In 2002, the Clinton County Health Department's MOMS program (Medicaid Obstetrical Maternal Services) had limited dental resources available to which to refer Medicaid-eligible prenatal clients. Annual reports had indicated that more than 50 percent of the MOMS clients had some specific dental concern or poor oral hygiene habits. Very few dental practices were accepting Medicaid-eligible clients, and the local dental clinic had a waiting list of several months. Poor oral hygiene in pregnancy is associated with an increase risk of low birth weight, pre-term infants.

The Clinton County Health Department realized that it could play a role in preventing poor outcomes in pregnancy related to oral hygiene. The health department could not dramatically change the number of dental practices/clinics in the area or increase the number of Medicaid clients served, but prevention could be done through education and by offering the MOMS clients a "dental kit" (toothbrush, toothpaste, dental floss, mouthwash, and a brochure on prenatal oral hygiene).

The goal of this program is to improve the individual oral hygiene practices of the prenatal women in order to reduce the number of low birth weight, pre-term infants born to this population.

A consultant dental hygienist provided training to the MOMS nursing staff on current standards for oral hygiene relating to pregnancy. As each patient completes her enrollment in MOMS and completes the nursing assessment (which includes a dental assessment/screening), the nurse will give her a dental hygiene kit. The MOMS nurse provides instruction on the importance of dental care and makes a referral to the Medicaid dental clinic or to an alternative dental practice that may provide services. This program has been well received and results have been positive.