Women's attitudes to and perceptions of oral health and dental care during pregnancy

Piloting of an oral health education program and knowledge test for midwives

Abstract Research shows limited emphasis being placed on oral health by midwives in Australia and the need for further education in this area. The study aim was to pilot a midwifery oral health education program and knowledge test and identify any flaws in its content and design. Twenty two midwives from an antenatal ward in South-western Sydney completed the program and 12 feedback forms/knowledge tests were returned. Data was analysed using descriptive statistics and content analysis. Feedback data showed all midwives appreciated that the program was available online and self-paced. Most found the program extremely informative and following completion were more confident in promoting maternal oral health. The mean correct responses in the knowledge test was 79 % (SD=12.3) which suggests most items were suitable for assessing knowledge improvement. However, in 3 items midwives had low correct responses. Various aspects that could be improved or clarified were identified and suggestions discussed.

The oral health status, practices and knowledge of pregnant women in south-western Sydney

BACKGROUND

Current evidence highlights the importance of oral health during pregnancy. However, little is known about the oral health of pregnant women in Australia. The aim of this study was to report the oral health status, knowledge and practices of pregnant women in south-western Sydney.

METHODS

A cross-sectional survey of 241 pregnant women attending a large hospital in south-western Sydney.

RESULTS

More than half (59.3%) reported dental problems during pregnancy, less than a third (30.5%) saw a dentist in the last six months, only 10% had received any information about perinatal oral health and many (>50%) were unaware of the potential impact of poor maternal oral health on pregnancy and infant outcomes. Analysis revealed a significant difference (<0.05) in the uptake of dental services among pregnant women who had higher household incomes, private health insurance, received information about perinatal oral health and knowledge about maternal oral health.

CONCLUSIONS

The participants reported significant barriers to obtaining dental care including limited access to affordable dental services and lack of awareness about the importance of maternal oral health. The findings suggest the need for preventive strategies involving dentists and antenatal providers to improve maternal oral health in Australia.

Does any relationship exist between self reported gingival bleeding, oral health perception, practices and concerns?

Background:

The objective was to determine the relationship between self-reported gingival bleeding, oral health perception, practices and concerns.

Materials and Methods:

This cross-sectional survey among undergraduates of University of Benin, Benin City, Nigeria was conducted between April and May, 2011 using a self-administered 21-item structured questionnaire. Data analysis was done using Statistical Packages for the Social Sciences and P<0.05 was considered significant.

Results:

Out of the 400 questionnaires that were distributed, 338 were returned filled giving a retrieval rate of 84.5%. About three-quarters (71.3%) of the respondents were younger than 22 years. Males constituted 65.1% while the remaining 34.9% were females. The prevalence of self-reported gingival bleeding among respondents in this study was 12.7%. Individuals with gingival bleeding were significantly more likely to rate their dental and gingival health as fair/poor, use strong brushing stroke during tooth brushing and report worsening condition of teeth despite daily tooth brushing, express worry about the gingival color and less likely to be satisfied about the appearance of their teeth and to have received professional instruction on tooth brushing.

Conclusion:

Data from this survey revealed an established relationship between gingival bleeding, perceived dental and gingival health, tooth brushing force, professional instruction on tooth brushing, perception of the condition of teeth in relation to daily tooth brushing, worry about the color of gingiva, and satisfaction with the appearance of the teeth.

Oral care during pregnancy: attitudes of Brazilian public health professionals

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.

How do dental and prenatal care practitioners perceive dental care during pregnancy? Current evidence and implications

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.

Turkish women's self-reported knowledge and behavior towards oral health during pregnancy

OBJECTIVES

The purpose of this study was to evaluate oral health care knowledge and behavior of women during pregnancy.

SUBJECTS AND METHODS

The study population consisted of 351 mothers with children under 3 months of age who presented at Gülhane Medical Academy's Department of Pediatrics for a routine child check-up. Mothers were asked to complete a questionnaire about their knowledge and behavior regarding dental care during pregnancy.

RESULTS

All the women who participated in the study had dental insurance, and most of them had high levels of education. Of the 351 mothers, 263 (75%) had heard about possible connections between oral health and pregnancy outcome, and 165 (47%) believed tooth and periodontal problems could affect pregnancy outcome. However, 256 (73%) women still believed that calcium would be drawn out of their teeth by the developing baby, and 151 (43%) believed in the erroneous statement 'A tooth for a baby'. 241 (68.7%) women had experienced oral health problems during pregnancy; however, only 48 (13.7%) visited a dentist during their pregnancy.

CONCLUSIONS

Turkish women, despite having knowledge that adverse pregnancy events may be related to dental and periodontal problems, did not seek oral health care during pregnancy. This suggests the need to better educate medical providers to inform pregnant women to obtain oral health care during pregnancy.

Dental care for pregnant women: an assessment of North Carolina general dentists

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.

Exploring dental care misconceptions and barriers in pregnancy

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.