Learning Objective #1: identify the potential benefits of obstetrical nurses screening pregnant women for periodontal disease.

Learning Objective #2: describe the accuracy of obstetrical nurses screening for periodontal disease.

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Introduction:  There is emerging evidence of a relationship between periodontal disease (PD) and adverse pregnancy outcomes.  Furthermore, this relationship has been replicated in many different parts of the world, including North and South America, Asia, and Europe.  Clinical examination for PD is usually completed by trained dental personnel and involves measuring pocket depths between the gum and the tooth using a calibrated probe.  In the United States, pregnant women have frequent contact with obstetrical health care providers, including nurses. Therefore, the purpose of the current study is to describe the accuracy of screening for PD by obstetrical nurses.  Methods:  The study population was drawn from one of the study sites participating in an ongoing randomized clinical trial investigating the impact of treating PD on preterm birth.  Between 10/2004 and 11/2006, 544 women were enrolled in the parent study.  The variables of interest were “screened +” by obstetrical nurse and “screened +” by dental hygienist.  Descriptive statistics were used to calculate frequency counts and determine measures of validity.  Results:  397 (73%) of the 544 enrolled subjects screened + for PD by the obstetrical nurses.  60% of this sample (238) returned for their treatment visit, which included a periodontal evaluation by the dental hygienist.  Of these 238 women, 3 (1%) were found not to meet the criteria for PD.  Therefore, the positive predictive value (PPV) of screening for PD by obstetrical nurses in this sample is 99%, with a sensitivity of 100%.  Neither the negative predictive value (NPV) nor the specificity are able to be calculated, as women who screened + for PD by the obstetrical nurses were not re-checked by the dental hygienist.  Conclusions:  Obstetrical nurses may provide an accessible, efficient and accurate resource to assist with screening pregnant women for periodontal disease during pregnancy.