Minnesota Title V MCH Needs Assessment Fact Sheets

Pregnant Women, Mothers and Infants

Dental Health for Women

Summer 2004

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Size of the Problem

In 2004 there were over 1,096,832 women of childbearing age (15 to 44 years old) in Minnesota [1].

Seriousness

Women affected by lack of access to dental health services
State data show that 75.8% of adults have made at least one dental visit in the past year while an estimated 61.1% of adult women and men have dental insurance [2]. An estimated 7.9% of women in Minnesota are uninsured [3]. Among women, having private insurance was strongly associated with a more recent visit to the dentist. According to national research 71.5% of women report that the cost of dental care, lack of dental insurance or the lack of a provider accepting type of insurance are the reasons they are unable to obtain desired dental care [4].

Researchers have identified sex-specific associations between oral health and women’s health.

  • Changes in hormone levels such as those that occur during puberty, pregnancy, menstruation, use of oral contraceptives, and menopause can exacerbate symptoms of gingivitis and promote development and progression of periodontal diseases [5].
  • Other contributing factors of high prevalence of adverse oral diseases among women include early onset of tobacco use and longer life expectancy.
  • Women with eating disorders are at a higher risk for oral health problems. Tooth erosion and loss of tooth enamel are found among women who binge eat and purge for at least two years [6].
Oral Health Conditions Among Women 18 Years of Age and Older in the US, 1988-1994
  Percentage
Dental Caries
46.90%
Periodontal Disease
67.10
Gingivitis
49.50%
Source: NIH. Agenda for Research on Women’s Health for the 21st Century. 1999.
  • Researchers found that pregnant women with periodontitis were 7.5 times more likely to have a preterm low-birth weight infant than control subjects [5].
  • Nationally, over 8 million women over the age of 20 have been diagnosed with diabetes. Women with diabetes have a higher than average risk of having periodontal diseases. Other dental complications for people with diabetes include dry mouth and thrush (fungus) in the mouth [7]. An association between diabetes and early tooth loss has been reported in national studies [8].
  • According to national PRAMS data, only 34.7% of pregnant women received dental services during their most recent pregnancy [9].
  • Women are disproportionately affected by several chronic and disabling oral conditions including oral-facial pain and salivary gland dysfunctions [4].

Healthy Minnesotans 2004 has an oral health goal to promote optimal oral health for all Minnesotans [2]. National data indicates that one in three adults has untreated dental decay and is in need of preventive and treatment services [10].

Incidence of Oral and Pharyngeal Cancers in Women by Race, 1992-1999
Race Rate/100,000
White
6.8
Hispanic
3.8
American Indian
3.6
Asian
5.8
African American
6.8
Source: CDC. Promoting Oral Health Throughout the Lifespan

Disparities
No oral health disparity data were documented specifically for women in Minnesota but national data indicates disproportionate higher adverse oral health conditions for low income and minority population groups.

Economic
Nationally, dental visits and dental problems resulted in productivity losses of approximately $3.7 billion for hours missed from work and $1.8 billion for days of restricted activity [10].

Interventions

Recommendations for interventions identified by the Johns Hopkins Women’s and Children’s Health Policy Center include: increase access to dental services during pregnancy; increase dental insurance/access for dental care among women of childbearing ages; and increased integration of oral health issues and dental care within the current system of health care accessed by women throughout their lives [9].

Effectiveness of Interventions
Oral Health strategies that work include community water fluoridation, dental sealants, daily oral hygiene brushing with fluoride toothpaste and flossing, periodic professional dental care, oral health education programs in schools and communities, eliminating use of tobacco products, healthy eating habits, and using protective gear to prevent oral-facial injuries.

Status

Minnesota Resources
Minnesota Department of Health, the Minnesota Board of Dentistry, and Minnesota DHS have implemented programs and strategies that increase access to dental services for women of childbearing ages:

  • Critical access dental provider designations;
  • Expanded authorization for dental hygienists and expanded duties for dental auxiliary;
  • Dental practice donation program;
  • Licensure of foreign-trained dentists and a retired dentist program;
  • Dentist loan-forgiveness program [11].

References

1. MDH, Minnesota Center for Health Statistics-2002.
2. MDH. Healthy Minnesotans: Public Health Improvement Goals 2004. 1998.
3. Kaiser Family Foundation. Women’s Health Policy Facts. Health Insurance Coverage of Women Ages 18 to 64 by State, 2001-2002.
4. Wattson, MR, Gibson,G, Guo,I. “Women’s Oral Health Awareness and Care Seeking Characteristics: A Pilot Study.” JADA. December 1998.129:1708-1716.
5. Krejci,CB, Bissada,NF. Women’s health issues and their relationship to periodontitis. JADA. March 2002. 133:323-329.
6. Steinberg, BJ. Women’s Oral Health Issues. J of Dental Education. March 1999. 63(3):271-275.
7. National Women’s Health Resource Center. The Women’s Guide to Oral Health. 22(1). February 2000.
Surgeon General of the US.Oral Health in America. Dental visit data by select characteristics: 1983-1993. May 2000
8. Moore PA, et al. Diabetes and oral health promotion. JADA.2000.131:133-1335.
9. Improving Women’s Health and Perinatal Outcomes: Snapshot on the Impact of Oral Diseases. Women and Children’s Health Policy Center. Bloomberg School of Public Health. Johns Hopkins University. February 2002.
10. CDC. Promoting Oral Health Throughout the Lifespan. www.cdc.ov/nccdphp/promising/oral_health/burden.htm
Accessed 7-15-04.
11. MDH. Healthy Minnesotan’s Strategies for Public Health, Volume 2. 2002.