Oral Health Risk Assessment for Prenatal Care Providers

1. When was your last dental visit?

Less than 6 months Less than 6 months
More than 6 months (Suggested provider response: I recommend you make a dental appointment as soon as possible. It is safe to get dental care during pregnancy and keeping your mouth and teeth healthy is important for the health of your baby. ) More than 6 months (Suggested provider response: I recommend you make a dental appointment as soon as possible. It is safe to get dental care during pregnancy and keeping your mouth and teeth healthy is important for the health of your baby. )

2. Do you have a dental home (regular dentist)?

Yes Yes
No (Suggested provider response: Do you need help finding a dental provider?) No (Suggested provider response: Do you need help finding a dental provider?)

3. Do you have any current mouth/tooth pain today?

Yes Yes
No (Suggested provider response: Let’s get you an appointment to see a dental provider as soon as possible.) No (Suggested provider response: Let’s get you an appointment to see a dental provider as soon as possible.)

4. Referral(1) Completed?

Optional (2) Oral Health Examination:

5. Potential caries, swollen or bleeding gums, other dental concern.

Yes (Suggested provider action: Document on referral form to dental provider.) Yes (Suggested provider action: Document on referral form to dental provider.)
No (Suggested provider action: Document on referral form to dental provider.) No (Suggested provider action: Document on referral form to dental provider.)

6. Sign of infection or other urgent need.

Yes (Suggested provider action: Document on referral form to dental provider.) Yes (Suggested provider action: Document on referral form to dental provider.)
No (Suggested provider action: Document on referral form to dental provider.) No (Suggested provider action: Document on referral form to dental provider.)

Citations and Notes

(1)

Ideally, the Prenatal Oral Health Risk Assessment is incorporated into electronic health record using a flowsheet with discoverable fields to pull reports. However, when needed, documenting in patient note can suffice, often using a SmartPhrase or Dot Phrase. ICD 10 code z13.84 (dental screening) can be used to flag charts of patients screened and then question 4 can be manually tallied to track referrals.
(2)

Recommended By American College of Obstetrics (ACOG) and Oral Health During Pregnancy: a National Consensus Statement
(3)

Complete training at Smiles for Life – Course 5, CME provided. Needed supplies: gloves, adequate light, tongue depressor