ArticlePDF Available

The role of nutrition in caries prevention and maintenance of oral health during pregnancy

Authors:
  • University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia

Abstract

Introduction: Pregnancy may pose an increased risk for the development of caries and other oral health problems. Continuous screening of oral health status, implementing appropriate preventive measures (particularly oral hygiene, healthy diet plans and education) is of paramount importance not only for oral health but also for the general health status of the future mother and her offspring. EFFECTS OF FOOD ON CARIES DEVELOPMENT: Caries prevention through healthy diet implicates the reduction in frequency and amount of intake of cariogenic food, above all ofrefined carbohydrates, i.e. sugars and sweets. Foods known to have caries-prophylactic effects should predominate in healthy diet plans. They mainly include solid foods, which have mechanical effects on teeth cleaning, as well as foods providing sufficient amounts of vitamins (A, C, D) and a variety of elements and compounds (calcium, phosphates, fluorides) favoring the preservation and remineralization of tooth structures. EDUCATION OF PREGNANT WOMEN ON HEALHY DEIT: In accomplishing these goals, education and direct positive communication between the educator and the pregnant woman play a crucial role. Educative approach is always individual and determined by the patient's specific cultural and socioeconomic features and status, as well as her habits, motivation and willingness to accept relevant recommendations. Accomplishing the aforementioned goals requires the appropriate organization and professional competence within the preventive dental service and its close cooperation with the relevant medical institutions and social support in the framework of public health protection. Conclusion: Preserving of oral health during pregnancy is predominantly influenced by the following factors: 1) healthy diet, 2) oral hygiene, 3) patients' education, 4) regular control of oral health, 5) appropriate organization of dental services and 6) community engagement.
Med Pregl 2015; LXVIII (11-12): 387-393. Novi Sad: novembar-decembar.387
Corresponding Author: Dr Jelena Pantelinac, Dom zdravlja “Dr Milorad Mika Pavlović”,
22320 Inđija, Srpskocrkvena 5, E-mail: jelenapantelinac@gmail.com
Summary
Introduction. Pregnancy may pose an increased risk for the develo-
pment of caries and other oral health problems. Continuous screening
of oral health status, implementing appropriate preventive measures
(particularly oral hygiene, healthy diet plans and education) is of para-
mount importance not only for oral health but also for the general heal-
th status of the future mother and her offspring. Effects of Food on
Caries Development. Caries prevention through healthy diet implicates
the reduction in frequency and amount of intake of cariogenic food,
above all of refined carbohydrates, i.e. sugars and sweets. Foods known
to have caries-prophylactic effects should predominate in healthy diet
plans. They mainly include solid foods, which have mechanical effects
on teeth cleaning, as well as foods providing sufficient amounts of vi-
tamins (A, C, D) and a variety of elements and compounds (calcium,
phosphates, fluorides) favoring the preservation and remineralization
of tooth structures. Education of Pregnant Women on Healhy Deit.
In accomplishing these goals, education and direct positive communi-
cation between the educator and the pregnant woman play a crucial role.
Educative approach is always individual and determined by the patient’s
specific cultural and socioeconomic features and status, as well as her
habits, motivation and willingness to accept relevant recommendations.
Accomplishing the aforementioned goals requires the appropriate orga-
nization and professional competence within the preventive dental ser-
vice and its close cooperation with the relevant medical institutions and
social support in the framework of public health protection. Conclusion.
Preserving of oral health during pregnancy is predominantly influenced
by the following factors: 1) healthy diet, 2) oral hygiene, 3) patients
education, 4) regular control of oral health, 5) appropriate organization
of dental services and 6) community engagement.
Keywords: Dental Caries; Preventive Dentistry; Oral Health; Pre-
gnancy; Mass Screening; Diet; Nutrition Policy; Public Health, Den-
tistry; Tooth Remineralization; Oral Hygiene; Diet, Cariogenic; Food
Habits; Health Education, Dental
Sažetak
Uvod. Tokom trudnoće rizik za nastanak karijesa zuba i drugih
poremećaja oralnog zdravlja je povećan. Redovni skrining stanja
oralnog zdravlja, sprovođenje odgovarajućih preventivnih mera
(prvenstveno oralne higijene, zdrave ishrane i edukacije) veoma su
značajni ne samo za oralno zdravlje nego i za opšte zdravstveno
stanje buduće majke i njenog potomstva. Uticaj hrane na razvoj
karijesa. U prevenciji karijesa zdravim načinom ishrane treba re-
dukovati učestalost i količinu unosa kariogene hrane, prvenstveno
rafinisanih ugljenih hidrata, odnosno šećera i slatkiša. U zdravoj
ishrani prednost ima hrana sa profilaktičkim dejstvom na karijes.
Ovde spada čvršća hrana, koja ima mehanički efekat u odnosu na
čišćenje zuba, kao i hrana koja obezbeđuje dovoljan unos vitamina
(A, C, D) i određenih elemenata i jedinjenja (kalcijuma, fosfata,
fluorida) koji pomažu u očuvanju i remineralizaciji građe zuba.
Edukacija trudnica o zdravoj ishrani. U postizanju ovih ciljeva
pomaže edukacija uz direktnu i pozitivnu komunikaciju između
edukatora i trudnice. Edukativni pristup je individualan jer svaka
trudnica ima specifična kulturološka i socioekonomska obeležja i
status, uz različite navike, motivisanost i spremnost za prihvatanje
datih preporuka. Za ostvarivanje pomenutih ciljeva potrebna je
odgovarajuća organizacija i stručnost stomatološke preventivne
službe i njena saradnja sa drugim medicinskim službama, uz druš-
tvenu podršku u okviru javnog zdravlja. Zaključak. U očuvanju
oralnog zdravlja tokom trudnoće važne uloge imaju: 1. zdrav način
ishrane, 2. oralna higijena, 3. edukacija trudnica, 4. redovne stoma-
tološke kontrole, 5. organizacija stomatološke službe i 6. društveno
angažovanje.
Ključne reči: Karijes; Preventivna stomatologija; Oralno zdravlje;
Trudnoća; Skrining; Ishrana; Pravila ishrane; Javno zdravlje, sto-
matologija; Remineralizacija zuba; Oralna higijena; Kariogena
ishrana; Navike u ishrani; Zdravstveno obrazovanje, stomatologija
REVIEW ARTICLES
PREGLEDNI ČLANCI
University of Novi Sad, Faculty of Medicine, Novi Sad1 Review article
Institute of Public Health of Vojvodina, Novi Sad2 Pregledni rad
Health Center “Dr Milorad Mika Pavlović”, Inđija3 UDK 616.314-002-084:613.2]-055.26
Dental Clinic of Vojvodina, Novi Sad4 DOI: 10.2298/MPNS1512387J
THE ROLE OF NUTRITION IN CARIES PREVENTION AND MAINTENANCE OF
ORAL HEALTH DURING PREGNANCY
ULOGA ISHRANE U PREVENCIJI KARIJESA I OČUVANJU ORALNOG ZDRAVLJA U TRUDNOĆI
Marija JEVTIĆ1, 2, Jelena PANTELINAC1, 3, Tatjana JOVANOVIĆ ILIĆ3,
Vasa PETROVIĆ3, Olja GRGIĆ1 and Larisa BLAŽIĆ1, 4
Acknowledgments. This paper was supported by the grant No. TR31095 of the Ministry of Education, Science and Technological
Development of the Republic of Serbia.
388
Introduction
Pregnancy is associated with an increased risk
for development of dental caries and other oral
health problems [1–5]. Specific alterations of hor-
monal status in pregnant women such as the increase
and change in progesterone and estrogen levels as
the most prominent ones stimulate fluid retention in
the body that may result in gingival swelling (ede-
ma). These changes are responsible for the increased
sensitivity of the gums, hyperemia and tendency for
bleeding, gingivitis, periodontitis, pyogenic granu-
loma, increased tooth mobility, plaque formation as
well as substantial colonization of bacteria involved
in caries pathogenesis [2, 4, 6–8].
Minozzi et al. [9] have identified the following
major etiologic factors which play a role in caries
development during pregnancy: 1) modified saliva
composition (elevated acidity and mucin levels) that
favors the formation of bacterial plaque; 2) changes
in dietary habits (smaller but more frequent meals
to prevent nausea, vomiting and hypoglycemia); 3)
inadequate dietary intake of minerals, vitamins and
other protective compounds; 4) erosive effects of
gastric acid (frequent vomiting and regurgitation);
5) poor oral hygiene, and 6) inadequate dental sur-
veillance and monitoring.
Dental caries is a change of multifactorial etiology
defined as the demineralization of the inorganic portion
and destruction of the organic structure of the tooth
[10]. Demineralization of the enamel and dentin, which
make a solid inorganic portion of the tooth, is caused
by organic acids produced in dental plaque as a by-
product of anaerobic sugar degradation by bacteria
from the diet of the host. Besides the sugar and spe-
cific bacteria, the caries development is determined by
bacterial species, tooth resistance, quality of the saliva
and salivary secretion rate. The saliva contains sub-
stantial amounts of calcium and phosphates, and the
pH range of pH7 (neutral) promotes the enamel rem-
ineralization process. However, the acid environment
resulting from the elevated acidity of the saliva during
pregnancy enhances the demineralization, which then
predominates over remineralization process, thus stim-
ulating the caries development [1, 2, 4, 6]. The tooth
demineralization is attributed to organic acids, which
increase the solubility of calcium hydroxyapatite in the
dental hard tissues. Furthermore, the factors that may
contribute to the development of caries during preg-
nancy include poor quality (composition) of food and
inadequate dietary regimen as well as inadequate oral
hygiene [1, 2, 6, 9, 11].
It is of vital importance to preserve and improve
oral health in pregnancy not only because of the
pregnant woman herself, but for the outcome of
pregnancy, health and development of the newborn
baby. In that respect, periodontitis in pregnant wom-
en can be associated with premature birth, low birth
weight of the newborn [2, 9, 12–15] as well as preec-
lampsia [15, 16]. Furthermore, cariogenic bacteria
(including Streptococcus mutans) from the oral cav-
ity of the mother with caries can be transmitted to
her baby’s mouth, which is significantly related to
the prevalence or incidence of caries in the child [1,
2, 9]. Adequate dental health protection in pregnant
women is indispensable and it should encompass
the implementation of preventive and therapeutic
measures and regular check-ups during pregnancy,
as well as the active involvement of pregnant wom-
an in preserving and maintenance of her oral health.
The aforementioned practices are of multiple ben-
efits for both oral health of the woman and preg-
nancy outcome, prenatal health and reduced inci-
dence of caries in her child [9, 17–20]. The active
involvement of the pregnant woman and her close
cooperation with the dentist, gynecologist and oth-
er specialists are of crucial importance for the ac-
complishment of these goals [3–5, 9]. The above-
mentioned measures and activities contribute to the
improvement of health status among the general
population. To reach the final positive outcome in
this sphere, interdisciplinary health care practices
and cooperation should be linked with identifying
the role of the existing environmental risk factors
and novel approaches and new aspects in dentistry,
medicine, pharmacy and other fields related to pub-
lic health [21–24].
The integrated prenatal health care and protection
should encompass preventive measures and control
of oral health of a pregnant woman; however, it is
often neglected in everyday practice [2]. Solving of
this problem is supported and improved by a range
of relevant handbooks and guidelines offering recom-
mendations on the preservation and improvement of
oral health during pregnancy [3, 6, 7, 11, 19, 25].
Effects of Food on Caries Development
in Pregnant Women
“Cariogenic” Food and its Impact
Some foods may increase the risk of caries for-
mation during pregnancy, which should be taken
into consideration when planning the diets for preg-
nant woman.
Easily digestible carbohydrates (mainly sugars)
are considered potential factors that may provoke
caries formation because acid by-products of their
bacterial decomposition attack and damage the den-
tal enamel and tooth structure. Monosaccharides,
glucose, and disaccharides (including saccharose
and lactose) are direct substrates in this process.
Maltodextrin, broken down by salivary amylase into
the aforementioned “aggressive” mono- and disac-
charides, also plays a role in caries formation [1, 11].
Frequent and abundant intake of standard sugar
(saccharose) and products containing substantial
amounts of sugar and honey (sweets) are considered
important risk factors in the caries development [6].
Other risk factors encompass prolonged keeping of
carbohydrates in the mouth, especially when taking
sticky candies that tend to adhere to the teeth. Some
food of plant origin such as corn flakes and similar
Jevtić M, et al. Caries Prevention During Pregnancy
Med Pregl 2015; LXVIII (11-12): 387-393. Novi Sad: novembar-decembar.389
processed cereals mostly used for breakfast dem-
onstrate similar properties. Such products are rich
in polysaccharides, thus easily decomposed by bac-
teria into acid compounds.
Restriction of concentrated carbohydrates in the diet
has positive effects on not only oral health, but also on
the prevention of overweight/obesity and diabetes and
related health conditions and complications, which
nowadays represent critical healthcare issues in both
pregnant women and general populations [26–28].
Consuming abundant amounts of foods contain-
ing organic acids, such as fruit juice, yoghurt, fer-
mented milk and cream may contribute to caries
formation. Harmful effects of these foods manifest
as direct demineralization of tooth surface and con-
sequent erosion of dental enamel. Fruit juices have
particularly high cariogenic potential as they contain
both acids and carbohydrates (glucose, fructose, sac-
charose). To that end, fruit juices should not be con-
sumed between meals. Taking fruit juices and bever-
ages at mealtime (immediately before/after or during
the meal) is recommendable because their cariogen-
ic effects are less pronounced. Lemonade has the
highest cariogenic potential of all fruit juices since it
contains both sugar and citric acid. Due to their car-
iogenic nature, some dairy products (yoghurt, fer-
mented milk, cream and sour milk cheese) are
strongly recommended to be consumed during meals
in order to reduce their own cariogenic effects [3–5].
The increased acidity in the mouth during preg-
nancy is commonly due to the presence of gastric acid
produced by frequent vomiting at the initial stage of
pregnancy and gastric reflux during the later preg-
nancy stages. Acute acid reflux into the mouth results
from a decreased esophageal sphincter tone and move-
ment of the acid contents of the stomach because of
the increased abdominal pressure caused by the en-
larged uterus [3–5, 7]. The presence of gastric acid in
the mouth can provoke erosion of dental enamel; there-
fore, immediate rinsing of the mouth with water is
highly recommendable. After vomiting, the acid neu-
tralization can be accomplished by rinsing the mouth
with sodium bicarbonate solution (1 teaspoon of bak-
ing soda in a glass of water) [3–5]. Some pregnant
women avoid frequent tooth brushing because of nau-
sea and vomiting tendency as well as because of vul-
nerable gums prone to bleeding and pain in contact
with the toothbrush, which adds to the persistent acid-
ity of the mouth and its negative effects [3–5]. Some
pregnant women tend to take frequent smaller meals
(because of nausea), yet without teeth brushing after
the meal, thus promoting intensive bacterial activity
and carbohydrate decomposition and consequent in-
crease of mouth acidity [7].
Frequent Intake of Foods Contributing to
Development of Caries
Besides consuming large amounts of sugar in
one meal, frequent intake of sugar, i.e. carbohy-
drates throughout the day puts pregnant women at
a substantial risk. The practice of taking sweet
snacks between the main meals causes prolonged
retention of carbohydrate in the mouth for a long
period. Thus, besides the type and amount of die-
tary carbohydrates, one should take into considera-
tion the frequency of their intake as well as the
duration of retention of food in the mouth [6]. Some
authors recommend to reduce the number of high-
sugar meals to fewer than four, with a maximum
sugar amount of less than 60 g/day [20]. Moynihan
P and Petersen PE from the WHO Collaborating
Centre for Nutrition and Oral Health recommend
that the frequency of consumption of foods contain-
ing free sugars should be limited to a maximum of
4 times per day along with tooth brushing with
fluoride toothpaste at least twice a day. These au-
thors also encourage the production of sugar-free
products and candies containing artificial sweeten-
ers as an alternative to the products rich in concen-
trated and free sugars [29]. Such strategy may pre-
vent both dental and other health problems, such as
overweight, which is quite a common condition dur-
ing pregnancy. Promoting healthy food and dietary
habits needs to be appropriately addressed through
adequate marketing strategies [26, 27].
Caries-Prophylactic Effects of Some Foods
Cariogenic food, i.e. food rich in carbohydrates
and acids, should be avoided while encouraging
caries-preventive diets in order to reduce the risk of
caries development. Prophylactic effects on dental
caries is best accomplished with diets providing suf-
ficient amounts of vitamins, minerals and specific
elements and compounds such as vitamins A, C, D,
calcium, phosphate and fluoride. Furthermore,
some foods exert a positive mechanical cleansing
action on teeth, thus representing a potential protec-
tive factor in caries prevention [6].
Indispensable vitamins are primarily provided
by the adequate intake of fruits and vegetables and
related foods. Fresh fruits and some vegetables
(though to a somewhat lesser extent) contain carbo-
hydrates that may undergo bacterial fermentation
and convert to acidic products; however, high water
contents in such foods dilute the concentration and
effects of carbohydrates while their fiber contents
helps mechanical teeth cleaning thus reducing the
risk of caries development.
Vitamin A plays an important role in the devel-
opment of healthy bones and teeth and in the regen-
eration of mucosa, skin and other tissues as well.
Major natural sources of vitamin A are orange-
colored foods, melon, peach and some vegetables
such as carrot, courgette, savoy cabbage (kale),
spinach and red peppers. Milk and dairy products
and eggs are also a good source of vitamin A [6].
Vitamin C offers a range of health benefits. Be-
sides its role in collagen synthesis, vitamin C pre-
vents gum bleeding, promotes iron and calcium
resorption and has a powerful antioxidative poten-
tial. High vitamin C foods include rose hip, red cur-
rant, bilberry, lemon, orange, tangerine, grapefruit,
390
kiwi, papaya, raspberry, strawberry, sour cherry,
melon, watermelon, paprika, tomatoes, cabbage and
other leafy vegetables, broccoli, cauliflower, kohlrabi,
parsley, potatoes and other fruits and vegetables [6].
Vitamin D is essential for the adequate absorption
and metabolism of calcium and phosphates, and it is
of particular importance for the maintenance of bone
and teeth density during pregnancy as well as for the
proper development of the bones and teeth of the
fetus. Good sources of vitamin D are milk and dairy
products, fatty saltwater fish (salmon, tuna, sardines,
herring, mackerel, and swordfish), fish oil and eggs.
The human body is capable of synthesizing vitamin
D in the skin cells through the sunlight-mediated
pathway; however, only moderate and controlled ex-
posure to sunlight is advisable during pregnancy [6].
Calcium, along with phosphorus and vitamin D,
is an important component in the bone and teeth
mineralization. The best food sources of calcium
are milk and dairy products (cheese, yoghurt), sar-
dines, salmon, leafy greens, beans, lentil, sesame
seed, soybean, figs, fruit juices (strawberry), dried
fruits, almond, hazelnut and grains [6].
Phosphorus is an integrative component of teeth
and bones, and it is contained in milk, cheese, eggs
(egg yolk), peanut butter, meat, fish and fish oil,
barley, legumes, walnut, fruit juices (red currant
and raspberry) and brown bread [6].
Liver, which is rich in vitamin D and vitamin A,
calcium and phosphorus, has not been listed in the
aforementioned sources because of its particularly high
vitamin A content that (if consumed frequently) could
negatively affect the development of the fetus [6].
Foods containing substantial amounts of dietary
fibers (roughage) are of solid consistency and their
mechanical mincing during chewing process ena-
bles mechanical cleansing of teeth, promotes blood
circulation in the gums, improves defense capacity
of periodontal tissues, improves the keratinization
and tonus of gingival tissue and stimulates salivary
secretion. This group of foods includes some veg-
etables (carrot, cucumber, radish, celery, cabbage,
lettuce, etc.) and nuts. The major benefit of such
foods is that they provide adequate intake of vita-
mins and minerals without an increased bacterial
production of acid compounds in the oral cavity [6].
The mechanical effects of teeth cleansing can be
attributed to some fruits of solid consistency (e.g.
some apple varieties, pears, etc.).
Meat and fish are an important source of proteins
as the major building block, so the adequate intake of
these foods during pregnancy is essential. Meat and
fish consumption does not induce acidity in the oral
cavity, and thus it may help to prevent dental caries [6].
Hard cheese, as a good source of calcium and phos-
phates, manifests caries-prevention properties through
its positive effects on mineralization and remineraliza-
tion of teeth. Cheese is also a strong sialogogue [1, 29].
It does not increase the acidity in the oral cavity, on
the contrary – it inhibits the acidification process in
the mouth thus acting as a preventive agent against
caries. Such positive effects are characteristic mainly
for hard (mature) cheeses, whereas fresh and sour milk
cheeses as well as yoghurt increase the acidity of the
mouth; therefore their consumption should be limited
to mealtime [12].
Mobley C et al. recommend chewing sugar-free
gum to protect and maintain oral health. The beneficial
effects of chewing gum are manifested by mechanical
teeth cleansing, improvement of gum tonus, stimula-
tion of salivary secretion and reduction of acidity and
bacterial count in the mouth [12]. Chour VG and Chour
GR identified some leading factors contributing to car-
ies development. Besides the refined carbohydrates
and cariogenic bacteria, they emphasized the role of
xerostomia (dry mouth), i.e. reduced secretion of the
saliva, which can occur during pregnancy [30].
Education of Pregnant Women on Healthy Diet
Nutrition during pregnancy and its effects on car-
ies development among the population of pregnant
women and consequent caries in children is deter-
mined by a wide range of factors, including cultural
and socio-economic ones [1–3, 12, 19]. Individual de-
terminants such as behavioral orientation (character-
istics, habits and education about nutrition), bad habits
(smoking, repeated consumption of sweets and alco-
hol), actual oral health status, willingness and motiva-
tion of a pregnant woman to accept the recommenda-
tions are of great importance for preserving oral health
during pregnancy. Furthermore, dietary recommenda-
tions should be tailored and adapted to the objective
circumstances and family and social conditions of the
pregnant womans life [1, 2, 11, 20, 30].
The first step in creating healthy diet during preg-
nancy is to identify potential current nutritional imbal-
ance. The subsequent step includes the correction and
modification of dietary habits, that is, eliminating bad
and promoting good eating habits. Having in mind
specific cultural and socio-economic characteristics
of pregnant women, their different habits, motivation
and willingness to accept relevant recommendations,
an individualized, patient-centered approach is of vi-
tal importance [1, 2, 11, 20, 30, 31].
In regard to individual educational approach, the
direct contact between the counselor and pregnant
woman and their adequate verbal and non-verbal pos-
itive communication are the most important moments.
These methods should motivate the pregnant woman
to participate actively in the education program and to
accept the recommended routine. The counselor should
show a certain degree of empathy and take the perspec-
tive of the patient, i.e. pregnant woman [19, 32].
Besides the personal contact, nutrition coun-
seling of pregnant women may include a range of
informative and educational materials as a useful
education tool [19, 32, 33].
Education process is highly complex, encompass-
ing initial assessment of the type and model of nutri-
tion as well as recording of particular eating habits of
the pregnant woman (in workshops, pregnancy cours-
Jevtić M, et al. Caries Prevention During Pregnancy
Med Pregl 2015; LXVIII (11-12): 387-393. Novi Sad: novembar-decembar.391
es, and specially designed questionnaires for statistical
processing). The assessment and, if necessary, correc-
tion and modification of eating pattern including meal
composition and number of meals taken per day play
a major role in caries-prevention procedures. The strat-
egy of healthy diet and nutrition education focus on
reducing the amount and rate of consumed carbohy-
drates, i.e. sugars [1–3, 7, 11, 20, 30]. Whenever pos-
sible, adequate oral hygiene should be practiced after
each meal containing sugars [1–3, 7, 11, 20, 32–34].
Besides the harmful effects of refined carbohydrates
(sugars) on oral health, they pose a substantial risk of
overweight in pregnant women, which is known to be
related to the development of periodontitis [35].
In addition to the restricted consumption of re-
fined carbohydrates as harmful factors, a sufficient
intake of beneficial food ingredients that promote
teeth remineralization (vitamins A, C, D, calcium,
phosphates and fluorides) plays an important role
in caries prevention. Substantial amounts of such
elements are provided from organic milk and dairy
products made using natural and healthy processing
methods [36]. Education process should emphasize
that healthy eating is of importance not only for oral
health of pregnant woman but also for her general
health condition, pregnancy course and health status
of her baby, which will give her motivation to accept
the recommendations and advice [11, 20].
Though not directly related to nutrition yet in the
aspect of general healthcare, pregnant women are
strongly encouraged to avoid alcohol and smoking.
Negative and harmful effects of smoking on oral health
of general population are well established, and they
can contribute to the development of periodontitis,
tooth loss, carcinoma, etc. In pregnant women, such
harmful effects are even more aggravated [20, 37].
Highly complex nature of oral health issue in
pregnant women and its relation to her overall health
status, quality of life, pregnancy outcome and health
of her baby requires a multidisciplinary approach and
involvement of health professionals and specialists
of different profiles, i.e. dentists, general practitioners
and gynecologists. Such an approach is useful in all
communities, and particularly among populations of
lower cultural and educational status and poorer eco-
nomical status characterized by higher incidence of
the aforementioned morbidities. In that respect, the
style and methods of promotion of oral health and
education should be adapted to the relevant popula-
tion [7, 38]. Establishing preventive prenatal oral
health institutions with educated and professional
staff, assessment and control of oral health status of
the pregnant women and referring them to relevant
health centers, adequate and successful education
programs as well as broader community engagement
and social support to such programs and activities
are highly valuable [39–42]. The importance of social
and financial support for oral health, particularly
among the populations of poorer cultural, educa-
tional and economical status, was demonstrated in
2005 in Serbia through the Law on Health Insurance,
which restricted the rights of adult population to oral
health care. The consequence of this Law was a sub-
stantially reduced access to oral health protection and
dental services that were formerly covered by manda-
tory social security funds, which consequently lead
to drastic deterioration of oral health status within
adult population [43–45] including women before
pregnancy.
Conclusion
The importance of following factors in preserv-
ing oral health during pregnancy should be empha-
sized: 1) healthy diet, 2) oral hygiene (regular teeth
brushing), 3) education and motivation of pregnant
women to practice appropriate procedures actively,
4) regular control of oral health status and potential
introduction of relevant therapeutic measures, 5)
appropriate organization and competence of preven-
tive dental services and their cooperation with
other medical care departments, and 6) community
engagement and social support.
The aforementioned factors play an important
role in the field of both dental health care (particu-
larly preventive dentistry) and the healthcare system
as a whole. They significantly affect and contribute
to overall health status of the population. Evidently,
systematic activities and initiatives undertaken by
relevant decision makers in this field are of utmost
importance for the improvement of both oral and
general health status of the population.
References
1.
Leitzmann C, Műller C, Michel P, Brehme U, Hahn A,
Laube H. Karies. Ernährung in Prävention und Therapie. 2nd
ed. Stuttgart: Hippokrates Verlag; 2003. p. 312-7.
2. Silk H, Douglass BA, Douglass MJ, Silk L. Oral health
during pregnancy. Am Fam Physician. 2008;77(8):1139-44.
3.
Food and Nutrition Guidelines for Healthy Pregnant and
Breastfeeding Women: A background paper. Revised in November
2008. Wellington: Ministry of Health. New Zealand. [cited 2014
November 14]. Available from: http://www.health.govt.nz/system/
files/documents/publications/food-and-nutrition-guidelines-preg-
and-bfeed.pdf
4. Giglio AJ, Lanni MS, Laskin MD, Nancy W. Giglio WN.
Oral health care for the pregnant patient. Tex Dent J. 2010; 27
(10):1061-70.
5.
Kumar J, Samelson R. Oral health care during pregnancy
and early childhood: practice guidelines. New York, NY: New York
State Department of Health, 2006. [cited 2014 November 14]. Ava-
ilable from: http://www.health.ny.gov/publications/0824.pdf
6. Clinical Practice Guideline. Nutrition for Pregnancy. Insti-
tute of Obstetricians and Gynaecologists, Royal College of Physi-
cians of Ireland and Directorate of Clinical Strategy and Program-
mes, Health Service Executive. 2013. [cited 2014 November 14].
Available from: http://www.hse.ie/eng/about/Who/clinical/natc-
linprog/obsandgynaeprogramme/nutpreg.pdf
392
7.
Kandan MP, Menaga V, Kumar RR. Oral health in pre-
gnancy (Guidelines to gynaecologists, general physicians & oral
health care providers). J Pak Med Assoc. 2011;61(10):1009-14.
8.
Marković D, Blažić L, Đurić M, Vučinić P, Blagojević
D, Bajkin B. Savremene tendencije u stomatološkoj praksi. Med
Pregl. 2007;60(11-12):663-8.
9.
Minozzi F, Chipaila N, Unfer V, Minozzi M. Odontosto-
matological approach to the pregnant patient. Eur Rev Med
Pharmacol Sci. 2008;12:397-409.
10.
Blažić L. Kompozitni ispuni II klase: izazovi savreme-
ne kliničke prakse. In: Zbornik radova, Simpozijum stomato-
loga i saradnika: 2010 maj 279-29; Novi Sad. Stomatološki
Informator. 2010;(Suppl):5-7.
11.
Guideline on Perinatal Oral Health Care Council on Clinical
Affairs. American Academy Of Pediatric Dentistry. Adopted 2009,
Revised 2011. Clinical Guidelines Reference Manual V 35 / NO 6
13 / 14 131-136. [cited 2014 November 14]. Available from: www.
aapd.org/media/Policies_Guidelines/G_PerinatalOralHealthCare.
pdf#xml=http://pr-dtsearch001.americaneagle.com/service/search.
asp?cmd=pdfhits&DocId=391&Index=F%3a%5cdtSearch%5caap
d%2eorg&HitCount=Guideline+on+Perinatal+Oral+Health+Care
12. Mobley C, Marshall AT, Milgrom P, Coldwell ES. The
contribution of dietary factors to dental caries and disparities
in caries. Acad Pediatr. 2009;9(6):410-4.
13.
Jeffcoat M, Parry S, Gerlach RW, Doyle MJ. Use of
alcohol-free antimicrobial mouth rinse is associated with de-
creased incidence of preterm birth in a high-risk population.
Am J Obstet Gynecol. 2011;205:382-6.
14. Águeda A, Echeverría A, Manau C. Association between
periodontitis in pregnancy and preterm or low birth weight: Review
of the literature. Med Oral Patol Oral Cir Bucal. 2008;13(9):609-15.
15. Polyzos PN, Polyzos PI, Mauri D, Tzioras S, Tsappi M, et
al. Effect of periodontal disease treatment during pregnancy on
preterm birth incidence: a metaanalysis of randomized trials. Am
J Obstet Gynecol. 2009;(3):225-32.
16. Boggess AK, Edelstein LB. Oral health in women during
preconception and pregnancy: implications for birth outcomes and
infant oral health. Matern Child Health J. 2006;10(5 Suppl):S169-74.
17. Ruma M, Boggess K, Moss K, Jared H, Murtha A, Beck
J, et al. Maternal periodontal disease, systemic inflammation, and
risk for preeclampsia. Am J Obstet Gynecol. 2008;198:389-95.
18. Blagojević D, Brkanić T, Stojić S. Oral health in pregnan-
cy. Med Pregl. 2002;55(5-6):213-6.
19.
American Dental Association Council on Access, Preven-
tion and Interprofessional Relations. Women’s oral health issues.
American Dental Association, 2006. [cited 2014 November 14].
Available from: http://www.ada.org/prof/resources/topics/heal-
thcare_womens.pdf.
20.
Maltz M, Jardim JJ, Alves LS. Health promotion and den-
tal caries. Braz Oral Res. 2010;24(Suppl 1):18-25.
21.
Jevtić M, Trajković-Pavlović Lj, Bijelović S, Popović M, Ba-
lać D, Bjelanović (Mirilov) J, et al. Urbani okoliš i javno zdravlje -
mesto i uloga analize rizika. Aktuelnosti u medicini, stomatologiji,
farmaciji i srodnim naukama: Zbornik radova povodom 50-godiš-
njice osnivanja Medicinskog fakulteta; 2010; Novi Sad. s. 355-71.
22.
Jevtic M. Sustainable development, Urban Environment and
Population Health. Editorial, Med Pregl. 2011;64(5-6):251-5.
23.
Jevtic M, Milutinović S. In: Sustainable Development and
Health in Serbia, ECO-Conference 2009; Ecological movement of
the City of Novi Sad; 2009 sep 23-26; p. 383-9.
24. Lainović T, Blažić L, Potran M. Nanotechnology in den-
tistry: current state and future perspectives. Sebian Dental Journal.
2012;598(1):44-50.
25.
Pantelinac J, Jovanović Ilić T. In: Promocija oralnog zdrav-
lja kod adolescenata. Treći kongres stomatologa Vojvodine; Zbornik
radova 2012 Maj 19-20; Novi Sad, Srbija. Novi Sad: DLV-SLD;
2012. s. 74.
26. Jevtić M, Filipović V, Janičić R. In: The role of marketing
in obesity prevention. XIII International symposium. Conference
proceedings Sym Org; 2012. Zlatibor, Serbia. p. 1177-85.
27. Jevtić M. Marketing u prevenciji gojaznosti. Edicija Initi-
um Monografija. Beograd: Zadužbina Andrejević; 2013.
28. Dokić M, Jevtić M, Balać D. Prevencija diabetesa meli-
tusa tipa 2 kod dece i adolescenata. Medicinski glasnik. 2011;16
(41):50-65.
29. Moynihan P, Petersen PE. Diet, nutrition and the preven-
tion of dental diseases. Public Health Nutr. 2004;7(1A):201-26.
30.
Chour VG, Chour GR. Diet Counselling: a primordial
level of prevention of dental caries. J Dent Med Sci. 2014;13(1):64-
70. [cited 2014 November 14] Available from: http://www.google.
rs/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CCI
QFjAA&url=http%3A%2F%2Fwww.iosrjournals.org%2Fiosr-
jdms%2Fpapers%2FVol13-issue1%2FVersion-2%2FN013126470.
pdf&ei=1r9kVYI1yLCxAdS2g9gO&usg=AFQjCNE2iXNqjD5
yyFGTv_E6iq8nNZ7ztA&sig2=iw3hiKp8tAKWUp0Egrq1DA
&bvm=bv.93990622,d.bGg
31. Grgić O, Blagojević D. Uticaj ishrane na oralno zdravlje.
Stomatološki informator. 2012;12(31):17-21.
32. Shaw D. Continuous consent and dignity in dentistry. Br
Dent J. 2007;203(10):569-71.
33. Patel AR, Dhillon SJ, Deshpande AN. Oral health care in
pregnancy: a collaborative effort by health care professionals. Re-
search and Reviews: Journal of Dental Sciences (RRJDS)
2014;2(1):21-5.
34. Tanaka K, Miyake Y, Sasaki S, Hirota Y. Dairy products
and calcium intake during pregnancy and dental caries in children.
Nutr J. 2012;11(33):1-8.
35.
Vogt M, Sallum AW, Cecatti JG, Morais SS. Factors asso-
ciated with the prevalence of periodontal disease in low-risk pre-
gnant women. Reprod Health. 2012;9(3):1-8.
36. Popović Vranješ A, Pejanović R, Cvetanovic D, Jevtić M,
Popović M, Glavaš Trbić M, et al. Primjena holističkih metoda u
analizi organskog mlijeka. Mljekarstvo 2012;62(4):284-90.
37.
Popović-Petrović S, Tomić S, Popović M, Petrović V.
Rehabilitation in oncology. Health MED 2010;4(4):815-8.
38. Acharya S, Bhat PV, Acharya S. Factors affecting oral
health-related quality of life among pregnant women. Int J Dent
Hyg. 2009;7(2):102-7.
39. George A, Johnson M, Blinkhorn A, Ellis S, Bhole S, Aj-
wani S. Maternal health: promoting oral health during pregnancy:
current evidence and implications for Australian midwives. J Clin
Nurs. 2010;19:3324-33.
40. Lamarca AG, Leal M, Leao AT, Sheiham A, Vettore VM.
Oral health related quality of life in pregnant and post partum women
in two social network domains; predominantly home-based and
workbased networks. Health Qual Life Outcomes. 2012;10(5):2-10.
41. Committee Opinion No. 569: oral health care during pre-
gnancy and through the lifespan. American College of Obstetrici-
ans and Gynecologists. Obstet Gynecol. 2013;122:417-22.
42.
American Dental Association. Center for Continuing Edu-
cation and Lifelong Learning – Seminar Series: Wright R. Top 10
Jevtić M, et al. Caries Prevention During Pregnancy
Med Pregl 2015; LXVIII (11-12): 387-393. Novi Sad: novembar-decembar.393
Skills for Success in Dental Communication. Chicago, Illinois,
USA; 2011. s. 1-24.
43. Institut za javno zdravlje Srbije „Dr Milan Jovanović Ba-
tut“. Zdravlje stanovnika Srbije - Analitička studija 1997-2007.
Beograd, 2008. s. 141-7. [cited 2014 November 14]. Available from:
http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=we
b&cd=1&ved=0CB4QFjAA&url=http%3A%2F%2Fwww.izjzkg.
rs%2Fdownload%2Fpublikacije%2Fmonografije%2FAnaliticka
%2520Studija%2520IZJZ%2520%2520KRAGUJEVAC.pdf&ei=
cllrVZSfHMi9swGko4H4BQ&usg=AFQjCNEa8zQwEu0d46o8
SCIjGpimNaRvwQ&sig2=fKsAMkHNsjBtRoQDZfOQKA&bv
m=bv.94455598,d.bGg&cad=rja
44. Rezultati istraživanja zdravlja stanovništva Srbije - 2013.
godina. Institut za javno zdravlje Srbije „Dr Milan Jovanović Ba-
tut“. Beograd, 2014. s. 63. [cited 2014 November 14]. Available
from: http://www.google.com/url?sa=t&rct=j&q=&esrc=s&sour
ce=web&cd=1&ved=0CB4QFjAA&url=http%3A%2F%2Fwww.
zdravlje.gov.rs%2Fdownloads%2FZakoni%2FStrategije%2FStra
tegija%2520Za%2520Prevenciju%2520I%2520Kontrolu%2520H
ronicnih%2520Nezaraznih%2520Bolesti.pdf&ei=LVlrVfJagZW
yAfbsgdgG&usg=AFQjCNGPO-Melz1Lnl-pgLT4k4J1Pz-1sA&
sig2=XQTEAU2arzHlPmXmf XOolw&bvm=bv.94455598,d.
bGg&cad=rja
45.
Istraživanje zdravlja stanovnika Republike Srbije-2013.
godina. Ipsos Strategic Marketing. Beograd, Srbija, 2014 [cited
2014 November 14]. Available from: http://www.google.com/url?
sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&
ved=0CB4QFjAA&url=http%3A%2F%2Fwww.zdravlje.gov.rs%
2Fdownloads%2F2014%2Fjul2014%2FJul2014IzvestajPrelimina
rni.pdf&ei=1VhrVcuXO4mxsAHgv4DIDg&usg=AFQjCNFJIw
HFz7jNHkiTuRmvxl-s-fnCPQ&sig2=rtIHsrHnFV8iC1GW2IV5
LQ&bvm=bv.94455598,d.bGg
Rad je primljen 3. VII 2015.
Recenziran 7. VII 2015.
Prihvaćen za štampu 17. VII 2015.
BIBLID.0025-8105:(2015):LXVIII:11-12:387-393.
... Makanan kaya protein harus menjadi bagian integral dari diet pneumonia. Pilih dari susu, daging, unggas, ayam, ikan, produk kedelai, kacang-kacangan dan biji-bijian (Jevtić, Pantelinac, Jovanović-Ilić, Petrović, Grgić, & Blažić, 2015). ...
Article
Full-text available
Pendahuluan: Penyakit infeksi masih menjadi penyebab utama kesakitan dan kematian, khususnya pada anak-anak. Di Indonesia, berdasarkan data pada tahun 2005, sebanyak 28% kematian anak masih disebabkan oleh infeksi yakni infeksi saluran pernapasan. Salah satu penyakit infeksi yang sering terjadi pada bayi dan balita adalah pneumonia. Pneumonia merupakan salah satu penyakit infeksi saluran pernapasan yang mengenai jaringan paru-paru. Tujuan: Untuk mensosialisasikan pencegahan penyakit pneumonia pada anak. Metode: Penelitian yang dilakukan melalui ceramah dan menggunakan media leaflet mengenai sosialisasi penyakit pneumonia pada anak. Penelitian dilakukan pada tanggal 5 Januari 2024 di Puskesmas Satelit Pahoman, Tanjung Agung Raya. Materi sosialisasi yang diberikan yaitu pengertian, penyebab, tanda dan gejala, penatalaksanaan, serta pencegahan pneumonia. Materi disampaikan selama 15 menit dilanjutkan dengan tanya jawab selama 5 menit. Hasil: Salah satu faktor penyebab pneumonia adalah lingkungan dan udara yang tidak sehat. Anak yang tinggal di lingkungan yang padat, sirkulasi udara yang buruk, serta keluarga yang merokok berpotensi lebih besar terkena penyakit ini. Sehingga dalam pencegahannya, menjaga lingkungan dan udara tetap bersih sangat penting untuk dilakukan Simpulan: Penyebab paling umum pneumonia adalah virus dan bakteri, diikuti oleh jamur dan parasit. Pneumonia juga dapat dikatakan sebagai komplikasi dari penyakit yang lain terutama penyakit yang terjadi secara kronis. Kata Kunci: Anak; Kesehatan Masyarakat; Pneumonia.
... Additionally, oral health conditions can exacerbate discomfort and stress during pregnancy, further affecting maternal health and fetal development (21). However, these potential issues can be prevented by maintaining adequate oral health through behavioral modifications (i.e., preventative dental screening, limiting sugar consumption, and a healthy diet) and promptly addressing dental issues (8,22). According to the American and Canadian Dental Association guidelines, visiting an oral health provider during pregnancy is not only safe but also essential for maintaining adequate oral health (11). ...
Article
Full-text available
Introduction Unfavorable beliefs about oral health and dental treatment during pregnancy can lead to the avoidance of dental care and the underutilization of dental services, adversely affecting adherence to good oral hygiene practices and, consequently, the health of the fetus. This study investigated the commonly held oral health beliefs among pregnant women in Southwestern Ontario, Canada. Methods Participants were recruited from the Family Medicine Obstetrics Clinic in London, Ontario, Canada. Eligible participants were pregnant women aged 18 or older, excluding those unwilling to participate. Participants completed a 33-item self-administered questionnaire, including three open-ended questions about oral health beliefs and their impacts on pregnancy, which were analyzed for this study. Thematic analysis in NVivo identified key patterns, while analysis determined the most common beliefs and the degree of diversity in responses. Responses were categorized into sub-themes, and the frequency and percentage of each category were calculated. Results A total of 130 participants met the inclusion criteria. Among them, 40.7% (n = 46) believed that oral health impacts their child's health, 48.2% (n = 53) believed that dental treatment affects fetal health, and 64.4% (n = 76) believed that pregnancy influences their oral health. Many beliefs regarding oral health during pregnancy regarded infection risks. Participants held negative beliefs about the effects of antibiotics, analgesics, and dental x-rays during pregnancy. Common beliefs about the impacts of pregnancy on oral health included developing conditions, such as tooth sensitivity, caries, and gingivitis, as well as a loss of minerals to the fetus. Conclusion This study revealed important misconceptions and concerns about oral health and dental treatment among pregnant women in Southwestern Ontario. The findings highlighted the need for enhanced oral health education for pregnant women to address these misconceptions and promote proper care during pregnancy. Healthcare providers are encouraged to focus on dispelling myths, emphasizing the safety of necessary dental treatments, and reinforcing the significance of maintaining good oral health for maternal and fetal well-being.
... Another important area of preventive dentistry is dietary advice. It has been realized that the reduction of sugar and acid intake will be able to provide a healthy environment in the mouth, which in turn will not only reduce the formation of caries on teeth but also help with erosion (Jevtić et al. 2015). Dental professionals can give tailored advice on how to ensure a balanced diet that will help in optimal oral health. ...
Article
Full-text available
Aim Evaluation of the quality of dental information produced by the ChatGPT artificial intelligence language model within the context of oral surgery, preventive dentistry, and oral cancer. Methodology This study adopted quantitative methods approach. The experts prepared 50 questions (including dimensions of, risk factors, preventive measures, diagnostic methods, and treatment options) that would be presented to ChatGPT, and its responses were rated for their accuracy, completeness, relevance, clarity or comprehensibility, and possible risks using a standardized rubric. To carry out the assessment of the responses by ChatGPT, a standardized scoring rubric was used. Evaluation process included feedback concerning the strengths, weaknesses, and potential areas of improvement in the responses provided by ChatGPT. Results While achieving the highest score for preventive dentistry at 4.3/5 and being able to communicate the complex information coherently, the tool showed lower accuracy for oral surgery and oral cancer, scoring 3.9/5 and 3.6/5, respectively, with several gaps for post-operative instructions, personalized risk assessments, and specialized diagnostic methods. Potential risks, such as a lack of individualized advice, were shown in 53% of the oral cancer and in 40% of the oral surgery. While showing promise in some domains, ChatGPT had important limitations in specialized areas that require nuanced expertise. Conclusion The findings point to the need for professional supervision while using AI-generated information and ongoing evaluation as capabilities evolve, for the assurance of responsible implementation in the best interest of patient care.
... Indigenous and modern methods are available to maintain oral health. The use of traditional means of oral hygiene such as plant-based traditional toothbrush sticks has been used to maintain oral hygiene good and to treat oral diseases as documented in literature [9][10][11][12]. The use of toothbrush sticks (in many cases also known as chewing sticks) is widespread in Ethiopia, both for esthetic and hygienic purposes. ...
Article
Full-text available
Background Poor oral hygiene affects the overall health and quality of life. However, the oral hygiene practice in rural communities and contributing factors are not well documented. Accordingly, this study was conducted to assess oral hygiene practices and associated factors among rural communities in northwest Ethiopia. Methods A cross-sectional study was conducted among 1190 households. Data were collected using a structured and pretested questionnaire, prepared based on a review of relevant literature. The questionnaire comprises socio-demographic information, access to health and hygiene messages, oral hygiene practices, and water quality. We assessed oral hygiene practices with these criteria: mouth wash with clean water in every morning, mouth wash with clean water after eating, brushing teeth regularly, and avoiding gum pricking. Gum pricking in this study is defined as sticking needles or wires into gums to make the gums black for beauty. Multivariable logistic regression was used to identify factors associated with oral hygiene practices. Significant associations were declared on the basis of adjusted odds ratio with 95% confidence interval and p-values < 0.05. Results Results showed that all the family members usually washed their mouth with clean water in everyday morning and after eating in 65.2% and 49.6% of the households, respectively. Furthermore, 29.9% of the households reported that all the family members regularly brushed their teeth using toothbrush sticks and one or more of the family members in 14.5% of the households had gum pricking. Overall, 42.9% (95% CI: 39.9, 45.6%) of the households had good oral hygiene practices. Health and/or hygiene education was associated with good oral hygiene practices in the area (AOR: 1.66, 95% CI: 1.26, 2.21). Conclusion More than half of the households had poor oral hygiene practices in the area and cleaning of teeth with toothpastes is not practiced in the area, where as gum pricking is practiced in more than one-tenth of the households. The local health department needs provide community-level oral health education/interventions, such as washing mouth with clean water at least twice a day, teeth brushing using indigenous methods such as toothbrush sticks or modern methods such as toothpastes, and avoiding gum pricking to promote oral health.
... avoiding frequent snacking and limiting the frequency of sugar consumption can effectively prevent dental caries during pregnancy [80,81]. In regard to unfavourable beliefs about oral hygiene, in three studies, participants believed that tooth brushing should be 'avoided' during and after pregnancy [12,29,39]. ...
Article
Full-text available
Background Oral conditions such as gingivitis and periodontitis are correlated with adverse pregnancy outcomes such as preeclampsia, preterm birth and low birth weight. Oral health-related unfavourable beliefs can have negative influences on oral health behaviours including hesitation in accessing preventative dental treatments and dental service utilization. The objective of this systematic review was to examine unfavourable beliefs that expectant or new mothers frequently hold about oral health and the safety of dental care during pregnancy. Methods An electronic database search on PubMed, Scopus, CINAHL, and MEDLINE (Ovid) followed by forward and backward citation tracing of the included studies was conducted. All English primary studies regardless of the year of publication were independently screened by two reviewers to identify studies addressing unfavourable beliefs about oral health and dental care during pregnancy. The CLARITY tool was applied to assess the risk of bias in the included studies. Results Out of a total of 5766 records, 39 quantitative and six qualitative studies met the inclusion criteria. The commonly held unfavourable beliefs were regarding the safety of dental services utilization and dental treatment procedures, the adverse impacts of pregnancy on oral health, and oral hygiene necessity during pregnancy. The most discussed unfavourable beliefs included “pregnant women lose their teeth because of pregnancy” ( n = 18), “dental treatments are not safe and harm the fetus” ( n = 17), and “the developing baby absorbs calcium from the mother’s teeth” ( n = 14). Conclusions Unfavourable beliefs about oral health and dental care utilization are common among pregnant women and new mothers. The literature suggests that a low level of oral health knowledge and seeking information from social networks can contribute to such beliefs. This has implications for health promotion.
... If you consume catfish, it can help meet phosphorus and calcium in the body. Its main function is to maintain health and strengthen bones and teeth (Jevtić et al., 2015). At the same time reduce the risk of osteoporosis (a condition when bone density decreases). ...
Article
Full-text available
Smoking is a method of cooking, flavoring, or preserving food, especially fish meat. The smoking of catfish in Pasie Pinang Village is still done in the traditional way. Smoking is done with coconut fiber, wood and sawdust as fuel, smoked fish is smoked with heat and the smoke from the fuel produces a distinctive taste and aroma in fish products and the color becomes golden and brownish. The purpose of this study was to determine the water content of smoked catfish in Pasie Pinang Village and to determine people's preferences for smoked catfish in Pasie Pinang Village. The panelists used in this research were 35 people consisting of students from the University of Teuku Umar. The results showed that the water content of the three smoked catfish samples varied. Organoleptic test (n=35) in terms of color, taste, aroma, texture and overall, from the three samples tested, the fanelis preferred smoked catfish in sample three. The traditional smoking of smoked fish still has a good value on consumer acceptance.
... Carbohydrates, lipids, proteins, vitamins, minerals, as well as water and dietary fiber, are all necessary nutrients that must be obtained from dietary sources (Fanzo, 2015,Naeem & Ugur, 2019,Nasir et al., 2015. This diverse macro-and micronutrient can be found in a number of meals and food groups, ensuring adequate nutritional consumption (Jevtić et al., 2015, Shrivastava, Shrivastava, & Ramasamy, 2013,USAID, 2012. Variety foods contain a wide range of nutrients; in fact, except for breast milk, no single food contains all the elements required for good health (Fanzo, 2015,Ruel, 2003. ...
Article
Full-text available
Introduction: Lactating women are more vulnerable to malnutrition due to increased physiological demands, the lactogenesis process, consuming an undiversified monotonous diet, and increased nutrient needs during lactation. However, meeting minimum standards of dietary diversity for lactating mothers is a challenge in many developing countries, including Ethiopia. As a result, the purpose of this study was to evaluate dietary diversity and associated factors among breastfeeding mothers. Method: A community-based cross-sectional study was conducted. A multistage sampling technique was used to get a total of 665 lactating mothers from their kebeles. Face-to-face interviews with a structured questionnaire were used to collect data. Data was entered into Epidata version 3.1 and exported to the Statistical Package for the Social Sciences version 23.0 for analysis. Bivariate and multivariable logistic regression models were used to identify the important predictors of maternal dietary diversity. Variables having p < 0.25 in bivariate analysis were fitted to multivariate analysis. The odds ratio, P-value < 0.05, and 95% CI were computed to show the association of variables. Result: A total of 665 lactating women participated, with a response rate of 96.2%. Only 163 (24.5 %) mothers satisfied the minimal dietary diversity criteria. Mothers' dietary diversity was significantly associated with their education status [AOR 5.173 (2.132-12.552)], head of household [AOR 3.822 (2.290-6.378)], family size [AOR 5.358 (2.838-10.116)], and meal frequency [AOR 3.379 (1.789-6.380). Conclusion: One in every four mothers met the dietary diversity standard. Concerned bodies should consider ensuring large-scale interventions that focus on the identified factors to improve dietary diversity practices.
... If you consume catfish, it can help meet phosphorus and calcium in the body. Its main function is to maintain health and strengthen bones and teeth (Jevtić et al., 2015). At the same time reduce the risk of osteoporosis (a condition when bone density decreases). ...
Article
Full-text available
Smoking is a method of cooking, flavoring, or preserving food, especially fish meat. The smoking of catfish in Pasie Pinang Village is still done in the traditional way. Smoking is done with coconut fiber, wood and sawdust as fuel, smoked fish is smoked with heat and the smoke from the fuel produces a distinctive taste and aroma in fish products and the color becomes golden and brownish. The purpose of this study was to determine the water content of smoked catfish in Pasie Pinang Village and to determine people's preferences for smoked catfish in Pasie Pinang Village. The panelists used in this research were 35 people consisting of students from the University of Teuku Umar. The results showed that the water content of the three smoked catfish samples varied. Organoleptic test (n=35) in terms of color, taste, aroma, texture and overall, from the three samples tested, the fanelis preferred smoked catfish in sample three. The traditional smoking of smoked fish still has a good value on consumer acceptance.
Article
Fluorosis, a chronic condition brought on by excessive fluoride ingestion which, has drawn much scientific attention and public health concern. It is a complex and multifaceted issue that affects millions of people worldwide. Despite decades of scientific research elucidating the causes, mechanisms, and prevention strategies for fluorosis, there remains a significant gap between scientific understanding and public health implementation. While the scientific community has made significant strides in understanding the etiology and prevention of fluorosis, effectively translating this knowledge into public health policies and practices remains challenging. This review explores the gap between scientific research on fluorosis and its practical implementation in public health initiatives. It suggests developing evidence-based guidelines for fluoride exposure and recommends comprehensive educational campaigns targeting the public and healthcare providers. Furthermore, it emphasizes the need for further research to fill the existing knowledge gaps and promote evidence-based decision-making. By fostering collaboration, communication, and evidence-based practices, policymakers, healthcare professionals, and the public can work together to implement preventive measures and mitigate the burden of fluorosis on affected communities. This review highlighted several vital strategies to bridge the gap between science and public health in the context of fluorosis. It emphasizes the importance of translating scientific evidence into actionable guidelines, raising public awareness about fluoride consumption, and promoting preventive measures at individual and community levels.
Article
Full-text available
Background: Dental disease remains a public health concern of this era. In 2020, World Health Organization reported that 3.5 billion of oral disease occurs every year. About 2.3 billion case is attributed to dental caries while gum disease affects 10% of the global population. Methods: This was a case control study carried out from November 2020 to February 2021. About 120 participants were recruited, of them, 60 were oral diseased, while the remaining 60 were selected as a control group. Oral swab samples were collected with the swab stick, and put into plastic sterile container to avoid external microbial contamination. Samples were transported to INES clinical microbiology laboratory for microbial identification. chi square was performed to test for association, while odd ratios and relative risk were performed to test for pathogenic microbial fraction. Results: The common oral diseases were tooth decay (56.6%) and gum disease (43.4%). the most affected age range was 5‑19years (53.33%), while females (63.3%) were the most affected sex. The most isolated microorganism was Lactobacillus spp (15.8%) for patients, while Staphylococcus aureus (11.2%) was the most isolate in the control group. The statistical significant association with oral microbial alteration and oral disease was observed on Streptococcus mutans (x2=8.9, P= 0.002852), Lactobacillus spp (x2=9.84, P=0.001708), Candida spp (x2=5.2, P=0.02258), Staphylococcus aureus (x2 = 15.6, P= 0.000078), and Providencia spp (x2 = 6, P=0.014306). The overall oral microbial alteration (x2=53, P< 0.00001) was statistically significant. The ratio of pathogenic microorganisms (OR=4, 95%CI:2.3786‑7.062 and RR=1.477, 95%CI:1.2478‑1.7153) was significantly associated with oral disease. Conclusion: Oral microbial alteration contributes to oral disease. Early detection of oral microbial alteration, and oral diseases are recommended.
Article
Full-text available
Nanotechnology has been considered as multidisciplinary field of scientific research about different types of nanoparticles as well as the application of new nanomaterials and nanodevices in numerous areas of human interest. It offers advances in industry, engineering, information and communication technology, electronics, environmental science and energy savings, economics etc. New nanoproducts and nanotehnology could be applied in almost all fields of human activity. Potential benefit of nanomaterials and nanorobots applied in medicine and dentistry is of main concern when thinking about nanoadvances. However, nanotechnology has become a controversial issue between scientific and public opinions due to the insufficient knowledge of potential hazard to human health and environment. Some of the raised questions are what are the advantages and disadvantages of nanotechnological evolution, and what kind of future can be expected when changes gain wider scale? The aim of this study was to present the importance of nanotechnology in various areas, especially in medicine and dentistry, and to point out possible consequences of their use to human health and environment.
Article
Full-text available
Maternal nutrition status during pregnancy may affect fetal tooth development, formation, and mineralization, and may affect dental caries susceptibility in children. We investigated the association between maternal intake of dairy products and calcium during pregnancy and the risk of childhood dental caries. Subjects were 315 Japanese mother-child pairs. Data on maternal intake during pregnancy were assessed through a diet history questionnaire. Outcome data was collected at 41-50 months of age. Children were classified as having dental caries if one or more primary teeth had decayed or been filled. Higher maternal cheese intake during pregnancy was significantly inversely associated with the risk of dental caries in children, showing a clear inverse dose-response relationship; the adjusted odds ratio (OR) in comparison of the highest tertile with the lowest was 0.37 (95% confidence interval [CI]: 0.17-0.76, P for trend=0.01). The inverse associations between maternal intake of total dairy products, yogurt, and calcium during pregnancy and the risk of childhood dental caries were of borderline significance: the adjusted ORs for the highest tertile of total dairy products, yogurt, and calcium were 0.51 (95% CI: 0.23-1.09, P for trend=0.07), 0.51 (95% CI: 0.23-1.10, P for trend=0.07), and 0.50 (95% CI: 0.23-1.07, P for trend=0.08), respectively. There was no evident relationship between maternal milk intake and the risk of childhood dental caries. These data suggested that high intake of maternal cheese during pregnancy may reduce the risk of childhood dental caries.
Article
Full-text available
To evaluate the prevalence of periodontal disease (PD) among Brazilian low-risk pregnant women and its association with sociodemographic factors, habits and oral hygiene. This cross-sectional study included 334 low-risk pregnant women divided in groups with or without PD. Indexes of plaque and gingival bleeding on probing, probing pocket depth, clinical attachment level and gingival recession were evaluated at one periodontal examination below 32 weeks of gestation. Independent variables were: age, race/color, schooling, marital status, parity, gestational age, smoking habit, alcohol and drugs consumption, use of medication, presence of any systemic diseases and BMI (body mass index). Statistical analyses provided prevalence ratios and their respective 95%CI and also a multivariate analysis. The prevalence of PD was 47% and significantly associated with higher gestational age (PR 1.40; 1.01-1.94 for 17-24 weeks and PR 1.52; 1.10-2.08 for 25-32 weeks), maternal age 25-29 years, obesity (PR 1.65; 1.02-2.68) and the presence of gingival bleeding on probing (OR(adj) 2.01, 95%CI 1.41-2.88). Poor oral hygiene was associated with PD by the mean values of plaque and bleeding on probing indexes significantly greater in PD group. The prevalence of PD is high and associated with gingival bleeding on probing, more advanced gestational age and obesity. A program of oral health care should be included in prenatal care for early pregnancy, especially for low-income populations.
Article
Full-text available
Individuals connected to supportive social networks have better general and oral health quality of life. The objective of this study was to assess whether there were differences in oral health related quality of life (OHRQoL) between women connected to either predominantly home-based and work-based social networks. A follow-up prevalence study was conducted on 1403 pregnant and post-partum women (mean age of 25.2 ± 6.3 years) living in two cities in the State of Rio de Janeiro, Brazil. Women were participants in an established cohort followed from pregnancy (baseline) to post-partum period (follow-up). All participants were allocated to two groups; 1. work-based social network group--employed women with paid work, and, 2. home-based social network group--women with no paid work, housewives or unemployed women. Measures of social support and social network were used as well as questions on sociodemographic characteristics and OHRQoL and health related behaviors. Multinomial logistic regression was performed to obtain OR of relationships between occupational contexts, affectionate support and positive social interaction on the one hand, and oral health quality of life, using the Oral Health Impacts Profile (OHIP) measure, adjusted for age, ethnicity, family income, schooling, marital status and social class. There was a modifying effect of positive social interaction on the odds of occupational context on OHRQoL. The odds of having a poorer OHIP score, ≥ 4, was significantly higher for women with home-based social networks and moderate levels of positive social interactions [OR 1.64 (95% CI: 1.08-2.48)], and for women with home-based social networks and low levels of positive social interactions [OR 2.15 (95% CI: 1.40-3.30)] compared with women with work-based social networks and high levels of positive social interactions. Black ethnicity was associated with OHIP scores ≥ 4 [OR 1.73 (95% CI: 1.23-2.42)]. Pregnant and post-partum Brazilian women in paid employment outside the home and having social supports had better OHRQoL than those with home-based social networks.
Article
Full-text available
The man, as a social being, has always wanted to live in a group. Mankind has been developing urban settlements for the last four thousand years out of two million years, that being the period during which the humans have existed on Earth. The balance between the number of inhabitants living in rural areas and those living in urban regions was disturbed in the last century as a result of industrial development [1]. Nowadays, more than a half of the world population lives in towns/cities and since there is a significant trend of further increase in the number of people living in urban environment, the percentage of population gravitating toward cities is expected to get even higher, particularly in undeveloped countries. Even now, more than 70% of population live in urban regions in developed countries and the number of cities with multi-million population, which are called megalopolises, is on the rise.The promotion of population health implies the orientation to those factors most affecting health (health potential). It is common nowadays to make a long list of health determinants such as heritage and individual characteristics, lifestyles, environment and availability, accessibility and efficiency of health services. Differences in the health status of population, among population groups and countries point to the fact that all of the above determinants are related to social and economic factors, which represent the basis of the social development of any local community, particularly of an urban environment. In order to prevent marginalization, unsafe living conditions and contracting diseases in these population groups the health policy must be integrated into a broader concept of the social policy, which implies taking measures and activities which are partly beyond the capacity of health sector but based on the values recognized by the European Council – respecting human and patients’ rights, dignity, righteousness, solidarity, equal opportunities for both sexes, participation in decision-making, freedom of choice – and balanced by the obligation to strengthen the responsibility for one’s own health. These measures and activities depend on national, regional and local community conditions and include the following sectors: education, housing, environmental conditions, health care and various kinds of interventions within social welfare. The focus of consideration has been placed on cities and urban environments. The modern approach to global problems and to tackling environmental and economic challenges as well as those associated with human health is aimed at achieving human well-being now and in the future. The importance of planning has been emphasized; changes in work organization have been directed towards better co-operation; the emphasis is placed on the support given to the community as well as to inter-sector cooperation, all of which speak of the fact that urban environment has become the focal point of activities and endeavours. All the needs that a modern man has within the community, craving for good quality of life, development of the community, economic and social progress, our necessity for available and accessible health care and education not only at the present moment but in the future as well lead towards the concept of sustainable development. Strategies and programmes within public health and health promotion should be, therefore, adapted to local needs and possibilities of certain urban surroundings and local communities taking into account different social, cultural and economic systems and in accordance of the principles of sustainable development.
Article
Primary health care providers are in a unique position to treat the pregnant mothers for dental as well as general health for a healthy mother and child. Oral cavity is also subjected to reversible as well as irreversible changes due to hormonal changes during pregnancy. Perinatal mortality rates in Pakistan are more than 10-fold greater than in developed countries. It increased with the severity of periodontal disease. Patients, physicians, and dentists are cautious, often avoiding treatment of oral health issues during pregnancy. This problem is compounded by a lack of clinical guidelines for the prevention and management of common oral conditions in pregnancy. This article reviews the commonly occuring oral problems during pregnancy and their management, guidelines for prenatal counselling, dental procedures that can be carried out during pregnancy and preventive strategies that could be helpful in preventing the commonly occurring diseases such as dental caries and periodontal disease.
Article
We sought to determine if treatment of periodontal disease during pregnancy with an alcohol-free antimicrobial mouth rinse containing cetylpyridinium chloride impacts the incidence of preterm birth (PTB) in a high-risk population. This single-blind clinical trial studied pregnant women (6-20 weeks' gestation) with periodontal disease who refused dental care. Subjects receiving mouth rinse were compared to designated controls who did not receive rinse (1 rinse:2 controls), balanced on prior PTB and smoking. Primary outcome was PTB <35 weeks. In all, 226 women were included in the analysis (71 mouth rinse subjects, 155 controls). Incidence of PTB <35 weeks was lower in the rinse group compared to controls (5.6% and 21.9% respectively, P < .01); relative risk was 0.26 (95% confidence interval, 0.096-0.70). Gestational age and birthweight were significantly higher in the rinse group (P < .01). A nonalcohol antimicrobial mouth rinse containing cetylpyridinium chloride was associated with decreased incidence of PTB <35 weeks.