Provider and patient perceptions about dental care during pregnancy

Department of Obstetrics and Gynecology, Maternal Fetal Medicine Division, Center for Biostatistics, The Ohio State University College of Medicine, 1654 Upham Drive, Columbus, OH 43210, USA.
Journal of Maternal-Fetal and Neonatal Medicine (Impact Factor: 1.21). 02/2008; 21(1):63-71. DOI: 10.1080/14767050701796681
Source: PubMed

ABSTRACT To compare the opinions of dentists, obstetricians, and patients on dental care in pregnancy: its necessity, accessibility, and safety.
A 35-item questionnaire was distributed within Ohio, to 400 patients and 1000 providers between October 2004 and July 2005. Univariate comparisons between dentists and obstetricians were made by Fisher's exact test. Adjustments for confounding were made through logistic regression models.
Most providers rated prenatal dental screening as important, agreeing that poor dental hygiene related to adverse pregnancy outcomes. Although 84% of patients reported dental visits as safe, only 44% received care; the main limitation was financial. Providers agreed that pregnant patients could undergo dental cleanings, caries treatments, and abscess drainage but disagreed regarding the safety of X-rays, periodontal surgery, amalgam, and narcotic usage. In general, obstetricians were more comfortable than dentists with procedures and medication usage but less often reported recommending routine prenatal dental care.
Different respondent perceptions exist regarding the safety, accessibility, and necessity of prenatal dental treatments. Professional guidelines about oral health screening in pregnancy and the safety of dental procedures would benefit our patients and colleagues.

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    ABSTRACT: Midwives may play an important role in oral health promotion of pregnant women, whom they are in close contact with. Our aim was to evaluate an educational intervention on the oral health attitude and practices among the junior midwifery students of Tehran University of Medical Sciences in 2010. The junior midwifery students were divided into intervention (n=29) and control (n=33) groups. The intervention group was first educated about general oral health, oral hygiene practices during pregnancy, and tooth brushing and flossing on models. Subsequently, the students performed role playing to ensure they understood the aforementioned lessons correctly. Before and three months after the training course the students filled out a validated self-administered questionnaire and a simplified plaque index was recorded. Statistical analysis was done by Mann-Whitney test and linear regression models. Before the intervention, the mean scores of attitude in general oral health for the intervention and control groups were 5.8 and 5.4, respectively, which improved to 8.9 and 5.4 after the intervention (P<0.001). The mean score of oral health attitude in pregnancy was 20.4 in the intervention group and increased to 30.9 (P<0.001). The intervention group demonstrated much better oral health practices in pregnancy and lower plaque index score after the intervention. The promising finding about attitude and practice improvement in midwifery students after participating in a short course on oral health promotion in pregnancy shows the necessity to enrich their training program by including this subject.
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    ABSTRACT: BACKGROUND: Globally, the oral health care for pregnant women is inadequate relating to education and health promotion sectors along with disparities in socio-economy and ethnicity. Neglected oral care often has long-term effects on our overall health, including the health of the baby during pregnancy. Serious problems like gingivitis and periodontal disease may also occur during this period as a result of neglected oral hygiene. OBJECTIVE: This descriptive type of cross sectional study was carried out to assess the pattern of common oral and dental diseases among pregnant women. MATERIALS AND METHODS: A total 147 pregnant women attended at the selected hospital and healthcare centre of Dhaka city for routine checkup over a period of five months from September 2013 to January 2014 fulfilled the eligibility criteria were selected consecutively. Pre-tested semi structured interviewer administrated questionnaires were used to collect the information. RESULTS: The study shows that most of the pregnant women (72%) age ranged from 20-24 years. Also, majority (88%) of them were housewives while only 11% were service holders with monthly family income of BDT≤10000 of more than half of the respondents (52%). Oral complaints found from the study were bleeding gums (78%), sensitive tooth (52%) and cavities (35%) respectively. In addition, 63% never access to their dentists throughout their whole life and only 6% visited their dentists at the time of pregnancy. Lastly, the frequency of oral diseases South American Journal of Medicine, Volume-2, Issue-2, 2014 166 revealed in this study was gingivitis (100%), dental caries (54%), dental erosion (52%), periodontitis (27%) and apthous ulcer (16%) respectively. CONCLUSION: It can be said from the study that educational and occupational statuses of pregnant women in Bangladesh were not satisfactory. An extensive number of pregnant women did not seek oral health care during pregnancy. There is a need for further study on oral health status of the pregnant women to formulate appropriate oral health guidelines for better oral and dental health outcome.
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    ABSTRACT: Background: Poor oral health during pregnancy is a significant public health issue because of its prevalence, impact on women’s and their future children’s oral health, and evidence suggesting oral-systemic links with adverse pregnancy and birth outcomes and chronic health conditions across the lifecourse. Subsequently, both medical and dental associations have endorsed inter-professional guidelines promoting prenatal oral health. The objective was to explore providers’ information, motivation and practice behaviors related to oral health during pregnancy. Methods: Twenty-two in-depth interviews were conducted with prenatal (PPs) and oral health providers (OHPs) based on the Information-Motivation-Behavioral Skills Model. Data were analyzed using the constant comparative method in NVivo 10. Results: Providers held variable knowledge with regards to identified oral-systemic connections and implications. Most providers were unaware of the guidelines; however, some OHPs reported avoiding specific treatment behaviors during this period. Motivation to address prenatal oral-systemic health included: prevention; healthy pregnancy/birth outcomes; patient’s complaint/question as cue to action; comprehensive care; ethical duty; and professional boards. OHPs reported assessing, educating, and communicating with patients about oral health issues; whereas PPs rarely addressed oral health but reported signing approval forms for patients to receive care from OHPs. OHPs often highlighted lifecourse implications and the need for family-centered care when addressing oral health among pregnant patients. Conclusions: Findings suggest gaps in oral health prevention information and behaviors among providers. Future efforts should examine effective dissemination and implementation strategies that translate evidence-based guidelines into clinical practice, with the ultimate goal of improving oral-systemic health among women and their offspring.