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May 14, 2019

A statewide community outreach pilot program for pregnant women in high-risk populations and run by University of Detroit Mercy School of Dentistry will continue and expand, thanks to a $630,000 grant from the Delta Dental Foundation (DDF).

Michigan Initiative for Maternal and Infant Oral Health (MIMOH), which started in 2017 with a nearly million-dollar grant from the Michigan Department of Health and Human Services, integrates a dental checkup into the mother’s scheduled obstetrician appointment, making it more convenient for her to address oral health needs during pregnancy.

“To improve the oral health outcomes for high-risk infants and young children we need to start looking at ways we can improve the perinatal oral health of the mother,” said Divesh Byrappagari, director of dental public health and outreach at Detroit Mercy Dental. Infants are also at higher risk of developing tooth decay if mothers have poor oral hygiene during and after pregnancy, he added.

MIMOH is modeled after a program Grace Health in Battle Creek has run for four years. Pilot sites were found through a partnership with the Michigan Primary Care Association (MPCA). In addition to Grace Health, they are Covenant Community Care in Detroit, Great Lakes Bay Health Center in Bay City, Ingham Community Health Center in Lansing, InterCare Community Health Network in Benton Harbor, Muskegon Family Care in Muskegon and Upper Great Lakes Family Health Center in Hancock. Through the grant, the sites were given funding to hire a dental hygienist who provided preventive dental care, oral health instructions and referrals to dentists for long-term care in a dental chair in their obstetrician’s office.

“This program provides critical access to dental services for many people who otherwise wouldn’t obtain it,” said Jen Anderson, MPCA spokesperson. “For many Medicaid beneficiaries, community health centers are the only places they can go to receive dental care. By connecting pregnant patients to a hygienist during their prenatal visit, it’s easier to help them — and their children — form the habits that promote good oral and overall health.”

At the end of the first year of this project, three of the sites Ingham Community, Grace Health, and InterCare — became self-sufficient and will continue the project without grant funding. The new funding from DDF and the initial MDHHS grant will help clinics currently in the project continue.

As the primary investigator on the project, Byrappagari oversees the program and collects outcomes data for research purposes. He says preliminary data shows bacterial loads were lower in the pregnant women who received dental care and dental hygiene instruction.

In this second year of the program, Detroit Mercy Dental faculty and students, led by Byrappagari will collect more data, including whether patients actually followed up by going to dentists to whom they were referred and the impact on early childhood preventable infectious diseases.

“This is a very positive outcome,” Byrappagari said.

“This program will fill a major need, allowing expectant mothers to receive dental care during one of the most critical life stages,” said Delta Dental Foundation Executive Director Holli Seabury. “Proper oral hygiene is important during pregnancy because hormonal changes can increase the risk of developing gum disease which, in turn, can affect the health of the developing baby. By promoting prenatal oral health education and dental appointments, we can help pregnant women avoid an adverse birth outcome and help them to have a healthy, full-term baby.”

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