Pregnancy may soon become an unexpected gateway to better dental care. New research from New York University and NYC Health + Hospitals/Bellevue suggests that one of the simplest interventions in prenatal medicine—scheduling a dental appointment before a patient leaves an obstetric clinic—can substantially increase the likelihood that she will actually receive dental care during pregnancy. The approach requires no new clinical staff, no additional medical equipment and, in its most direct form, only a coordinated hand-off between prenatal and dental providers.
The study, published in the American Journal of Public Health, examined strategies for improving dental-care use among pregnant patients insured through Medicaid, a population that faces disproportionately high levels of untreated oral disease. Researchers found that nearly 44 percent of patients referred through the New York University/Bellevue Prenatal Oral Health Program ultimately attended a dental appointment. Patients whose appointments were scheduled immediately at the prenatal clinic were 2.6 times more likely to see a dentist than patients who received a referral without a prearranged appointment. The findings point to a practical behavioral mechanism: reducing the number of steps between recognizing a health need and receiving care.
The result is important because oral health is not separate from pregnancy physiology. Hormonal changes during pregnancy can increase blood flow to the gums and alter the body’s inflammatory response, contributing to gingivitis, gum tenderness and bleeding. Some patients also experience changes in diet, nausea, vomiting or oral hygiene routines that can raise the risk of tooth decay. If inflammation or infection is left untreated, pain can interfere with eating, sleep and general well-being. Dental treatment during pregnancy was once unnecessarily restricted, but current medical guidance recognizes that preventive, diagnostic and emergency dental procedures can generally be performed safely when clinically indicated.
For decades, many dentists avoided treating pregnant patients except during emergencies or limited routine care to the second trimester. That caution was based largely on concern about fetal exposure to medications, radiation or procedural stress. However, subsequent evidence and professional guidelines have clarified that delaying necessary dental treatment can itself create risks. Dental radiographs, when needed and performed with appropriate shielding and technique, expose patients to very low levels of radiation. Local anesthetics commonly used in dentistry can also be selected and administered within established safety guidelines. The American College of Obstetricians and Gynecologists and dental organizations now emphasize that pregnancy should not be treated as a reason to postpone needed oral health care.
The access problem is particularly severe among patients living with economic insecurity. Medicaid beneficiaries often encounter a combination of barriers, including limited dental-provider participation, transportation difficulties, inflexible work schedules, language differences, childcare responsibilities and uncertainty about whether pregnancy-related dental services are covered. These obstacles can transform a simple referral into an extended series of decisions and logistical challenges. Women with Medicaid coverage are substantially less likely to receive a cleaning during pregnancy than women with private insurance, even though their need for preventive services may be greater. For patients who begin pregnancy with untreated cavities or periodontal disease, postponement can allow manageable conditions to become more complicated.
To address this gap, NYU College of Dentistry and Bellevue clinicians established a prenatal oral-health program that brought dental screening into a setting pregnant patients were already visiting. During weekly sessions in Bellevue’s prenatal clinic, patients received a standardized assessment of their oral health. Those with identified needs were educated about the safety and importance of dental treatment during pregnancy and informed that Medicaid covers dental care in New York. They were then referred to NYU College of Dentistry, where follow-up treatment could be provided. The design effectively placed oral health inside the prenatal-care pathway rather than treating it as a separate service patients had to discover and navigate independently.
The study included 420 prenatal patients referred to NYU Dentistry between 2018 and 2020. Most participants were Hispanic, and approximately half spoke Spanish as their primary language. Researchers compared two forms of referral support. In one pathway, staff scheduled a dental appointment immediately, while the patient was still at the prenatal clinic. In the other, patients worked with a bilingual patient navigator who explained oral-health recommendations, reminded them about appointments and followed up afterward to identify problems that might prevent attendance. Both approaches improved the likelihood of dental utilization, but immediate scheduling produced the strongest association with completed care.
The finding does not mean that patient navigators are ineffective. Navigation can address language barriers, clarify insurance coverage, arrange transportation and help patients respond to unexpected obstacles. However, the data suggest that even highly supportive counseling may be less powerful than eliminating the need for patients to make a later appointment themselves. In health-services research, this is often described as a “warm hand-off”: responsibility for the next step moves directly from one provider or care team to another. Each additional task—finding a dentist, calling an office, confirming insurance, arranging transportation or remembering an appointment—creates an opportunity for care to be delayed or abandoned.
Stefanie Russell, an associate professor at Rutgers School of Dental Medicine and adjunct associate professor at NYU College of Dentistry who led the research while at NYU, said many patients vulnerable to oral disease enter pregnancy with existing dental problems that may worsen as pregnancy progresses. Shulamite Huang, an assistant professor of epidemiology and health promotion at NYU College of Dentistry, described immediate scheduling as an intervention that can increase dental-care use without hiring additional personnel. The researchers caution, however, that attending a dental appointment is an intermediate outcome, not proof that the program improved long-term oral health, pregnancy outcomes or the health of the child. Future work will examine those outcomes and determine whether similar integration strategies can succeed in other clinics, health systems and communities.
The broader significance of the study lies in its challenge to the way medical systems divide the body into specialties. Prenatal clinics already monitor blood pressure, laboratory markers, fetal development and nutrition; adding oral-health screening recognizes that the mouth is part of the same biological and social system. Treating dental care as a routine component of prenatal medicine could help identify infection earlier, reduce avoidable pain and make preventive care more equitable. The Bellevue experience suggests that a small change in workflow—turning a referral into a scheduled appointment before a patient walks out the door—may have an outsized effect, particularly for people who face the greatest barriers to care.
Subject of Research: People
Article Title: Strategies to Improve Dental Care Utilization During Pregnancy for Vulnerable Urban Women: The New York University/Bellevue Oral Health Program Experience
News Publication Date: 13-Aug-2026
Web References: https://doi.org/10.2105/AJPH.2026.308613; https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/08/oral-health-care-during-pregnancy-and-through-the-lifespan
References: American Journal of Public Health; DOI: 10.2105/AJPH.2026.308613
Keywords: Pregnancy, prenatal care, dental care, oral health, Medicaid, dental access, gingivitis, preventive medicine, health equity, patient navigation, obstetrics, public health
Tags: behavioral interventions for dental careimpact of oral health on pregnancy outcomesimproving oral health in pregnant womenintegrated prenatal and dental servicesMedicaid dental healthcare accessobstetric and dental healthcare coordinationpregnancy-related hormonal effects on oral healthprenatal dental carepublic health approaches to maternal oral healthreducing untreated oral disease in pregnancyscheduling dental appointments during pregnancystrategies for increasing dental appointment attendance
