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The U.S. economy continues to sputter and that means state legislators around the country are once again debating deep cuts in spending. Here in Washington, the latest round of budget-cutting threatens to wash away one of the state’s vital though too often overlooked programs for families: Prenatal dental care.
Today, Washington covers dental care for low-income pregnant women, and it’s a smart investment. A new mother with healthy teeth passes less cavity-causing bacteria to her baby and often establishes good oral hygiene habits for her children, which means healthier families and Medicaid savings over the long run.

This month, however, legislators are struggling to cut $2 billion from the state budget. They have few, if any, easy choices left, and among the proposed cuts is the elimination of Medicaid’s prenatal dental coverage. But, getting rid of dental care for the state’s poorest expectant mothers could only cost more over the long run.

Why? Without dental coverage, many pregnant women couldn’t afford checkups and restorative care and that could easily land them in the emergency room or oral surgery in the coming years, further straining the Medicaid system.

As important, prenatal dental care is about more than mom’s teeth because her health can affect the whole family. Poor oral health during pregnancy has been associated with low-birth weight, pre-mature birth and other complications in research studies.# It is one more problem for new mothers struggling in poverty.
"The need is unbelievable. I can’t tell you how many women we see who have full-blown gum disease and inflammation, as well as extensive dental decay,” said Dr. Martin Lieberman, dental director for Seattle-based Neighborcare Health. “But, this is not just about the mom’s dental disease….it is about how the disease affects her child. From adverse pregnancy outcomes, to children with preventable pain leading to the loss of schools days, the loss of sleep, it all builds up.”

When a new mom has poor oral health it is more likely her child will too, and childhood dental disease can be far more than a toothache. It can disrupt a child’s education and development by making it harder to pay attention, sleep and even attend school. Currently, nearly 40 percent of Washington kindergartners start school with tooth decay and nearly 15 percent begin with rampant decay.

If legislators cut coverage for pregnant women they risk making this problem even worse.

Unfortunately, Washington’s proposed cut reflects what has been happening around the country. Four years ago only half of all U.S. states provided some dental coverage for low-income pregnant women, according to a National Academy for State Health Policy report (, and the number is likely even lower today given the decline of the U.S. economy.
Preserving the program would be a smart choice that could save money over the long run and preserve a vital part of Washington’s social safety net. Getting rid of it would mean states, Medicaid, mothers and their children would pay a lot more later.

For more information about the importance of dental coverage during pregnancy visit Oral Health Watch ( or get updates on Twitter: @OralHealthWatch

Paul Nyhan, a 20-year journalism veteran, is working with the Washington Dental Services Foundation on highlighting the importance of prenatal dental care for low-income women.

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