriate preventive and/or therapeutic services provided, as there is emerging evidence that women with periodontal disease may be more at risk to deliver a preterm low birth weight baby. Consumer and media information are posted on the web at: http://www.perio.org/consumer/pregnancy.htm

Clinical guidelines suggest that routine plaque and calculus removal via polishing, scaling and curettage can be performed safely during pregnancy, regardless of trimester (19) but the most conservative approach saves dental treatment for the second and early third trimester. Dentists and obstetricians agree that routine dental care should be maintained throughout pregnancy(20,21). However, despite the growing evidence and literature to support the association between periodontal disease and PLBW, this recommendation has not been widely translated into clinical or public policies and pregnant women and their obstetricians have noted that many dentists are hesitant about caring for pregnant women.

Medicaid programs, administered by the states within federal guidelines, are required to provide certain populations with specified (“mandatory”) benefits. Dental is only mandated under Early and Periodic, Screening, Diagnostic, and Treatment Services Program ( EPSDT) and is therefore available to pregnant adolescents but not typically to pregnant women over 21. Pregnant women over age 21 who are in Medicaid therefore can only access dental benefits in states that elect to provide it (22). As the federal and state governments seek Medicaid cuts, elective dental services have been susceptible to termination. As of 2005, only 6 states provided reasonably comprehensive dental benefits to adults while others provide emergency treatment or no dental benefit at all.