Dental provider availability and access to prenatal oral healthcare: a cross-sectional analysis of PRAMS data 2018–2019

Examining 2018–2019 Pregnancy Risk Assessment Monitoring System (PRAMS) data and national dental provider databases, this cross-sectional analysis assessed how dental provider availability is associated with pregnant women’s perceived difficulty in finding dentists who accept pregnant patients and their dental services utilization. The sample included 28,782 women across 14 states and Washington D.C., representing a weighted population of 1,539,814 women. The correlations between (1) dental provider availability and pregnant women experiencing difficulty finding a dentist, and (2) dental provider availability and dental service utilization during pregnancy were examined, adjusting for other variables using partial and semi-partial correlation estimates. 5.4% of women reported challenges in finding a dentist who would accept pregnant women. After adjusting for socio-demographic factors and adequacy of prenatal care, non-Hispanic black women (aOR = 1.48, 95% CI [1.12–1.96], p = 0.006), Medicaid enrollees (aOR = 2.68, 95% CI [2.06–3.48], p < 0.001), and non-English speakers (aOR = 2.39, 95% CI [1.53–3.75], p < 0.001) were significantly more likely to encounter difficulty. Both the number of dentists per 100,000 residents and the dental needs met percentage were negatively correlated with challenges finding a dentist, with a stronger association for the HPSA percentage of dental needs met (pcorr = -0.5523) than for the number of dentists per 100,000 residents (pcorr = -0.1692). In contrast, the correlation between dentist availability and utilization of dental services ([dental cleaning: NCHS pcorr = 0.0251, p = 0.0001; HPSA pcorr = 0.0074, p = 0.2344], [dental visit for problems: NCHS pcorr = 0.0548, p = 0.0002; HPSA pcorr = 0.0213, p = 0.1444]) was much weaker than the correlation between dentist availability and difficulty in finding dentists (access to care) (NCHS pcorr = -0.1692, p < 0.0001; HPSA pcorr = -0.5523, p < 0.0001), indicating that provider availability was related to pregnant women’s ability to find a dentist but showed little relationship with actual service use. These findings suggest that increasing dentist availability, particularly in designated shortage areas, may help reduce the difficulty pregnant women experience in finding a dentist willing to accept them for prenatal dental care, although availability alone showed little relationship with actual utilization of dental services. Policymakers should consider increasing dentist availability in designated shortage areas as one strategy to reduce the difficulty pregnant women face in finding a dentist who will accept them, particularly among vulnerable populations, while recognizing that dentist availability alone may not address low utilization of dental services during pregnancy.