Oral Health Education for Pregnant Women

RDH 2520

Public Health & Epidemiology

Pregnancy Care Center, Old Hickory

Azmitia, A., Hughes, F., Miller, B., Pros, L., Wolfe, M.

March 22, 2022

 Table of Contents

Assessments 5

Planning 7

Implementation 9

Evaluation 12
Pre-presentation Survey 14
Post-presentation Survey 18

Personal Narratives 22
Azmitia’s Personal Narrative 22
Hughes’ Personal Narrative 24
Miller’s Personal Narrative 25
Pros’ Personal Narrative 27
Wolfe’s Personal Narrative 29

PowerPoint Presentation 31
 Introduction

The outreach project, Oral Health Education for Pregnant Women, took place in the

Pregnancy Care Center located at 4989 Lebanon, Old Hickory. Oral health education was

delivered to a small group of nine pregnant women via zoom on March 15th, 2022, at 2:00 pm.

The presentation addressed oral changes that can be present during pregnancy, oral hygiene

instructions, dental visits, safe procedures for pregnant women and babies, and how to take care

of baby oral health to prevent diseases. On February 8th, 2022, Miller and Pros met with Rachel

Ropiecki, the Client Service Director at the pregnancy center, to see if she was interested in our

group doing an oral hygiene presentation for the ladies at the center. Mrs. Ropiecki was excited

about the idea, yet the presentation would have to be via zoom due to COVID.

After the meeting, Pros kept in contact via email with Mrs. Ropiecki to process the

documentation and arrange the date and time for our presentation. Pros also send the lesson plan

and PowerPoint ahead of time so she can review and provide feedback. Because we wanted to

give some oral hygiene supplies to expected mothers and babies, Mrs. Rapiecki helped us with

the number of participants on the site. Also, Mrs. Ropiecki wanted our group to do a second

session that would take place on March 23rd, 2022, at 10:30 am. We would be presenting to a

different community of non-English speaking women with the help of an interpreter. This

presentation would have to be modified by using more images and targeting the importance of

oral hygiene and oral hygiene instructions.

For planning and making the presentation, we all agreed that we wanted to educate

pregnant women about oral health since their body and their mouth can go through many

changes during pregnancy. Miller helped us find the pregnancy center, where her mother

volunteers. Then, Pros communicated with Mrs. Ropieck and informed us of the discussed
information. Also, Pros assembled the goodie bags and made flyers with summary information

from the PowerPoint.

To create our lesson, we all added our objectives and survey questions that could be

asked to our target population. When creating the PowerPoint, everyone had a specific topic to

research and add to the slides. Azmitia's part was to educate women about common signs and

symptoms of pregnancy gingivitis, the developing pyogenic granuloma, and the cause of

gingivitis. Hughes talked about periodontists and changes in tooth structures such as decay and

erosion. Miller's part was to educate the expected mother about adequate oral hygiene and

provide oral hygiene instructions, including brushing and flossing techniques and preventive

methods for erosion. Wolf information was based on what trimester was safe to see the dentist,

what to expect in a dental appointment, the safe use of x-ray and local anesthesia, and the

teratogenic effect of nitrous oxide. Lastly, Pros provided education about the baby's oral health,

preventing early childhood caries, and when to take the baby to the dentist. All this information

was successfully added to our PowerPoint presentation. Additionally, some true and false

questions were dispersed through the slides so the audience could interact with us throughout the

presentation. All of us worked together to create a presentation that could flow smoothly with

everyone's information, and that was easy for listeners to understand and implement.
 Assessments

As a team, we decided to do our outreach project with pregnant women. Miller chose the

location site for our team at the Pregnancy Care Center, Old Hickory. Miller’s mom volunteers

every Monday and arranged a date for Miller and Pros to share our outreach project proposal.

Our team specifically chose the Pregnancy Care Center because pregnant women face

various oral needs that begin to require special care at the time of pregnancy. Our team is

committed to our role and wants to help stand by their side to maintain and improve oral health.

Additionally, our team believes oral health education is essential for everyone and ensures

healthy smiles for pregnant women and their families.

The target group's need at the pregnancy care center was proper oral health education and

dental care. The pregnant women’s oral health education level is poor due to the general public’s

lack of dental health education. If the target population is unaware, the pregnant women are more

susceptible to tooth decay, gingivitis, periodontal diseases, and much more. Our team decided

and partnered with the pregnancy care center to implement oral educational strategies that

integrate interprofessional oral health awareness, prevention, and treatment of oral problems in

pregnant women.

Our team specified and clearly identified of measured profile indicators to help us

determine what the pregnancy care center needs and how to best help them. The clients at the

pregnancy care center's age range from seventeen to thirty-five. 75% of the pregnant women are

single, and 25% are married. The majority of the pregnancy care center’s clients are below the

poverty line. There were several ethnicities including Caucasian, Egyptian, African, and

Hispanic immigrants. The majority are minorities. Most of the pregnant women are working
low-wage jobs. The majority of women do not have health or dental insurance but have welfare

(TennCare).

Our team provided several resources available that helped meet the pregnant women's

needs. We created a PowerPoint to present oral education to pregnant women over Zoom,

including images. A few materials that would enhance meeting our teems goal is providing

toothbrushes for pregnant women and infants. Providing flosses, toothpaste, and handouts

summarizing oral hygiene techniques for mothers and children to reinforce learned information

from the oral presentation.

There were several constraints that prevented pregnant women at the pregnancy care

center from receiving adequate dental care. The several barriers identified in our target group

faced transportation, financial hardship, lack of insurance, and poor oral health literacy. Our

team is committed to taking advantage of the opportunities to redress these inequalities in oral

health because we believe access to oral care is for everyone.

Their lack of access to dental care is high due to no health insurance and not prioritizing

their oral health. Our team can educate pregnant women about the importance of visiting the

dentist for routine cleanings and addressing any possible oral problems. We can share and

provide a flier about our clinic at South College Dental Clinic, Nashville. To access and increase

the pregnant women’s oral health knowledge, our team will make a Powerpoint to present to the

mothers over Zoom, educating common pregnant oral complications, proper oral hygiene care,

and the importance of dental appointments for the mother and children. Our team will provide a

dental goody bag for each attendant, including an adult toothbrush, baby toothbrush, floss picks,

toothpaste, and an oral care brochure. After the oral presentation, this resource is a great reward

to encourage pregnant women to practice and develop good oral habits at home.
 Planning
The contact person at the pregnancy center requested a list of local clinics that would be

affordable. InsureKidsNow.gov was suggested for a list of dental service providers that cover

Medicaid and Children's Health Insurance Program (CHIP). These programs provide free or low-

cost dental services for eligible children. A printable list of locations was emailed to the contact

person at the pregnancy center. Flyers of South College’s dental clinic was also provided with

information about affordable adult and child cleanings.

Like the goals and objectives stated in the lesson plan, the focus was to increase

awareness and improve oral health education for pregnant women, their babies, and growing

children. The focus did not deviate from the goal of the presentation. It had to be modified

depending on the language and education level of the audience from one presentation to the next.

However, the focus remained the same.

A logical sequence of how the project was to be planned and implemented was made.

First, the Pregnancy Center was contacted, and an in-person meeting was set up with the Client

Service Director, Rachel Ropiecki. She gave information on how to meet the oral health needs of

the pregnant women that visit the clinic. Because of pandemic measures, the presentation was

required to be online over Zoom. A lesson plan was made to set measurable goals and objectives

for the presentation. The objectives were addressed in sections of the online presentation: oral

changes during pregnancy, oral hygiene routine for pregnant women, dental office visits, and

oral care for an infant. A Google slideshow was made to present it in an organized manner. Each

group member was given a topic and section. Patient bags with toothbrushes, toothpaste, floss

picks, and a summary of topics for proper oral care were given to participants after the lecture.
 Measurable objectives helped guide the presentation and achieve the overall goal of the

presentation. Questions were discussed to keep the audience engaged, challenging their

knowledge of oral hygiene. Surveys were sent to participants before or after the presentation to

evaluate their level of oral hygiene education and determine what participants learned. There was

a positive understanding of the material, meaning the goals and objectives were met.
 Implementation

When targeting a specific group of individuals, the entire group agreed on the pregnancy

care center. Miller’s mother volunteers at the pregnancy center in Old Hickory. Miller and Pros

went to discuss with the manager and team staff to see if it would be okay for our team to come

to speak to some of the ladies at their facility. Our team scheduled a class for the women to

attend and receive baby bucks for attending the course.

Before starting the PowerPoint, each team member was designated topics to present in

the PowerPoint. Miller created and shared a google document and PowerPoint to be prepared for

our presentation. Additionally, before our presentation day, our team met after class and on zoom

to modify any necessary changes and practiced how we presented the information. Our goal was

to give adequate information and use layman terms for clarity. Our presentation was via zoom at

the pregnancy center. If needed to reschedule, the pregnancy center would have to assign a class

and let the moms know for another session. The women that attended the class would receive

“baby bucks” for attending the class and would be able to shop for necessities.

Pro was the primary person in contact with the pregnancy center. Pros discussed the date

and time, in which she relayed the information to our team. The team discussed how much of the

supplies we felt the pregnancy center would need. On the day of presenting, Pros brought the

goody bags for the pregnant women to retrieve after the session.

On the presentation day, our team arrived early and looked our best. We presented in

Ropiecki’s office and Pros set up her laptop for zoom. As a team, we prayed together before

starting. We all discussed who would take photos while each of us was going over our topic, and

rotated. We used photos in the presentation for visual aids. Miller displayed a video in her

section, but the video would not play due to technical difficulties, but she improvised using hand
motions to show the moms how to brush their teeth. There were moments where zoom would

malfunction and there were times when it was hard for the women to hear us. Some of the

women did not understand how to mute their microphones, which made a lot of noise from some

of their animals, children, or other activities. It was a challenge for our team to talk over them.

Finally, our team realized we were able to mute all microphones, so it worked out to minimize

the distractions. Since our oral presentation was on zoom, our team was limited to 45 minutes for

our presentation.

The women that attended the zoom presentation were very appreciative and enjoyed the

presentation. There was one mom in particular that asked several questions and interacted

throughout the session. Some of the women attending were quieter but were engaged. Many of

them did not realize the connection of oral health linked to the rest of the body. When doing the

true and false questions, the women did not realize those baby teeth are just as important as adult

teeth. The pregnancy center was very thankful to have us present and wanted us to do another

presentation for pregnant moms who speak Egyptian. For the second presentation, our team will

have to make modify our PowerPoint in a 3rd-grade level, which the pregnancy care center

recommended. Additionally, our team will be partnering with a translator to communicate and

educate the women.

Overall, the presentation went very well. As a team, we were nervous but could fight

through the nerves. Everyone was kind and presented the information respectfully. Everyone

stayed on task and presented promptly. We kept our primary focus on educating pregnant women

and relaying the information to them. Once the presentation was over, our team debriefed and

were proud of ourselves. The pregnancy center was very appreciative to have us there, and it
made us feel very grateful and blessed to be a part of it. This public outreach project was

enriching, being able to help others in return benefitted us as well.

 Evaluation

Overall, our project was a success. The audience that we chose to present to take away

some valuable lessons from our presentation. The objectives that we set out to accomplish, such

as using props to demonstrate proper brushing and flossing technique, explaining proper oral

care for infants, and educating pregnant women on the safety of X-rays, were achieved. These

objectives allowed us to meet our ultimate goal of increasing awareness and improving oral

health education for pregnant women and their babies.

An obstacle that we faced during our project, was finding time to get together as a group

to work on creating goals, objectives, and a lesson plan. We utilized Zoom and group FaceTime

calls to work around this bump since everyone has a different work schedule and lives in

different towns. Communication was also a little challenging with our site coordinator, as there

was only one of us communicating, waiting on our contact’s response, and relaying that

information to the group. Thankfully, our team member that communicated with our site contact

was able to pass on the information in a timely manner.

Finding out that our presentation could not be held in person was another obstacle. As

difficult as it is to conduct this kind of presentation without being present, we were able to adapt

to the situation and host a successful Zoom meeting.

The data that was collected before, during, and after our presentation gave us a good idea

of how successful our teachings were. Before we hosted the presentation, we sent out a

questionnaire to assess things like how knowledgeable our audience was on their own oral health

and their children’s, if there had been any changes in their oral health since pregnancy, and what

their initial feelings towards visiting the dentist were. We received four responses from the initial

survey. Those findings gave us an idea that most of these women had not prioritized their oral
health in the past few years and could agree that bleeding gums and morning sickness was

common during pregnancy.

To gain some more feedback and promote an interactive experience, we placed a few

True/False questions in the PowerPoint presentation. These responses were a bit inconclusive but

helped us to determine that overall, most of the women did not know the correct answers to these

questions. Our objective for those questions was for the women to keep certain topics in mind as

they listened to the rest of the presentation so that we could assess what they learned through the

second survey.

The post-presentation survey was formulated to assess what information they learned

during our presentation and find out what stuck with them the most. Its purpose was also to find

out first-hand how pregnancy has changed women’s oral health in a small population. The three

post-presentation survey responses that we received showed an improvement in attitude towards

and knowledge of oral health.

The only obstacle that we faced during evaluation was lack of responses to our surveys.

The responses we received were greatly appreciated, but our objectives would have been more

successful if more participants would have filled out both surveys.

 Pre-presentation Survey

1. On a scale of 1-5, how anxious do you feel when you think about visiting the dentist?

● 1 (least anxious) X

● 2X

● 3 XX

● 4

● 5 (most anxious)

2. When was your last dental visit?

● within the last 6 months

● over 6 months ago

● over 1 year ago X

● 2+ years ago XXX

3. Do your gums bleed while brushing or flossing?

● Yes XX

● No

● Yes, since getting pregnant XX

4. Do you have toothaches, problems eating or chewing food, or other problems in

your mouth?

● Toothaches X

● Problems eating or chewing

● Other

● None XXX

5. How often do you brush your teeth?

● Once a day XX

● Twice a day X

● Whenever I finish eating a meal

● When something is stuck in my teeth

● Less than once a day X

● Other:

6. How often do you floss?

● Once a day X

● Twice a day

● When I finish a meal

● 1-2 times per week

● When something is stuck in my teeth X

● Never XX

7. Since becoming pregnant, have you experienced morning sickness?

● Yes XXXX

● No
8. If you said yes to morning sickness, how often do you experience it?

“Just in the morning”

“Around once a week”

“In the morning”

“When I wake up”

9. Would you agree to get an X-ray during your dental visit?

● Yes

● No XXX

● Not sure X

10. Do you use fluoride in your toothpaste, mouthwash, or professional applications,

etc.?

● Yes XX

● No

● Maybe XX

11. Did you know that oral issues that could arise during pregnancy?

● Yes XX

● No XX

12. How likely are you to seek dental care during your pregnancy?

● Not at all
● 1 XX

● 2X

● 3

● 4X

● 5

● Very likely

13. When do you think you should be taking your child to the dentist?

● When they are 1 year old X

● When they start developing teeth XX

● When they are 2 years old X

● When they are 3 years old

 Post-presentation survey

1. How important is your oral health during pregnancy?

● Not important

● 1

● 2

● 3

● 4

● 5

● Very important XXX

2. How important is the oral health of your baby/ child?

● Not important

● 1

● 2

● 3

● 4

● 5X

● Very important XX

3. Will you consider using fluoride in your toothpaste, mouthwash, or professional

applications, etc.?

● Yes XX

● No
● Maybe X

4. How often should you brush your teeth?

● Once a day

● Twice a day XXX

● Whenever I finish eating a meal

● When something is stuck in my teeth

● Less than once a day

● Other:

5. How often should you floss?

● Once a day X

● Twice a day XX

● When I finish a meal

● 1-2 times per week

● When something is stuck in my teeth

● Never

6. How would you rate your overall fear of the dental office?

● None

● 1 XX

● 2

● 3X
● 4

● 5

● High

7. How likely are you to seek dental care during your pregnancy?

● Not at all

● 1

● 2

● 3

● 4

● 5

● Very likely XXX

8. Did you know South College dental clinic offers $20 cleanings for adults (including

dentist exams and x-rays)?

● Yes XXX

● No

9. What was the most valuable part of the presentation for you?

“Learning about gum disease”

“Finding out how to help with my baby’s teeth”

“The part about brushing your teeth was interesting”

10. How can we improve in the future?

“You did a good job”

“Talk more about cavities”

 Personal Narratives

Azmitia’s Personal Narrative

When we all agreed that we wanted our project to focus on pregnant women's education,

I was really excited. Before I started the dental hygiene program, one cousin used to live with

me. At that time, she was pregnant, and I saw her experiencing a rough time during her

pregnancy. She was vomiting all the time; her gums were swollen, and she could not stand

brushing since it was painful and her gums were bleeding. I had no idea how to help her or

whether it was something normal. Because I was part of my cousin's journey, I could imagine

how beneficial this presentation would be for her back there. Therefore, I was happy that we all

wanted to educate pregnant women because I know that stage can be challenging. I knew that we

could have a positive impact on their oral hygiene routine as well as for them to reach for

professional help.

My expectation from this project was that all the women present during our presentation

could learn something that could impact or enhance their oral care and feel confident visiting the

dentist.

I feel this is a great way to help communities without access to dental care and education.

I'm not a big fan of presenting, but I also think it is part of my profession to help spread oral

health awareness and be part of the change. I came from Honduras, a small country where oral

care education is poor, and I would love to go back there as part of an organization to deliver oral

awareness to the small communities.

The best part of doing this project was working together to meet our population's needs.

It also was the first time for some of us to do a presentation like this, so it was nice that we all
gave each other mutual support. However, when preparing for the presentation, there were things

where I would want to be more involved or divide the roles more evenly.

Something that I would want to change is delivering our presentation via zoom. I

understand that zoom was the best way to connect with our target population since we are in the

middle of a pandemic. However, I did notice that some of the ladies were easily distracted from

things going on around the house. Other than that, I feel that our presentation went well, and

even when I was nervous when delivering my presentation, I'm proud of myself and my group

for the result of our project.

 Hughes’ Personal Narrative

As soon as I found out about this project, I knew that I wanted to do it for the pregnancy

center. There are so many changes that occur for women during pregnancy, especially orally.

Not only did we educate moms, but we also helped them be preventative with their child’s oral

care. I honestly felt like I learned a lot from my peers when listening to them present their

section. I fully believe there is always more to learn with anything. I know that I can look back

on this PowerPoint one day when I am with a child, Lord willing, and reeducate myself as well.

After presenting, it makes me want to get involved with public health that much more

with dental hygiene. I definitely have a heart for people in general, but it is the best feeling to

help educate others about their oral care. A lot of people do not realize that their oral cavity is a

reflection of the rest of the body. I know I would like to be an advocate and get involved with the

community to help educate not only pregnant moms but all people. I feel like as health care

providers we should want to do that anyway.

I really enjoyed doing this project. In future group projects though, I feel like I would do

some things differently. I was very appreciative of everything that was done, but I would have

more distinguished roles applied. I would like to work more as a team so that the stress of a

project is more equally weighted. Overall, I feel like when it came to us presenting, we worked

fluently and did really well. I know everyone has a lot on their plate in general and group

projects can be hard. I know that we all did our best, and that is what matters most. I feel like we

all learned a lot and everything we did for this project we can apply to future projects. I believe

everyone did a great job and once everything was fully together, it was all presented and flowed

smoothly. I appreciate everyone in the group and I know they are all hard workers. I’m very

thankful for each one of them.

 Miller’s Personal Narrative

I was excited to hear that our class was going to do an outreach community project. Our

team had a common goal in promoting oral health for pregnant women. pregnant women face

various oral complications during pregnancy, and it is necessary to educate and encourage

expecting mothers not to neglect oral health, avoiding periodontal diseases and deterioration of

oral health.

My first expectation was every member of the group would respect one another, establish

communication skills, and share goals and ideas. The pregnant women would learn from our

presentation and would apply it in their lives. I simply thought my team and I would create an

oral presentation and present it to the pregnant women in a classroom. However, I learned that

our community project took a lot of designing, preparation, and time in order to properly meet

the pregnancy care center’s needs.

After conducting the outreach project, I enjoyed serving my community, and look

forward to volunteering as a licensed registered dental hygienist (RDH). The best part of doing

this project was educating pregnant women on the importance of proper oral care, because I love

interacting with them, learning from them, and seeing the connection between what they are

learning and their lives. For instance, I learned how to modify, create, and present oral

information to pregnant women, such as educating them about warm water with baking soda and

oral complications during pregnancy. Improving pregnant women’s oral health is one means of

achieving a healthy community. I learned that there is an urgent need for more target populations

to be educated about proper oral health, creating and leaving numerous opportunities for dental

professionals to improve oral health for everyone.

 I believe our team did well in the development and presentation. However, there were no

assigned roles for our group project. I would have liked to have assigned roles to ensure

everyone feels valuable. Another thing I would like to change is to not let stress control and

motivate our project’s goals, which left areas that made others less confident in volunteering and

hindered our team's effectiveness. Also, teaching on zoom was a bit challenging, and would have

love to met in person. Overall, my team and outreach project was beneficial. Being able to help

others and, in return, benefitted me as well. I hope to continue and seek public health

opportunities to serve others best.

 Pros’ Personal Narrative

My experience with this project was enjoyable and stressful at times. I liked the idea of

serving in a pregnancy center to help pregnant women have a better understanding of their oral

health during pregnancy. I also liked informing the women about how to have good oral hygiene

themselves and take care of their child’s oral health. It was a lot of work to develop a lesson plan

and create tools to meet the goals and objectives. There was a fair amount of coordination

between our group and the contact at the pregnancy center. It was also stressful to form deadlines

as a group.

As a registered dental hygienist, I would love to work at a pregnancy center and give oral

hygiene instruction again. It may be beneficial to provide preventative agents, such as fluoride

varnish, as well. As a licensed RDH, I would like to extend my skills to underserved

communities that cannot afford dental care or do not have dental insurance.

The most challenging part of the project was doing the lecture all online because it did

not seem it was as engaging as in-person lectures. It would have been nice to do demonstrations

in person with the women at the pregnancy center and have a lot of time for questions. It would

also be nice to get to know the women a little more. There are more distractions when the

audience is online. Our team was also on a strict time because it was a free Zoom meeting, so the

lecture could have been cut off if it was too long.

If I were to change anything about the project, I would change how our group divided

work and met deadlines. I think it could have been done much better if we had divided the

assessment and planning portion of the project. That way a range of different ideas could be

implemented and a few members did not get burnt out from doing a lot of work for the project. I

also think it would have been much better if the lecture could have been in-person because it
would be more dynamic and engaging. Overall, I think the presentation went very well and we

had some positive feedback. The pregnancy center contact was very thankful for our group’s

presentation.
 Wolfe’s Personal Narrative

Through this project, I expected to create a well-structured, educational lesson plan to

share with our target audience, pregnant moms. Going into the presentation, I pictured my team

presenting to a group of fifteen or so people. My hope was that through our presentation,

pregnant mothers would better know how to care for their oral health and the health of their

children.

As a licensed hygienist, I think it would be extremely rewarding to branch out into public

health and provide oral health education to those who may not have access to it and those who

are unaware of its importance. Once I am settled into my career for a little while, I would be

open to getting involved with a program that provides education in a similar manner that we did

for this project. The best part about doing this project for me was getting connected with this

pregnancy center and finding out what the people that work and volunteer there accomplish.

Learning about how the center reaches women of many different backgrounds is very interesting

and puts into perspective how lucky we are to be receiving an education that teaches us the

importance of oral and systemic health.

The most difficult part for me was structuring the entire project and seeing the big

picture. When there are so many different parts to a project, it can be very overwhelming and get

very confusing. However, I was thankful to have teammates who understood what was expected

from the project and took up leadership roles to help accomplish it. If possible, it would have

been nice to be able to present our lesson in person to the women. Conducting it over Zoom had

a few hiccups that it is hard to prepare for. One thing that happened that would have been

avoided if done in-person, was that someone unmuted themselves during the presentation and

their dog was barking for a few minutes. It definitely threw me off a little bit and took a second
to figure out how to mute everyone, but once we did it was fine. It is also easier to connect with

your audience when you are presenting in person. Being able to see their facial expressions and

assess their interest can make all the difference. Since our group is conducting another

presentation at the pregnancy center, I am hoping that we will be more prepared and that

everything runs a little bit smoother.

PowerPoint Presentation