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For a mother-to-be, pregnancy presents an opportunity to improve not only her health and well being but also that of the immediate family, particularly the newborn infant. The National Consensus Statement of the Oral Health Care During Pregnancy Expert Group together with both governmental and non-governmental guidelines indicate that dental care is both safe and effective during pregnancy. These statements and guidelines may not be widely understood across all healthcare providers that form the perinatal care team, and confusion seems to exist among the general public regarding the safety of and necessity for dental care during pregnancy. Only about half of pregnant patients seek care, even those with dental problems. Previous articles in this series have reviewed appropriateness of dental care during a healthy pregnancy and specific steps to be taken in consideration of the altered physiology brought on by pregnancy and the increased risk associated with oral diseases such as changes in periodontal status, dental caries, and acid erosion; communication through the technique of motivational interviewing with patients who are either planning to become or are pregnant; and collaboration with the perinatal team of providers to ensure improved health outcomes for mother and baby. This final article in the series addresses considerations during and after pregnancy to ensure mother and child may follow a pathway to a future of good oral health.

Collaboration with other health professionals can be challenging when attempting to coordinate healthcare before, during, and after pregnancy. However, advantages of interdisciplinary and interprofessional collaborative approaches include facilitation of accurate and timely diagnosis and optimally sequenced treatment for improved health outcomes. This article reviews the current guidelines fostering collaboration between dental professionals and members of the perinatal team and identifies the roles of healthcare providers to support the care of women around the time of pregnancy. Recognizing the maternal oral changes that occur during pregnancy will enable providers to effectively offer diagnosis and referral and organize and deliver comprehensive care. The article discusses how complementing medical care with early professional dental care can help reduce unplanned, expensive "emergency" treatment and describes the concepts of medical and dental homes.

Many current myths and outdated practices exist regarding dental care for pregnant women. Additionally, many medical care providers fail to check pregnant patients for dental problems and refer them for dental care. Therefore, it is critical that dental healthcare providers and their medical colleagues are well-informed of the risks and benefits of dental care throughout pregnancy and are equipped with the tools to discuss the importance of dental health with patients. Patient-centered interventions, such as motivational interviewing (MI), are effective tools to alter patient behaviors and fully engage patients as active participants in their care. This review provides a framework of patient-centered interventions to improve patient involvement in their oral and overall well-being, offering methods and examples of a patient-centered approach, based on the fundamentals of MI.

Oral health is essential for general health and well-being, and this is especially so during pregnancy. Pregnancy may present challenges to the oral health of the mother, mainly because of adaptations in basic physiology. However, many mothers-to-be and their health professionals, both prenatal and dental, are unsure as to the safety of providing dental care during pregnancy. National guidelines, together with recommendations from numerous state-level and professional organizations, consistently indicate that provision of dental care is both safe and essential during pregnancy. Pregnancy also provides opportunities for the oral health of both infant and new mother after delivery that can set the infant on a lifetime pathway that minimizes preventable oral disease. This review summarizes guidelines for dental care during pregnancy, provides an overview of physiologic changes that occur and their relevance to oral health and dental care delivery, outlines risk factors for oral conditions, and considers timely preventive strategies. It also underscores the need for interprofessional collaboration with the perinatal team to optimize the quality of healthcare and ensure positive outcomes.

While most pregnancies are healthy and uncomplicated, adverse pregnancy outcomes and pregnancy complications do occur and may frequently present in the dental office. Management of patients with high-risk pregnancies and/or established pregnancy complications within the dental office should be undertaken to establish and maintain optimal oral health and an integrated approach to overall health. The dental team's understanding of potential pregnancy complications, their implications for oral health, and standards for management of patients with a complicated pregnancy within the dental office is critical to the overall well-being of all pregnant patients. Recognizing and differentiating between normal pregnancy sequelae and more serious complications, as well as proper referral to and adequate communication with the perinatal team, are critical to promoting wellness for patients experiencing pregnancy complications. [ABSTRACT FROM AUTHOR]

The article focuses on the charter signed by 41 leaders within dental education, dental research, dental care delivery, and the dental business community in Philadelphia, Pennsylvania on August 3, 2011. It says that the leaders have signed the charter because they believe that oral health professionals can serve to bring people together to overcome political conflicts. Moreover, the keynote address by professor Sari Nusseibeh was included in the signing event.