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: 1.37).
02/2008; 21(1):63-71. DOI: 10.1080/14767050701796681
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.
Available from: Robert A Yaffee
- "Also, because of a lack of knowledge regarding the safety of treatment during pregnancy, fear of malpractice, or fear that a woman may go into labor, dentists may refuse outright to treat pregnant women (Strafford et al., 2008), may revise treatment plans when they discover a woman's pregnancy, or may postpone care until after the woman has given birth (Livingston et al., 1998; Pistorius et al., 2003). Additionally, some pregnant women feel that going to the dentist is unsafe during pregnancy (Strafford et al., 2008) and may postpone treatment until after the birth, but at that point access to dental care may be restricted due to childcare and time or financial constraints (Redford, 1993). Pregnant women in the US have high levels of dental disease (Silberman et al., 1980) and treatment needs (Gaffield et al., 2001; Lydon-Rochelle et al., 2004), but the proportion of pregnant women who report having a dental visit is low (22.4- "
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ABSTRACT: While parity (number of children) reportedly is related to tooth loss, the relationship between parity and dental caries has not been extensively investigated. We used path analysis to test a theoretical model that specified that parity influences dental caries levels through dental care, psycho- social factors, and dental health damaging behaviors in 2635 women selected from the NHANES III dataset. We found that while increased parity was not associated with a greater level of total caries (DFS), parity was related to untreated dental caries (DS). The mechanisms by which parity is related to caries, however, remain undefined. Further investigation is warranted to determine if disparities in dental caries among women are due to differences in parity and the likely changes that parallel these reproductive choices.
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ABSTRACT: For decades pastoral theology has emphasized care for the whole person and, more recently, this focus has been expanded to include caring for the physical health of parishioners. However, an overlooked area of general fitness has been the importance of oral health. Dental caries and periodontal disease are among the most common chronic diseases that disproportionately affect the most vulnerable populations. Despite significant progress in preventing and managing these oral diseases, there is a large segment of the population that have not experienced the same gains. This paper seeks to begin to fill this gap by identifying key epidemiological, professional and ethical issues related to social justice and oral health. Disparities of oral disease and access to oral health care in the United States will be addressed by examining questions and issues related to social justice. Critical problems are identified, including inadequate financial resources, a disjointed infrastructure of care, separation from the general medical care system, and poor understanding of important oral health determinants. Furthermore, if oral health is integral to one’s overall health and general well-being, then the concept of a basic human right should be entertained. Faith-based groups could provide a link for bridging this disparity gap in oral health among their parishioners through active listening, advocacy and targeted educational programs.
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ABSTRACT: A growing number of studies and reports indicate preventive, routine and emergency dental procedures can be provided safely to pregnant patients to alleviate dental problems and promote oral health of mothers and children.
In 2006 and 2007, the authors conducted a survey of 1,604 general dentists in Oregon. The survey asked dentists about their attitudes, beliefs and practices regarding dental care for pregnant patients. The authors compared the responses with 2006 guidelines from a New York State Department of Health expert panel.
The response rate was 55.2 percent. Most respondents (91.7 percent) agreed that dental treatment should be part of prenatal care. Two-thirds of respondents (67.7 percent) were interested in receiving continuing dental education (CDE) regarding the care of pregnant patients. Comparisons of self-reported knowledge and practice with the aforementioned guidelines revealed several points of difference; the greatest regarded obtaining full-mouth radiographs, providing nitrous oxide, administering long-acting anesthetic injections and use of over-the-counter pain medications.
Dentists need pregnancy-specific education to provide up-to-date preventive and curative care to pregnant patients. The results of the study identified specific skills and misinformation that could be addressed through CDE.
Comprehensive dental care provided during pregnancy is needed to ensure the oral health of all women at risk of experiencing pregnancy-specific problems, as well as the prevention of early childhood caries.
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