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The Case for Improved Interprofessional Care: Fatal Analgesic Overdose Secondary to Acute Dental Pain during Pregnancy. Case Rep Dent 2016; 2016:7467262. [PMID: 27847654 PMCID: PMC5101371 DOI: 10.1155/2016/7467262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 09/28/2016] [Indexed: 11/18/2022] Open
Abstract
Prenatal oral health extends beyond the oral cavity, impacting the general well-being of the pregnant patient and her fetus. This case report follows a 19-year-old pregnant female presenting with acute liver failure secondary to acetaminophen overdose for management of dental pain following extensive dental procedures. Through the course of her illness, the patient suffered adverse outcomes including fetal demise, acute kidney injury, spontaneous bacterial peritonitis, and septic shock before eventual death from multiple organ failure. In managing the pregnant patient, healthcare providers, including physicians and dentists, must recognize and optimize the interconnected relationships shared by the health disciplines. An interdisciplinary approach of collaborative and coordinated care, the timing, sequence, and treatment for the pregnant patient can be improved and thereby maximize overall quality of health. Continued efforts toward integrating oral health into general healthcare education through interprofessional education and practice are necessary to enhance the quality of care that will benefit all patients.
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Azofeifa A, Yeung LF, Alverson CJ, Beltrán-Aguilar E. Dental caries and periodontal disease among U.S. pregnant women and nonpregnant women of reproductive age, National Health and Nutrition Examination Survey, 1999-2004. J Public Health Dent 2016; 76:320-329. [PMID: 27154283 PMCID: PMC5097890 DOI: 10.1111/jphd.12159] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 02/29/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study assessed and compared the prevalence and severity of dental caries and the prevalence of periodontal disease among pregnant and nonpregnant women of reproductive age (15-44 years) using data from the National Health and Nutrition Examination Survey, NHANES (1999-2004). METHODS Estimates were derived from a sample of 897 pregnant women and 3,971 nonpregnant women. Chi-square and two-sample t-tests were used to assess differences between groups stratified by age, race/ethnicity, education, and poverty. Bonferroni method was applied to adjust for multiple comparisons. RESULTS In general, there were no statistically significant differences in the prevalence estimates of dental caries and periodontal disease between pregnant women and nonpregnant women. However, results showed significant differences when stratified by sociodemographic characteristics. For example, the prevalence of untreated dental caries among women aged 15-24 years was significantly higher in pregnant women than in nonpregnant women (41 percent versus 24 percent, P = 0.001). Regardless of their pregnancy status, racial/ethnic minorities or women with less education or lower family income had higher prevalence of untreated dental caries, severity of dental caries, and periodontal disease compared to the respective reference groups of non-Hispanic whites or women with more education or higher family income. CONCLUSION Results of this study show few clinical differences in dental caries and periodontal disease between pregnant and nonpregnant women but persistent disparities by sociodemographic characteristics. In order to reduce oral health disparities in the United States, it is important to improve access to oral health care particularly among vulnerable groups. Integrating oral health into the overall health care could benefit and improve women's oral health outcomes.
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Affiliation(s)
- Alejandro Azofeifa
- Division of Evaluation, Analysis and Quality, Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lorraine F. Yeung
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - C. J. Alverson
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
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Suresh KS, Kumar P, Javanaiah N, Shantappa S, Srivastava P. Primary Oral Health Care in India: Vision or Dream? Int J Clin Pediatr Dent 2016; 9:228-232. [PMID: 27843255 PMCID: PMC5086011 DOI: 10.5005/jp-journals-10005-1369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 03/21/2016] [Indexed: 11/23/2022] Open
Abstract
The contemporary approach to dental caries management in children focuses on prevention than treatment. Pediatricians, general dentists and pediatric dentists must be involved in a detailed preventive program, which includes prenatal counselling, treatment of expectant mothers at risk for dental caries, infant oral health care and the establishment of the dental home, so that dental disease can be prevented in infants, starting at a young age. Various health care system and organizations in India must join together to promote oral health care for all the children and specially focused toward children from disadvantaged background and children with special health care needs. HOW TO CITE THIS ARTICLE Suresh KS, Kumar P, Javanaiah N, Shantappa S, Srivastava P. Primary Oral Health Care in India: Vision or Dream? Int J Clin Pediatr Dent 2016;9(3):228-232.
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Affiliation(s)
- Kotumachagi S Suresh
- Professor and Head, Department of Pedodontics, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Pravin Kumar
- Postgraduate, Department of Pedodontics and Preventive Dentistry Government Dental College and Research Institute, Bengaluru Karnataka, India
| | - Nagarathna Javanaiah
- Lecturer and Assistant Professor, Department of Pedodontics, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Shruti Shantappa
- Postgraduate Student, Department of Pedodontics, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Pooja Srivastava
- Postgraduate Student, Department of Pedodontics, Government Dental College and Research Institute, Bengaluru, Karnataka, India
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Kolisa Y. Assessment of oral health promotion services offered as part of maternal and child health services in the Tshwane Health District, Pretoria, South Africa. Afr J Prim Health Care Fam Med 2016; 8:e1-8. [PMID: 27247154 PMCID: PMC4845516 DOI: 10.4102/phcfm.v8i1.794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 02/15/2016] [Accepted: 10/30/2015] [Indexed: 11/29/2022] Open
Abstract
Objectives The study aimed to assess the oral health promotion services provided as part of the maternal and child health (MCH) services in the Tshwane Health District, Pretoria, South Africa. Methods The research design was a descriptive cross-sectional study using a modified standard questionnaire. The population was drawn from the parents/caregivers (PCGs) and the MCH nurses at seven clinics during June 2012 and June 2013 in Pretoria. Results The nurses’ response rate was 83%; average age of 37 years. The majority of the nurses (65%) were females; 60% were professional nurses. Most (63%) of the nurses reported that they provided oral health education (OHE) services. A shortage of dental education materials (43%), staff time (48%), and staff training (52%) were large constraints to nurses providing OHE. The majority of PCGs (n = 382; mean age 31.5 years) had a low education level (76%). About 55% of PCGs received information on children’s oral health from the television and 35% at the MCH clinics. PCGs beliefs were worrying as about 38% believed primary dentition is not important and need not be saved. Conclusion There is evidence of minimal integration of OHE at MCH sites. Parents’ beliefs are still worrying as a significant number do not regard the primary dentition as important. The MCH site remains an important easily accessible area for integration of oral health services with general health in complementing efforts in prevention of early childhood caries.
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Affiliation(s)
- Yolanda Kolisa
- Department of Community Dentistry, University of Witwatersrand.
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Oral-systemic health during pregnancy: exploring prenatal and oral health providers' information, motivation and behavioral skills. Matern Child Health J 2016; 19:1263-75. [PMID: 25366104 DOI: 10.1007/s10995-014-1632-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Pregnancy is identified as a sensitive period of increased risk for poor oral health among mothers and offspring. Subsequently, both medical and dental associations have re-endorsed consolidated, inter-professional guidelines promoting oral health during pregnancy. The objective was to explore prenatal and oral health providers' information, motivation and practice behaviors related to oral health during pregnancy. Twenty-two in-depth interviews were conducted with prenatal and oral health providers based on the Information-Motivation-Behavioral Skills Model. Data were analyzed using the constant comparative method in NVivo 10. Providers held variable knowledge with regards to identified oral-systemic connections and implications. Most providers were unaware of the guidelines; however, some oral health providers reported avoiding specific treatment behaviors during this period. Motivation to address oral-systemic health during pregnancy included: prevention; healthy pregnancy/birth outcomes; patient's complaint/question as cue to action; comprehensive, patient-centered, and family-centered care; ethical duty; and professional governing body. Oral health providers reported assessing, educating, and communicating with patients about oral health issues; whereas prenatal providers rarely addressed oral health but reported signing approval forms to receive such care. A few oral health providers highlighted lifecourse implications and the need for family-centered care when addressing poor oral health among pregnant patients. Findings suggest gaps in oral health prevention information and behaviors among prenatal and oral health providers. Future efforts should examine effective dissemination and implementation strategies that translate evidence-based guidelines into clinical practice, with the ultimate goal of improve oral-systemic health among women and their offspring across the lifecourse.
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Stein REK, Hurlburt MS, Heneghan AM, Zhang J, Kerker B, Landsverk J, Horwitz SM. For Better or Worse? Change in Service Use by Children Investigated by Child Welfare Over a Decade. Acad Pediatr 2016; 16:240-6. [PMID: 26851614 PMCID: PMC5560869 DOI: 10.1016/j.acap.2016.01.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 01/25/2016] [Accepted: 01/29/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Children, particularly minority children, referred to child welfare because of suspected maltreatment are vulnerable and need many services. We sought to assess whether service use has improved over the past decade and whether racial-ethnic disparities in service use have decreased. METHODS We used 2 national data sets (the National Survey of Child and Adolescent Well-Being [NSCAW] I and II) collected a decade apart to assess changes over time in health, education, mental health (MH), and dental services and overall service use. RESULTS In NSCAW II more children were young, had lower Child Behavior Checklist (CBCL) scores, and were Hispanic. We found significant increases in dental services, a decrease in special education services, and a decrease in MH services on the bivariate level (all P < .01). A large proportion of the change in MH services occurred in school settings, but the pattern continued when examining only those services delivered outside of school. The greatest decrease occurred for children with CBCL scores <64. However, in multivariate analyses, older children, white non-Hispanic children, and children placed out of the home were significantly more likely to receive MH services. Rates of MH services controlling for CBCL scores showed no improvement over the decade, nor was there a decrease in racial and ethnic disparities. CONCLUSIONS These data showed no change in MH services over time for children referred for child welfare evaluation, but improvement in dental services was noted. Racial and ethnic disparities persist. Decrease in MH services occurred predominantly among children whose MH symptoms were below the clinical range.
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Affiliation(s)
- Ruth E K Stein
- Albert Einstein College of Medicine/Children's Hospital at Montefiore, New York, NY.
| | - Michael S Hurlburt
- School of Social Work, University of Southern California, Los Angeles, Calif; Child and Adolescent Services Research Center, Rady Children's Hospital, San Diego, Calif
| | - Amy M Heneghan
- Palo Alto Medical Foundation, Palo Alto, Calif; Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Jinjin Zhang
- Child and Adolescent Services Research Center, Rady Children's Hospital, San Diego, Calif
| | - Bonnie Kerker
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY; Nathan Kline Institute for Psychiatric Research, Orangeburg, NY
| | - John Landsverk
- Child and Adolescent Services Research Center, Rady Children's Hospital, San Diego, Calif
| | - Sarah McCue Horwitz
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY
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Oberoi J, Kathariya R, Panda A, Garg I, Raikar S. Dental knowledge and awareness among grandparents. World J Clin Pediatr 2016; 5:112-7. [PMID: 26862510 PMCID: PMC4737685 DOI: 10.5409/wjcp.v5.i1.112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 08/06/2015] [Accepted: 10/16/2015] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate grandparent's knowledge and awareness about the oral health of their grandchildren. METHODS Grandparents accompanying patients aged 4-8 years, who were living with their grandchildren and caring for them for a major part of the day, when both their parents were at work were included in the study. A 20-item questionnaire covering socio-demographic characteristics, dietary and oral hygiene practices was distributed to them. The sample comprised of 200 grandparents (59 males, 141 females). χ(2) analysis and Gamma test of symmetrical measures were applied to assess responses across respondent gender and level of education. RESULTS Oral health related awareness was found to be low among grandparents. In most questions asked, grandparents with a higher level of education exhibited a better knowledge about children's oral health. Level of awareness was not related to their gender. CONCLUSION Oral hygiene and dietary habits are established during childhood. There is a great need for dental education of grandparents as they serve as role models for young children.
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Kell DB, Kenny LC. A Dormant Microbial Component in the Development of Preeclampsia. Front Med (Lausanne) 2016; 3:60. [PMID: 27965958 PMCID: PMC5126693 DOI: 10.3389/fmed.2016.00060] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 11/04/2016] [Indexed: 12/12/2022] Open
Abstract
Preeclampsia (PE) is a complex, multisystem disorder that remains a leading cause of morbidity and mortality in pregnancy. Four main classes of dysregulation accompany PE and are widely considered to contribute to its severity. These are abnormal trophoblast invasion of the placenta, anti-angiogenic responses, oxidative stress, and inflammation. What is lacking, however, is an explanation of how these themselves are caused. We here develop the unifying idea, and the considerable evidence for it, that the originating cause of PE (and of the four classes of dysregulation) is, in fact, microbial infection, that most such microbes are dormant and hence resist detection by conventional (replication-dependent) microbiology, and that by occasional resuscitation and growth it is they that are responsible for all the observable sequelae, including the continuing, chronic inflammation. In particular, bacterial products such as lipopolysaccharide (LPS), also known as endotoxin, are well known as highly inflammagenic and stimulate an innate (and possibly trained) immune response that exacerbates the inflammation further. The known need of microbes for free iron can explain the iron dysregulation that accompanies PE. We describe the main routes of infection (gut, oral, and urinary tract infection) and the regularly observed presence of microbes in placental and other tissues in PE. Every known proteomic biomarker of "preeclampsia" that we assessed has, in fact, also been shown to be raised in response to infection. An infectious component to PE fulfills the Bradford Hill criteria for ascribing a disease to an environmental cause and suggests a number of treatments, some of which have, in fact, been shown to be successful. PE was classically referred to as endotoxemia or toxemia of pregnancy, and it is ironic that it seems that LPS and other microbial endotoxins really are involved. Overall, the recognition of an infectious component in the etiology of PE mirrors that for ulcers and other diseases that were previously considered to lack one.
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Affiliation(s)
- Douglas B. Kell
- School of Chemistry, The University of Manchester, Manchester, UK
- The Manchester Institute of Biotechnology, The University of Manchester, Manchester, UK
- Centre for Synthetic Biology of Fine and Speciality Chemicals, The University of Manchester, Manchester, UK
- *Correspondence: Douglas B. Kell,
| | - Louise C. Kenny
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
- Department of Obstetrics and Gynecology, University College Cork, Cork, Ireland
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McNeil DW, Hayes SE, Randall CL, Polk DE, Neiswanger K, Shaffer JR, Weyant RJ, Foxman B, Kao E, Crout RJ, Chapman S, Brown LJ, Maurer JL, Marazita ML. Depression and Rural Environment are Associated With Poor Oral Health Among Pregnant Women in Northern Appalachia. Behav Modif 2015; 40:325-40. [PMID: 26643277 DOI: 10.1177/0145445515615353] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Both oral health problems and depression among pregnant women contribute to maternal-infant health outcomes. Little is known, however, about the potential effects of clinically significant depression on the oral health status of pregnant women. The purpose of the present study was to determine the influence of clinically significant depression and rural- or urban-dwelling status on oral health outcomes among pregnant women. Pregnant women (N = 685) in rural (i.e., West Virginia) and urban (i.e., Pittsburgh, PA) areas of northern Appalachia were assessed by calibrated examiners regarding gingivitis, oral hygiene, and DMFT (decayed, missing, and filled teeth), completed the Center for Epidemiologic Studies-Depression Scale (CES-D) and provided demographics. Participants were categorized based on clinically significant depressive symptoms (CES-D ≥ 16) and rural/urban domicile. Women with depression and those living in rural areas had worse oral health on all three indices than their non-depressed and urban counterparts. Depression, particularly among women in rural areas, affects certain oral health indices and represents a modifiable target for intervention. Moreover, treatments designed specifically for rural populations may be of particular utility. Women who are pregnant or planning to become pregnant may benefit from regular depression screenings from their dental and medical health care providers.
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Affiliation(s)
- Daniel W McNeil
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Sarah E Hayes
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Cameron L Randall
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Deborah E Polk
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
| | - Kathy Neiswanger
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
| | - John R Shaffer
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
| | - Robert J Weyant
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
| | - Betsy Foxman
- Center for Oral Health Research in Appalachia University of Michigan, Ann Arbor, USA
| | - Elizabeth Kao
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Richard J Crout
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Stella Chapman
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Linda J Brown
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Jennifer L Maurer
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
| | - Mary L Marazita
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
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Jeelani S, Khader KA, Rangdhol RV, Dany A, Paulose S. Coalition of attitude and practice behaviors among dental practitioners regarding pregnant patient's oral health and pregnant patient's perception toward oral health in and around Pondicherry. J Pharm Bioallied Sci 2015; 7:S509-12. [PMID: 26538908 PMCID: PMC4606650 DOI: 10.4103/0975-7406.163520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: This study aims to evaluate the knowledge, attitude, practice behaviors among general dental practitioners and assess the perception toward oral health by pregnant patients in and around Puducherry. Methodology: A self-designed and structured questionnaire was used to obtain information from the dental practitioner and the pregnant patients. Results: The majority of the dental practitioners had a lack of knowledge, attitude, practice behaviors regarding pregnant patient's oral health and similarly majority of pregnant patient's perception toward oral health was poor. Conclusions: Drowning and dilemmatic attitude and practice behavior of dentists to be streamlined to render right care to the pregnant women at the right time. Perplexing perception toward oral health care by pregnant women to be overcome to orient them to understand the impact of oral health on their general systemic health.
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Affiliation(s)
- S Jeelani
- Department of Oral Medicine and Radiology, Indira Gandhi Institute of Dental Sciences, SBV, Puducherry, India
| | - K Abdul Khader
- Department of Oral Medicine and Radiology, Indira Gandhi Institute of Dental Sciences, SBV, Puducherry, India
| | - R Vishwanath Rangdhol
- Department of Oral Medicine and Radiology, Indira Gandhi Institute of Dental Sciences, SBV, Puducherry, India
| | - A Dany
- Department of Oral Medicine and Radiology, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Swetha Paulose
- Department of Oral Medicine and Radiology, Indira Gandhi Institute of Dental Sciences, SBV, Puducherry, India
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Desai K, Desai P, Duseja S, Kumar S, Mahendra J, Duseja S. Significance of maternal periodontal health in preeclampsia. J Int Soc Prev Community Dent 2015; 5:103-7. [PMID: 25992334 PMCID: PMC4415327 DOI: 10.4103/2231-0762.155734] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective: The aim of the present case–control study was to evaluate the association between maternal periodontitis and preeclampsia. Association studies between maternal periodontitis and elevated risk for preeclampsia have shown conflicting results. Periodontal maintenance is necessary to reduce the risk of adverse pregnancy outcomes like preeclampsia. Materials and Methods: Periodontal parameters [bleeding on probing, probing depth (PD), and clinical attachment level (CAL)] of 1320 women were assessed, followed by retrieval of their demographic and medical data from the medical records. Based on the medical records, 80 women were excluded from the study, leaving 1240 females as the eligible sample for the study. The women were divided into control group (1120 non-preeclamptic women who gave birth to infants with adequate gestational age) and case group (120 preeclamptic women). Logistic regression analysis revealed that primiparity and maternal periodontitis were the two significant variables causing preeclampsia. Further analysis was carried out by matching the two groups for primiparity to find the significance of maternal periodontitis. Maternal periodontitis was defined as PD ≥4 mm and CAL ≥3 mm at the same site in at least four teeth. Results: The results showed that maternal periodontitis (odds ratio 19.8) was associated with preeclampsia. Maternal periodontitis also remained associated with preeclampsia after matching for primiparity, which was another significant confounding factor in the study (odds ratio 9.33). Conclusion: Maternal periodontitis is a risk factor associated with preeclampsia, emphasizing the importance of periodontal care in prenatal programs.
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Affiliation(s)
- Khushboo Desai
- Department of Periodontics, Karnavati School of Dentistry, Gujarat, India
| | - Parth Desai
- Department of Conservative Dentistry and Endodontics, Karnavati School of Dentistry, Gujarat, India
| | - Shilpa Duseja
- Department of Periodontics, Karnavati School of Dentistry, Gujarat, India
| | - Santosh Kumar
- Department of Periodontics, Karnavati School of Dentistry, Gujarat, India
| | - Jaideep Mahendra
- Department of Periodontics, Meenakshi Ammal Dental College, Tamil Nadu, India
| | - Sareen Duseja
- Department of Prosthodontics, Karnavati School of Dentistry, Gujarat, India
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Vamos CA, Thompson EL, Avendano M, Daley EM, Quinonez RB, Boggess K. Oral health promotion interventions during pregnancy: a systematic review. Community Dent Oral Epidemiol 2015; 43:385-96. [PMID: 25959402 DOI: 10.1111/cdoe.12167] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 03/31/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Maternal oral disease during pregnancy is a significant public health issue due to its prevalence and lifecourse connections with adverse pregnancy/birth outcomes, early childhood caries, and chronic diseases. Although both medical and dental professional organizations have discipline-specific and co-endorsed guidelines, whether interventions exist that translate oral health evidence into practice remains unknown. Thus, we conducted a systematic review to examine the range, scope and impact of existing oral health promotion interventions during pregnancy. METHODS Search terms related to oral health, health promotion, and pregnancy produced 7754 articles published before March 2013 from five search engines. INCLUSION CRITERIA (i) intervention-based; (ii) quasi-experimental, experimental, or pretest/post-test design; (iii) pregnant women participants; (iv) outcomes including oral health knowledge, attitudes, and/or behaviors; (v) ≥5 participants; (vi) peer-review publication; and (vii) English language. RESULTS All interventions (n = 7) were delivered in prenatal care settings and focused on education. Modalities varied, including the use of oral instruction and audiovisual presentations, in both individual and group formats; however, content was directed toward infant oral health. Few studies specifically addressed prenatal oral health guidelines. Primary outcomes measured included knowledge, beliefs, attitudes, self-efficacy and oral hygiene, and health-seeking behaviors. All but one study showed significant improvement in one of these outcomes postintervention. CONCLUSIONS Few oral health interventions among pregnant women addressed oral-related symptoms, hygiene behaviors, and potential oral-systemic implications specific to mothers. Subsequently, more theory- and evidence-based interventions addressing current prenatal oral health guidelines using rigorous designs are needed to improve oral and systemic health for both women and their offspring.
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Affiliation(s)
- Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Erika L Thompson
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Maryouri Avendano
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Rocio B Quinonez
- Department of Pediatric Dentistry, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kim Boggess
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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64
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Azofeifa A, Yeung LF, Alverson CJ, Beltrán-Aguilar E. Oral health conditions and dental visits among pregnant and nonpregnant women of childbearing age in the United States, National Health and Nutrition Examination Survey, 1999-2004. Prev Chronic Dis 2014; 11:E163. [PMID: 25232750 PMCID: PMC4170723 DOI: 10.5888/pcd11.140212] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Oral diseases can be prevented or improved with regular dental visits. Our objective was to assess and compare national estimates on self-reported oral health conditions and dental visits among pregnant women and nonpregnant women of childbearing age by using data from the National Health and Nutrition Examination Survey (NHANES). METHODS We analyzed self-reported oral health information on 897 pregnant women and 3,971 nonpregnant women of childbearing age (15-44 years) from NHANES 1999-2004. We used χ(2) and 2-sample t tests to assess statistical differences between groups stratified by age, race/ethnicity, poverty, and education. We applied the Bonferroni adjustment for multiple comparisons. RESULTS Our data show significant differences in self-reported oral health conditions and dental visits among women, regardless of pregnancy status, when stratified by selected sociodemographic characteristics. Significant differences were also found in self-reported oral health conditions and dental visits between pregnant and nonpregnant women, especially among young women, women from minority race/ethnicity groups, and women with less than high school education. CONCLUSION We found disparities in self-reported oral health conditions and use of dental services among women regardless of pregnancy status. Results highlight the need to improve dental service use among US women of childbearing age, especially young pregnant women, those who are non-Hispanic black or Mexican American, and those with low family income or low education level. Prenatal visits could be used as an opportunity to encourage pregnant women to seek preventive dental care during pregnancy.
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Affiliation(s)
- Alejandro Azofeifa
- Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-86 Atlanta, GA 30333. E-mail:
| | | | - C J Alverson
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Folayan MO, Chukwumah NM, Onyejaka N, Adeniyi AA, Olatosi OO. Appraisal of the national response to the caries epidemic in children in Nigeria. BMC Oral Health 2014; 14:76. [PMID: 24957148 PMCID: PMC4091672 DOI: 10.1186/1472-6831-14-76] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 06/16/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This article reviews the caries profile for children in Nigeria and proposes an appropriate framework for addressing the silent caries epidemic. DISCUSSION We reviewed the caries prevalence among children in Nigeria, assessed the existing responses to the caries epidemic including the national oral healthcare delivery situation in the country and discussed the current caries management in children. We then proposed a response framework for Nigeria. We argue that successful interventions will require the adoption of a socio-ecological model. This would ensure that the micro-, meso-, exo- and macrosystems required to support the behavioural, structural and biological interventions for promoting caries prevention are addressed. National oral health surveys are required to help understand the epidemiology, social determinants of and factors that undermine the ability of children to access oral health care. A global caries prevention agenda for children would help get the government's support for a national response agenda. Currently, there is no global call for action on the caries epidemic in children. This lack of an agenda needs to be urgently addressed. SUMMARY A combination of approaches for the prevention of caries in children in Nigeria is needed. A national survey is needed to generate the needed evidence for the planning of community relevant responses to the national caries epidemic in children. The design of a global health agenda for children is an important first step that can facilitate the development of a national oral health programme for children in Nigeria.
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Affiliation(s)
- Morenike O Folayan
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Nneka M Chukwumah
- Department of Child Dental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Nneka Onyejaka
- Department of Child Dental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Abiola A Adeniyi
- Department of Preventive Dentistry, Lagos State University College of Medicine, Ikeja, Lagos State, Nigeria
| | - Olubukola O Olatosi
- Department of Child Dental Health, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
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Lee HJ, Jun JK, Lee SM, Ha JE, Paik DI, Bae KH. Association between obesity and periodontitis in pregnant females. J Periodontol 2014; 85:e224-31. [PMID: 24502613 DOI: 10.1902/jop.2014.130578] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND The purpose of this study is to investigate whether overweight and obesity before pregnancy are associated with periodontitis during pregnancy. METHODS This study examined a total of 315 pregnant females at 21 to 24 weeks of gestation. Overweight and obesity were defined based on criteria proposed by the World Health Organization Expert Consultation. Periodontal conditions were assessed by measuring clinical periodontal attachment loss (AL). To investigate whether obese pregnant females have increased risk according to the extent of periodontitis, the data were divided into two groups: 1) generalized periodontitis and 2) localized periodontitis. A comparison among underweight, normal-weight, and overweight/obese groups for explanatory variables was analyzed using the χ(2) test for categorical variables and an analysis of variance for continuous variables. Multivariate logistic regression analysis was performed with adjustments for age, health and oral health behaviors, and obstetric information. RESULTS Age, age at first delivery, periodontitis, and periodontal conditions (two or more interproximal sites with AL ≥4 mm not on the same tooth) were significantly associated with body mass index (BMI) (P <0.05). The adjusted odds ratio of periodontitis was 4.57 (95% confidence interval = 2.30 to 9.07) for overweight and obese females (BMI ≥23 kg/m(2)), after adjusting for all of the covariates. CONCLUSION There is a strong association between prepregnancy overweight/obesity and periodontitis in pregnant females.
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Affiliation(s)
- Hyo-Jin Lee
- Department of Preventive and Public Health Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
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Kim NH, Lee EJ, Kwak SY, Park MR. A Phenomenological Study on the Experiences of Parenting Burden of Working Mother with Young Children in Korea. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2013; 19:188-200. [PMID: 37684764 DOI: 10.4069/kjwhn.2013.19.3.188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023] Open
Abstract
PURPOSE The purpose of this study was to describe the essential structure of the lived experience of working mothers' parenting burden in Korea. METHODS Eight working mothers with young children were interviewed. The Colaizzi analysis of phenomenological research was applied. RESULTS Seven theme clusters were extracted: a life with constant conflict, sense of guilt, feeling anxious because of lack of information about education for their children, social stigma as a deficient mother, family relationship becoming distant, a life being exhausted, day to day struggle. CONCLUSION These results provide an opportunity to have a better understanding of the experiences of working mothers related to parenting their young children. It would also serve as a medium for the formulation of appropriate nursing intervention relevant to burdens of parenthood.
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Affiliation(s)
- Na Hyun Kim
- College of Nursing, Keimyung University, Daegu, Korea
| | - Eun Joo Lee
- College of Nursing, Keimyung University, Daegu, Korea
| | - Su Young Kwak
- College of Nursing, Keimyung University, Daegu, Korea
| | - Mee Ra Park
- College of Nursing, Keimyung University, Daegu, Korea
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Plonka K, Pukallus M, Barnett A, Holcombe T, Walsh L, Seow W. A Longitudinal Case-Control Study of Caries Development from Birth to 36 Months. Caries Res 2013. [DOI: 10.1159/000345073] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Merglova V, Hecova H, Stehlikova J, Chaloupka P. Oral health status of women with high-risk pregnancies. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2012; 156:337-41. [PMID: 23073528 DOI: 10.5507/bp.2012.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 04/12/2012] [Indexed: 11/23/2022] Open
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Alves RT, Ribeiro RA, Costa LR, Leles CR, Freire MDCM, Paiva SM. Oral care during pregnancy: attitudes of Brazilian public health professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012. [PMID: 23202756 PMCID: PMC3509465 DOI: 10.3390/ijerph9103454] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
There is little information about health professionals’ behavior regarding oral health care during pregnancy. We evaluated attitudes of obstetricians/gynecologists, nurses, and dentists working at a public community service towards pregnant women’s oral health. Health professionals responded to a self-applied questionnaire. Cluster analysis identified two clusters of respondents; Chi-square, Student’s t test, and logistic regression were used to compare the two clusters in terms of the independent variables. Respondents were categorized into cluster 1 ‘less favorable’ (n = 159) and cluster 2 ‘more favorable’ (n = 124) attitudes. Professionals that had attended a residency or specialization program (OR = 2.08, 95% CI = 1.15–3.77, p = 0.016) and worked exclusively at the public service (OR = 2.15, 95% CI = 1.10–4.20, p = 0.025) presented more favorable attitudes. Obstetricians/gynecologists (OR = 0.22, 95% CI = 0.09–0.54, p = 0.001) and nurses (OR = 0.50, 95% CI = 0.29–0.86, p = 0.013) showed less favorable attitudes than dentists. Health care providers’ attitudes regarding pregnant women’s oral health were related to their occupation, qualification, and dedication to the public service.
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Affiliation(s)
- Renata Toledo Alves
- Estacio de Sa College, Avenida Presidente Joao Goulart, 600, Cruzeiro do Sul, Juiz de Fora, MG 30130-900, Brazil;
| | - Rosangela Almeida Ribeiro
- Department of Social and Child Dentistry, Faculty of Dentistry, Federal University of Juiz de Fora, Rua José Lourenço Kelmer, Bairro São Pedro, Juiz de Fora, MG 36036-900, Brazil;
| | - Luciane Rezende Costa
- Department of Preventive and Restorative Dentistry, Faculty of Dentistry, Federal University of Goias, Primeira Avenida, Setor Universitario, Goiania, GO 74605-220, Brazil;
- Author to whom correspondence should be addressed; ; Tel.: +55-62-3209-6047; Fax: +55-62-3209-6325
| | - Claudio Rodrigues Leles
- Department of Preventive and Restorative Dentistry, Faculty of Dentistry, Federal University of Goias, Primeira Avenida, Setor Universitario, Goiania, GO 74605-220, Brazil;
| | - Maria do Carmo Matias Freire
- Department of Stomatological Sciences, Faculty of Dentistry, Federal University of Goias, Primeira Avenida, Setor Universitario, Goiania, GO 74605-220, Brazil;
| | - Saul Martins Paiva
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Minas Gerais, Avenida Antonio Carlos, 6627, Pampulha, Belo Horizonte, MG 31270-901, Brazil;
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George A, Shamim S, Johnson M, Dahlen H, Ajwani S, Bhole S, Yeo AE. How do dental and prenatal care practitioners perceive dental care during pregnancy? Current evidence and implications. Birth 2012; 39:238-47. [PMID: 23281906 DOI: 10.1111/j.1523-536x.2012.00553.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Poor maternal oral health may be associated with adverse pregnancy and infant outcomes. However, women seldom seek dental care during pregnancy, and misconceptions by prenatal care practitioners about oral health care during pregnancy may contribute to the problem. The aim of this study was to review current knowledge, attitudes, and behavior of dental and prenatal care practitioners about oral health care during pregnancy. METHODS This review examined all studies published in English that explored the knowledge, attitude, behavior, and barriers faced by dentists, general practitioners, midwives, and obstetricians/gynecologists with respect to oral health care during pregnancy. RESULTS Despite acknowledging the importance of maternal oral health, many dentists are uncertain about the safety of dental procedures and are hesitant in treating pregnant women. General practitioners and midwives are poorly informed about the impact of poor maternal oral health and rarely initiate this topic during prenatal care. Many general practitioners also believe that dental procedures are unsafe during pregnancy. Obstetricians/gynecologists are well informed about perinatal oral health and are supportive of dental procedures, but because of lack of training in this area and competing health demands they seldom focus on oral health care during their prenatal care. CONCLUSION No real consensus exists among dentists and prenatal care practitioners with respect to oral health care during pregnancy. This issue poses a significant deterrent for pregnant women seeking dental care. Practice guidelines in perinatal oral health are needed for health professionals to emphasize this important aspect of prenatal care.
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Affiliation(s)
- Ajesh George
- Centre for Applied Nursing Research (CANR), South Western Sydney Local Health District (SWSLHD)/University of Western Sydney, Sydney, New South Wales, Australia
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Corbella S, Del Fabbro M, Taschieri S, Francetti L. Periodontal disease and adverse pregnancy outcomes: a systematic review. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.ios.2011.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kang KH, Kim KW, Kim DH. Utilization Pattern and Cost of Medical Treatment and Complementary Alternative Therapy in Children with Atopic Dermatitis. ACTA ACUST UNITED AC 2012. [DOI: 10.7581/pard.2012.22.1.27] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Kyeong Hwa Kang
- Division of Nursing, Hallym University College of Medicine, Chuncheon, Korea
| | - Kyung-Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Hee Kim
- Department of Nursing, Sungshin Women's University College of Nursing, Seoul, Korea
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Ereş G, Altıok E, Özkul A, Açıkel CH. Subgingival Epstein-Barr and Cytomegalovirus Occurrence in Pregnancy Gingivitis. J Periodontol 2011; 82:1676-84. [DOI: 10.1902/jop.2011.100587] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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George A, Johnson M, Duff M, Ajwani S, Bhole S, Blinkhorn A, Ellis S. Midwives and oral health care during pregnancy: perceptions of pregnant women in south-western Sydney, Australia. J Clin Nurs 2011; 21:1087-96. [DOI: 10.1111/j.1365-2702.2011.03870.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sayar F, Hoseini MS, Abbaspour S. Effect of periodontal disease on preeclampsia. IRANIAN JOURNAL OF PUBLIC HEALTH 2011; 40:122-7. [PMID: 23113094 PMCID: PMC3481644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2011] [Accepted: 08/11/2011] [Indexed: 11/17/2022]
Abstract
BACKGROUND A lot of studies have shown periodontal diseases as a risk factor for adverse pregnancy outcomes. The association between periodontitis and preeclampsia has been studied recently with controversy. Considering the importance of preventing preeclampsia as a dangerous and life-threatening disease in pregnant women, the present study was carried out. METHODS Two hundred and ten pregnant women participated in this case-control study (105 controls & 105 cases) during years 2007 and 2008. Preeclamptic cases were defined as blood pressure ≥140/90mmHg and proteinuria +1. Control group were pregnant women with normal blood pressure without proteinuria. Both groups were examined during 48 hours after child delivery. Plaque Index (PLI), Pocket Depth (PD), Clinical Attachment Level (CAL), Bleeding On Probing (BOP), Gingival Recession (GR) were measured on all teeth except for third molars and recorded as periodontal examination. Data was analyzed using t-test, chi-square, and Mann-Whitney U statistical tests. RESULTS There was no significant difference between the two study groups for PD. CAL, GR, BOP significantly increased in the case group (P< 0.02). This study showed that preeclamptic cases were more likely to develop periodontal disease (P< 0.0001). Eighty three percent of the control group and 95% of the case group had periodontal disease (P< 0.005) which had shown that preeclamptic cases were 4.1 times more likely to have periodontal disease (OR= 4.1). CONCLUSION Preeclamptic cases significantly had higher attachment loss and gingival recession than the control group.
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Affiliation(s)
- F Sayar
- Dept. of Periodontology, Dental Branch, Islamic Azad University, Tehran, Iran,Corresponding author: Tel: +98 21 22746248, E-mail:
| | - M Sadat Hoseini
- Dept. of Obstetrics and Gynecology, School of Medicine, Shahid Beheshti University, MC, Tehran, Iran
| | - S Abbaspour
- Dept. of Periodontology, Dental Branch, Islamic Azad University, Tehran, Iran
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Agarwal V, Nagarajappa R, Keshavappa SB, Lingesha RT. Association of maternal risk factors with early childhood caries in schoolchildren of Moradabad, India. Int J Paediatr Dent 2011; 21:382-8. [PMID: 21668809 DOI: 10.1111/j.1365-263x.2011.01141.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Children who have caries in their primary teeth in infancy or toddlerhood tend to develop dental caries in their permanent dentition. Although risk indicators are helpful in identifying groups at risk, they give little information about the causes of difference in caries experience. AIM To identify the association between maternal risk factors and early childhood caries among 3- to 5-year-old schoolchildren of Moradabad City, Uttar Pradesh, India. DESIGN A total of 150 child-mother pairs participated in the study. The maternal risk factors were assessed by a pretested questionnaire. After obtaining the consent, the mothers and their children were clinically examined for dental caries using Radike criteria (1968). Saliva was collected from all the participating mothers for assessing the Streptococcus mutans level. RESULTS Significant differences were found in mothers' caries activity, high level of S. mutans, educational level, socioeconomic status, frequency of maternal sugar consumption, and their child's caries experience (P < 0.001). CONCLUSIONS Differences between children's situations in these underlying factors play out as consequential disparities in both their health and the health care they receive.
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Affiliation(s)
- Vartika Agarwal
- Department of Public Health Dentistry, PDM Dental College and Research Institute, Sarai Aurangabad, Bahadurgarh, Haryana, India.
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Hunter LP, Yount SM. Oral health and oral health care practices among low-income pregnant women. J Midwifery Womens Health 2011; 56:103-9. [PMID: 21429073 DOI: 10.1111/j.1542-2011.2011.00041.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Access to dental care is a problem in California as in many parts of the United States. Many women, including half of those having dental problems, do not see a dentist during pregnancy. The objective of this study was to describe the oral health status and oral health practices of low-income pregnant women in San Diego, California, and to determine the needs for oral health care education in this population. METHODS This descriptive, retrospective, correlational study examined oral health and oral health care practices by age, ethnicity, and gravidity by using medical records from a convenience sample of 380 low-income pregnant women. RESULTS Most participants were primigravida, aged between 19 and 29 years, of Hispanic ethnicity, and insured by the state (Medi-Cal). All women received education on oral health. The majority (84%) were encouraged to get a dental examination. It had been more than 1 year since the last dental visit for most women (55%). Hispanic women were in need of dental care more than Filipina women or women of other ethnicities. A broken tooth was the primary reason for immediate dental referrals. Regularity of flossing and brushing teeth differed significantly (P= .015, P < .001) across ethnic groups, with Filipina women reporting better oral care practices. DISCUSSION The results provide information for the future planning of effective dental health promotion programs. Findings suggest that low-income pregnant women have some healthy oral health care practices but are in need of dental services and oral health education. An oral health history, oral health education, dental screening, and dental referral, if needed, should be a routine part of prenatal care and annual examinations.
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Affiliation(s)
- Lauren P Hunter
- San Diego State University, School of Nursing, San Diego, CA, USA.
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George A, Johnson M, Duff M, Blinkhorn A, Ajwani S, Bhole S, Ellis S. Maintaining oral health during pregnancy: Perceptions of midwives in Southwest Sydney. Collegian 2011; 18:71-9. [DOI: 10.1016/j.colegn.2010.10.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Cibulka NJ, Forney S, Goodwin K, Lazaroff P, Sarabia R. Improving oral health in low-income pregnant women with a nurse practitioner-directed oral care program. ACTA ACUST UNITED AC 2011; 23:249-57. [DOI: 10.1111/j.1745-7599.2011.00606.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Oral health is essential to overall health in the prenatal period. Pregnancy is not a time to delay dental care. Several studies have shown an association between periodontal disease and poor pregnancy outcomes including preterm birth. Interventions to provide periodontal treatment to pregnant women yield inconsistent results regarding preterm birth but have established the safety of periodontal therapy during pregnancy. Postpartum women in poor dental health readily transmit the tooth decay pathogen Streptococcus mutans from their saliva to their infants, resulting in increased risk of early childhood caries. Preventive services and treatment for acute problems should be recommended, fears allayed, and women referred. Dental radiographs may be performed safely with the use of appropriate shielding. Nonemergent interventions are best provided between 14 and 20 weeks' gestation for comfort and optimal fetal safety. Most gravid women do not seek dental care. Increased interprofessional communication to encourage dentists to treat pregnant women will reduce the number of women without care. In states where it is available, Medicaid coverage of dental services for pregnant women is typically allowed during pregnancy and for 2 months postpartum. Women's health providers should understand the importance of protecting oral health during pregnancy and educate their patients accordingly.
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Affiliation(s)
- Megan K Kloetzel
- Madigan Army Medical Center: Joint Base Lewis-McChord, WA 98431, USA.
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Buerlein JK, Horowitz AM, Child WL. Perspectives of Maryland women regarding oral health during pregnancy and early childhood. J Public Health Dent 2011; 71:131-5. [DOI: 10.1111/j.1752-7325.2010.00211.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kaylor MB, Polivka BJ, Chaudry R, Salsberry P, Wee AG. Dental insurance and dental service use by U.S. women of childbearing age. Public Health Nurs 2011; 28:213-22. [PMID: 21535106 DOI: 10.1111/j.1525-1446.2010.00914.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Oral health has a significant effect on health, and for women, poor oral health can lead to poor birth outcomes and can affect their child's health. Nursing interventions to improve the oral health of at-risk women have the potential to increase maternal and child systemic and oral health. The identification of women at a high risk for poor oral health is a necessary to develop and evaluate these interventions. DESIGN AND SAMPLE This study examined the factors related to dental insurance and dental service use for women of childbearing age in the United States. A secondary analysis of the 2003-2004 National Health and Nutrition Examination Survey was completed to examine the predisposing, enabling, and need variables associated with dental insurance status and dental service use in a representative random sample of 1,071 women. RESULTS The results showed that over 40% of women had no dental insurance. Women with less education, lower income, and dental need were significantly less likely to have dental insurance. Dental utilization by the uninsured was low and a racial/ethnic disparity was noted. CONCLUSION A lack of dental insurance and dental service utilization is a significant concern. Nurses working with low-income women should educate the population about oral health and advocate for policies to increase dental insurance coverage.
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Affiliation(s)
- Mary Beth Kaylor
- Wright State University College of Nursing and Health, Dayton, Ohio 45435, USA.
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Abstract
BACKGROUND The authors conducted a study to examine factors associated with general dentists' provision of care for pregnant women and the extent to which they provide comprehensive dental care. METHODS The authors mailed an 86-item questionnaire to 1,000 practicing general dentists in North Carolina. Survey domains included provider knowledge about pregnancy and dental health, dental treatment practices, barriers to providing care, outcome expectancy, and personal and practice demographics. The primary dependent variables the authors analyzed were whether dentists provided any treatment to pregnant women and, among those who did, the extent to which they provided comprehensive services. The authors performed multivariate regression analyses to determine factors associated with dentists' provision of care to pregnant women (P < .05). RESULTS A total of 513 surveys were returned (a response rate of 51.3 percent), of which 495 surveys had complete responses. The authors included the completed surveys in their analyses. The mean age of the respondents was 46 years. The results of multivariate analysis showed that respondents who perceived a lack of demand for services among pregnant women and provided preconception counseling were less likely to provide any treatment for pregnant patients than were those who perceived a demand for services and who did not provide preconception counseling, respectively. Dentists who were male, had a low knowledge score, provided preconception counseling and treated largely white populations of patients were less likely than female dentists, those who had moderate or high knowledge scores, and those who treated a population of minority patients to provide comprehensive care for pregnant women. CONCLUSIONS Most general dentists in private practice provide care for pregnant women, but the authors found notable gaps in dental provider knowledge and comprehensive dental services available for pregnant women. CLINICAL IMPLICATIONS Although many general dentists provide some dental care to pregnant women, more should be done to ensure that this care is comprehensive.
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Abstract
BACKGROUND Poor oral health is increasingly linked to adverse pregnancy outcomes, including preterm birth and low-birthweight infants. Little is known about childbearing women's experiences in obtaining dental care. The objective of this study was to explore Florida women's experience of barriers in obtaining dental care before and during their pregnancies. METHODS Study data were derived from a larger data set of a study that examined barriers to prenatal care. One month after giving birth face-to-face interviews were conducted with 253 African American women, 18 to 35 years old, who were residents of one of three Florida counties. Interview questions about women's experiences on obtaining oral health care before and during pregnancy, and recall of guidance about oral health care during prenatal visits were transcribed and analyzed qualitatively. Through subject-level content analysis, key themes were assessed about the participants' perspectives on obtaining oral health care before and during pregnancy. RESULTS Most participants did not obtain dental care and did not recall receiving dental information during prenatal visits. Barriers to dental care included lack of insurance, difficulty in finding a dentist, low priority given to dental care, misconceptions about the safety and appropriateness of dental care during pregnancy, and sporadic anticipatory guidance during prenatal care. CONCLUSIONS Misconceptions about the appropriateness of oral health care during pregnancy may affect women's access to and use of this care. Given the implications of poor oral health on possible adverse birth outcomes and its larger connection with the general health of mothers and babies, attention to oral health misconceptions and barriers is warranted.
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Affiliation(s)
- Linda A Detman
- Lawton & Rhea Chiles Center for Healthy Mothers and Babies, College of Public Health, University of South Florida, Tampa, Florida 33613-4660, USA.
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George A, Johnson M, Blinkhorn A, Ellis S, Bhole S, Ajwani S. Promoting oral health during pregnancy: current evidence and implications for Australian midwives. J Clin Nurs 2010; 19:3324-33. [PMID: 20955483 DOI: 10.1111/j.1365-2702.2010.03426.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES The aim of this paper is to examine current evidence supporting the promotion of oral health during pregnancy and proffer aspects of a potential role for Australian midwives. BACKGROUND Research continues to show that poor oral health during pregnancy can have an impact on the health outcomes of the mother and baby. Poor maternal oral health increases the chances of infants developing early caries and is strongly associated with adverse pregnancy outcomes such as preterm and low birth-weight babies. Unfortunately in Australia, no preventive strategies exist to maintain the oral health of pregnant women. DESIGN Systematic review. METHOD This review examines all literature on oral health during pregnancy published to date in the English language and focuses on whether preventive oral health strategies during the prenatal period are warranted in Australia and if so, how they could be provided. RESULTS Maintaining oral health is important during pregnancy and many developed countries have implemented preventive strategies to address this issue using non-dental professionals such as prenatal care providers. However, despite the positive international evidence, limited importance is being given to the oral health of pregnant women in Australia. It is also evident that the unique potential of prenatal care providers such as midwives to assess and improve maternal oral heath is not being thoroughly utilised. Compounding the issue in Australia, especially for pregnant women from socioeconomically disadvantaged backgrounds, is the limited access to public dental services and the high cost of private dental treatment. CONCLUSION Promoting and maintaining oral health during pregnancy is crucial, and preventive prenatal oral health services are needed in Australia to achieve this. RELEVANCE TO CLINICAL PRACTICE Midwives have an excellent opportunity to offer preventive oral health services by providing oral health assessments, education and referrals for pregnant women attending antenatal clinics.
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Affiliation(s)
- Ajesh George
- Centre for Applied Nursing Research, Sydney South West Area Health Service, University of Western Sydney, Liverpool, NSW, Australia.
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88
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Medicaid reforms in Oregon and suboptimal utilization of dental care by women of childbearing age. J Am Dent Assoc 2010; 141:688-95. [PMID: 20516101 DOI: 10.14219/jada.archive.2010.0259] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The authors conducted a study of dental services used by women of childbearing age who were enrolled in Medicaid in Oregon during the early 2000s, a period of reform during which health care coverage was expanded. They compared claims for pregnant women, women who were not pregnant and had children and women who were not pregnant and did not have children. They also compared differences in claims between those for women enrolled in managed care and those for women enrolled in fee-for-service plans. METHODS The authors computed the proportion of women for whom a dental claim was submitted in six-month spans for 2000, 2001, 2002 (before reform) and 2005 (after reform). RESULTS Before and after reforms, the mean utilization rate for pregnant women, adjusted for the proportion of the period covered, decreased from 0.36 (standard deviation [SD] = 0.025) to 0.22 (SD = 0.028). Among women who were not pregnant and had children, the average adjusted rates decreased from 0.49 (SD = 0.201) to 0.21 (SD = 0.078). The pattern was similar among women who had no dependent children: rates decreased from 0.50 (SD = 0.028) to 0.19 (SD = 0.078). Most of the claims were for diagnostic services. The authors found no differences between women enrolled in managed care and those enrolled in fee-for-service plans. CONCLUSION Contrary to their intention, health care reforms in Oregon were detrimental to the vulnerable populations that Medicaid is intended to serve. CLINICAL IMPLICATIONS Dental care is important for maternal and child health. However, utilization is unlikely to improve without changes in Medicaid and the dental care delivery system.
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Abstract
Oral health is a prevalent health issue for children. Pediatricians have an important role in screening, educating, and making referrals during well-child visits. Advice must be age-specific to be effective. Topics to be covered include hygiene, diet, habits, fluoride, and referrals to dentists. Other members of the office can play a role in educating care givers. Special needs children and literacy issues demand extra attention in oral health management. There are many oral health resources available for pediatricians and parents.
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Affiliation(s)
- Hugh Silk
- University of Massachusetts Medical School, Worcester, MA, USA.
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90
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Watson JT, Fields M, Martin DL. Introduction of agriculture and its effects on women's oral health. Am J Hum Biol 2010; 22:92-102. [PMID: 19533607 DOI: 10.1002/ajhb.20958] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
This study explores the dynamic relationship between the introduction of agriculture and its effects on women's oral health by testing the hypothesis that female reproductive physiology contributes to an oral environment more susceptible to chronic oral disease and that, in a population undergoing the foraging to farming transition, females will exhibit a higher prevalence of oral pathology than males. This is tested by comparing the presence, location, and severity of caries lesions and antemortem tooth loss across groups of reproductive aged and postreproductive females (n = 71) against corresponding groups of males (n = 71) in an Early Agricultural period (1600 B.C.-A.D. 200) skeletal sample from northwest Mexico. Caries rates did not differ by sex across age groups in the sample; however, females were found to exhibit significantly more antemortem tooth loss than males (P > 0.01). Differences were initially minimal but increased by age cohort until postreproductive females experienced a considerable amount of tooth loss, during a life stage when the accumulation of bodily insults likely contributed to dental exfoliation. Higher caries rates in females are often cited as the result of gender differences and dietary disparities in agricultural communities. In an early farming community, with diets being relatively equal, women were found to experience similar caries expression but greater tooth loss. We believe this differential pattern of oral pathology provides new evidence in support of the interpretation that women's oral health is impacted by effects relating to reproductive biology.
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Affiliation(s)
- James T Watson
- Arizona State Museum, University of Arizona, Tucson, 85721, USA.
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91
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Rothe V, Kebriaei A, Pitner S, Balluff M, Salama F. Effectiveness of a presentation on infant oral health care for parents. Int J Paediatr Dent 2010; 20:37-42. [PMID: 20059592 DOI: 10.1111/j.1365-263x.2009.01018.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this study was to evaluate an infant oral health education programme, using a pre-post test design, for parents attending a paediatric clinic. METHODS The subjects were parents attending the well baby appointments at 3, 6, and 9 months of age. The study participants were men and women, all with an infant between 3 and 12 months of age. A 16 question assessment in the form of a questionnaire was completed immediately before and after the introduction of a 30 min educational intervention in the form of a PowerPoint presentation and a video of infant oral hygiene for parents. The parents completed the questionnaire twice (pre-post test design) in the same visit. Recruited parents attended only one presentation. The presentation educated parents about infant oral health and provided anticipatory guidance. RESULTS Forty-seven parents or caretakers participated in the study. On the pre-test 28% had a score of 70% or less, and on the post-test 87% got a score of 88% or better. On the pre-test, 72% had a score of 70% or higher, and on the post-test 87% got a score of 88% or higher. Most parents (80%) reported that the presentation was helpful and indicated that the information would change the way they care for their baby's teeth at home. CONCLUSION This study demonstrated the effectiveness of a 30 min PowerPoint and Video presentation in improving the oral health knowledge of parents caring for an infant.
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Affiliation(s)
- Vincent Rothe
- Hospital Dentistry Department, College of Dentistry, University of Nebraska Medical Center, Omaha, Nebraska
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92
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Dental Services Utilization by Women of Childbearing Age by Socioeconomic Status. J Community Health 2009; 35:190-7. [DOI: 10.1007/s10900-009-9214-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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93
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Collins JL, Lehnherr J, Posner SF, Toomey KE. Ties that bind: maternal and child health and chronic disease prevention at the Centers for Disease Control and Prevention. Prev Chronic Dis 2008; 6:A01. [PMID: 19080007 PMCID: PMC2644605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Janet L. Collins
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office of the Director
| | - John Lehnherr
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Mofidi M, Zeldin LP, Rozier RG. Oral health of early head start children: a qualitative study of staff, parents, and pregnant women. Am J Public Health 2008; 99:245-51. [PMID: 19059853 DOI: 10.2105/ajph.2008.133827] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We explored the oral health knowledge, attitudes, and activities of Early Head Start (EHS) staff members, parents, and pregnant women, along with their suggestions related to future oral health educational interventions targeting EHS children. METHODS Nine focus groups were conducted with EHS staff, parents, and pregnant women. Audiotapes of sessions were transcribed and entered into ATLAS.ti 5.0 for coding and analysis. RESULTS Attitudes about the importance of children's oral health among parents and pregnant women were mixed. Staff members voiced responsibility for children's oral health but frustration in their inability to communicate effectively with parents. Parents in turn perceived staff criticism regarding how they cared for their children's oral health. Gaps were noted in the oral health activities of EHS programs. Participants expressed confusion regarding the application of Head Start oral health performance standards to EHS. The need for culturally sensitive, hands-on oral health education was highlighted. CONCLUSIONS Tailored, theory-based interventions are needed to improve communication between EHS staff and families. Clear policies on the application of Head Start oral health performance standards to EHS are warranted. Educational activities should address the needs and suggestions of EHS participants.
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Affiliation(s)
- Mahyar Mofidi
- Schools of Dentistry and Public Health, University of North Carolina, Chapel Hill, NC, USA.
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95
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Siqueira FM, Cota LOM, Costa JE, Haddad JPA, Lana ÂMQ, Costa FO. Maternal Periodontitis as a Potential Risk Variable for Preeclampsia: A Case-Control Study. J Periodontol 2008; 79:207-15. [DOI: 10.1902/jop.2008.070174] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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96
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Quinonez R, Stearns SC. Issues and early evidence for the economic evaluation of the effects of periodontal therapy on pregnancy outcomes. J Periodontol 2008; 79:203-6. [PMID: 18251634 DOI: 10.1902/jop.2008.070286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Rocio Quinonez
- Department of Pediatric Dentistry and Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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