Last Updated: January 2023

Author: Division of Maternal and Child Health, Vermont Department of Health

The Pregnancy Risk Assessment Monitoring System (PRAMS) is a survey of women who recently gave birth that asks about their experiences, behaviors, and healthcare utilization before, during and shortly after their pregnancy. Women receive the survey two to six months after giving birth. This report presents highlights for 2020 Vermont births.

Vermont has seen a decrease in the number of women who had a preventive dental visit during pregnancy, from 63% in 2018 to 53% in 2020 according to the PRAMS,

Additionally, disparities exist among subpopulations:

• About half (53%) of pregnant people had a teeth cleaning during pregnancy, significantly lower than in years 2016-2019 (59%-63%). 
  • Perinatal people whose deliveries were covered by Medicaid were less likely to have a teeth cleaning than those with deliveries covered by private insurance (41% to 61%). 
• Nine in ten pregnant people knew it was important to care for their teeth and gums during pregnancy.
• About half of pregnant people (46%) who received prenatal care had a discussion with a health care worker about the health of their teeth and gums during a prenatal care visit.
  • People who discussed the health of their teeth and gums with a prenatal health care provider were significantly more likely to have a teeth cleaning during pregnancy than those who did not (60% versus 47%).
  • 29% of pregnant people who received prenatal care had a doctor, nurse, or other health care worker suggest that they go see a dentist. 

18% needed to see a dentist for a problem during their pregnancy; of those needing a visit, 28% did not see a dentist or a dental clinic about a problem.

According to the CDC:

• Nearly 60 to 75% of pregnant women have gingivitis, an early stage of periodontal disease Periodontitis has also been associated with poor pregnancy outcomes, including preterm birth and low birth weight.
• 1 in 4 women of childbearing age have untreated cavities.⁵
• Children of mothers who have high levels of untreated cavities or tooth loss are more than 3 times more likely to have cavities as a child.⁶
• Children with poor oral health status are nearly 3 times more likely to miss school because of dental pain.

Dental care, including X-rays and local anesthesia, is safe during pregnancy. In Vermont, pregnant women who are insured by Medicaid have no dollar limit on covered dental services during pregnancy and up to one year after the end of pregnancy.

• Vermont Department of Health │ Oral Health Program
• Vermont Department of Health │ Maternal and Child Health
• Vermont Department of Health │ Office of Local Health
• Vermont Oral Health Coalition

• Educate and train obstetricians and dental providers about the importance and safety of oral health care during pregnancy
• Provide access for pregnant people to dental providers
  • Reduce/eliminate insurance barriers
  • Increase the number of dental providers that accept Medicaid
  • Increase the number of dental providers and across Vermont
• Educate pregnant people about the importance and safety of oral health care during pregnancy

• MCH Coordinators in the Offices of Local Health work in tangent with co-located public health dental hygienists to assess dental health landscape and share resource availability with health care and community partners
• Public health dental hygienists (PHDH) provide oral health assessment, screening, education & information to families enrolled in WIC
• To increase the update of dental visits among pregnant people and young children, MCH Coordinators and PHDHs partner at the District office level provide outreach to:
  • Ob/Gyns regarding: a) the expanded Medicaid benefit for pregnant women; b) Bright Futures guidelines
  • Dentists regarding a) evidence-based oral health practice; b) support for seeing patients beginning at age 1
  • Pediatricians regarding: a) oral health education and referral to a dental home; and 2) fluoride varnish
• MCH leadership serves on the statewide oral health coalition, with a priority focus on pregnancy
• Promote mid-level dental provider (dental therapists) role in Vermont’s oral health workforce
• Work collaboratively with the Vermont chapter of ACOG to strengthen its membership and provide training and organizational support to ensure key public health messaging/ content is integrated into clinical services

Similar to statewide efforts, local partners are using data to drive local strategy. For regional data on Maternal and Infant Health indicators, check out our Public Health Data Explorer.

Data is updated as it becomes available and timing may vary by data source.

The PRAMS sample of women who have had a recent live birth is drawn from the state's birth certificate file. Each participating state samples between 1,300 and 3,400 women per year. Women from some groups are sampled at a higher rate to ensure adequate data are available in smaller but higher risk populations. Selected women are first contacted by mail. If there is no response to repeated mailings, women are contacted and interviewed by telephone. Data collection procedures and instruments are standardized to allow comparisons between states.