Am Fam Physician. 2025;112(1):online
Author disclosure: The authors codirect the 100 Million Mouths Campaign, which is funded by an unrestricted educational grant from Colgate-Palmolive.
To the Editor:
We were impressed with the Practice Guidelines from Dr. Bybel and colleagues.1 Family physicians play a vital role in the health of veterans. The US Department of Veterans Affairs and Department of Defense (VA/DoD) provided evidence-based guidelines reminding clinicians that pregnancy presents an opportunity to positively affect patients’ oral health.2
The guideline states that periodontal disease occurs in 40% of pregnancies and is associated with adverse perinatal outcomes, including preterm delivery, low birth weight, fetal growth restriction, and preeclampsia.2 Treating periodontal disease in pregnant patients is safe and leads to improvement in maternal oral health.2–4 The guideline reiterates the positions of other national obstetric and dental organizations that most dental services are safe during pregnancy.2,3,5 Evidence indicates mothers can transfer caries-causing bacteria to their infants and young children, providing another important reason to promote oral health and dental referrals as part of comprehensive prenatal care.2,5
Routine dental care, including radiography, periodontal therapy, and good oral hygiene, should be recommended throughout pregnancy.2,5,6 Although access to oral health care is challenging for many veterans, work is being done to highlight this need, expand access, and coordinate services. Physicians may see CareQuest Institute for Oral Health for more information.
Editor’s Note: This letter was sent to the authors of “Management of Pregnancy: Guidelines From the VA/DoD,” who declined to reply.
