1
|
Winckler K, Rasmussen MU, Laugenborg J, Bukkehave KH, Fischer H, Heitmann BL, Wæhrens EE. Barriers for why pregnant women do not visit a dentist on a regular basis: using group concept mapping methodology. Acta Odontol Scand 2024; 83:30-37. [PMID: 37982800 DOI: 10.1080/00016357.2023.2283198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES Periodontitis in pregnancy represents a significant, but often overlooked challenge due to its association to adverse pregnancy (preeclampsia and gestational diabetes) and birth related outcomes (preterm birth and low birth weight). The overall study aim was to identify, organize, and prioritize barriers influencing dental visits among Danish pregnant women not seeing a dentist on a regularly basis. MATERIALS AND METHODS Participants were pregnant women screened at weeks 11-13 of gestation, and were recruited if they were not seeing a dentist regularly. The study was conducted at Holbæk and Nykøbing Falster Hospital in Region Zealand, Denmark. The Group Concept Mapping (GCM) approach was applied. The pregnant women participated in brainstorming (n = 18), sorting (n = 20), and rating (n = 17) the seating question 'Thinking as broadly as you can, please list all barriers of importance to you for not seeing a dentist on a regular basis'. RESULTS A total of 38 unique barriers were identified, organized, and prioritized online. The multidimensional scaling analysis involved 10 iterations and revealed a low stress value of 0.21. A cluster solution with five clusters including 'economic reasons', 'lack of priority', 'lack of time and energy', 'no problems with teeth', and 'dental fear', was discussed and interpreted at a validation meeting. CONCLUSIONS Five overall clusters explaining barriers for not seeing a dentist regularly were revealed. Of the five clusters, 'economic reasons' and 'lack of priority' were rated as the most important clusters. Accordingly, such barriers should be considered in the planning of future strategies of dental care during pregnancy.
Collapse
Affiliation(s)
- Karoline Winckler
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
| | - Marianne Uggen Rasmussen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jeannet Laugenborg
- Department of Pediatrics, Gynaecology and Obstetrics, Nykøbing Falster Hospital, Region Zealand, Denmark; Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Kathrine Hansen Bukkehave
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Heidi Fischer
- Department of Obstetrics and Gynaecology, Holbæk Hospital, Region Zealand, Denmark
| | - Berit Lilienthal Heitmann
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Public Health, Section for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Eva Ejlersen Wæhrens
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark; Occupational Science, User Perspectives and Community-based Research, Department of Public Health, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
2
|
Cagetti MG, Salerno C, Ionescu AC, La Rocca S, Camoni N, Cirio S, Campus G. Knowledge and attitudes on oral health of women during pregnancy and their children: an online survey. BMC Oral Health 2024; 24:85. [PMID: 38229165 DOI: 10.1186/s12903-023-03732-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/01/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Life-long healthy behaviors are established during pregnancy and the first years of life. In this cross-sectional survey, new mothers with a high level of schooling living in Northern Italy (Lombardy Region) were interviewed to assess their knowledge and attitudes towards their and child oral health. METHODS A questionnaire (27 items) was developed to assess socio-demographic factors, knowledge, and attitudes towards maternal and child oral health. The questionnaire was disseminated in perinatal courses, private gynecological clinics, and via social media. Mothers aged ≥18 years, with at least a child aged 0-36 months, with a high school diploma or higher, were included in the survey. RESULTS A total of 1340 women completed the questionnaire, 1297 of whom had a child aged 0-36 months, 792 lived in Lombardy, and 600 had a high level of education and were finally included. About half of the sample (44.67%) was aged between 31 and 35 years, 76.50% were employed, and the majority had only one child (81.50%). During pregnancy, 28.33% of the sample reported problems with teeth and gums, while only 36.00% visited a dentist. More than 40% of the sample said they were not aware of a possible link between oral health and pregnancy, and 73.17% had not received any advice about their oral health or the future health of their baby's mouth. Less than 20% of women were aware of the increased caries risk associated with prolonged or night-time breastfeeding. Better knowledge/attitude was associated with the age of the child (p < 0.05), the number of children (p < 0.05) and whether the mother had received advice during pregnancy (p < 0.05). CONCLUSIONS The results of this survey show a lack of dental care during pregnancy, a lack of information about oral health from health professionals during and after pregnancy, and consequently gaps in the knowledge needed to care for the oral health of the woman and her child. There is a need for training in oral health for pregnant women and new mothers, but also a need for behavioural change among health professionals who care for pregnant women.
Collapse
Affiliation(s)
- Maria Grazia Cagetti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142, Milan, Milan, Italy
| | - Claudia Salerno
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3012, Bern, Switzerland.
| | - Andrei Cristian Ionescu
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Pascal 36, 20133, Milan, Milan, Italy
| | - Serena La Rocca
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142, Milan, Milan, Italy
| | - Nicole Camoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142, Milan, Milan, Italy
| | - Silvia Cirio
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142, Milan, Milan, Italy
| | - Guglielmo Campus
- Department of Surgery, Microsurgery and Medicine Sciences - School of Dentistry University of Sassari, Sassari, Italy. Viale San Pietro, 43. Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3012, Bern, Switzerland
| |
Collapse
|
3
|
Velosa-Porras J, Rodríguez Malagón N. Prevalence of dental caries in pregnant Colombian women and its associated factors. BMC Oral Health 2023; 23:793. [PMID: 37875831 PMCID: PMC10598961 DOI: 10.1186/s12903-023-03419-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/16/2023] [Indexed: 10/26/2023] Open
Abstract
OBJECTIVE To identify the prevalence of dental caries in pregnant women in the Colombian population and its association with the medical history and social determinants, based on data from the fourth National Oral Health Survey (ENSAB IV). MATERIALS AND METHODS A total of 1,047 pregnant women from different areas of Colombia were evaluated. A dental evaluation was performed using a flat oral mirror and blunt-tipped probe (World Health Organization, 2007). For diagnosis of the dental condition, the DMFT index was used. A negative binomial regression analysis was performed to evaluate the association between social determinants and the DMFT index. RESULTS The results of this national study show a 59% prevalence of caries in this population. Regarding the experience of caries, 89.9% of pregnant women showed having had caries. CONCLUSIONS The results of this national study on pregnant women show a high prevalence of dental caries. The women's level of education is an important factor associated with dental caries and filled teeth, so the role of oral health education and dental check-ups are important. CLINICAL RELEVANCE The findings of this study show the oral health situation of pregnant women, with a high prevalence of dental caries. This leads to the development and strengthening of oral health education strategies that empower pregnant women in their care. In addition, dental checkups during pregnancy should be implemented and reinforced to prevent and treat oral pathologies and thus prevent complications during this stage.
Collapse
Affiliation(s)
- Juliana Velosa-Porras
- Ph.D. Program in Clinical Epidemiology, Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia.
| | - Nelcy Rodríguez Malagón
- MPH, Biostatistics, Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| |
Collapse
|
4
|
Wu TT, Sohn M, Manning S, Beblavy R, Gill S, Quataert S, Vasani S, Jang H, Zeng Y, Bruno J, Vazquez A, Fiscella K, Xiao J. Metagenomic analysis examines oral microbiome changes and interplay with immune response following prenatal total oral rehabilitation. J Transl Med 2023; 21:172. [PMID: 36871005 PMCID: PMC9985285 DOI: 10.1186/s12967-023-03997-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Suboptimal maternal oral health during pregnancy is potentially associated with adverse birth outcomes and increased dental caries risks in children. This study aimed to assess the oral microbiome and immune response following an innovative clinical regimen, Prenatal Total Oral Rehabilitation (PTOR), that fully restores women's oral health to a "disease-free status" before delivery. METHODS This prospective cohort study assessed 15 pregnant women at baseline and 3 follow-up visits (1 week, 2 weeks, and 2 months) after receiving PTOR. The salivary and supragingival plaque microbiomes were analyzed using metagenomic sequencing. Multiplexed Luminex cytokine assays were performed to examine immune response following PTOR. The association between salivary immune markers and oral microbiome was further examined. RESULTS PTOR was associated with a reduction of periodontal pathogens in plaque, for instance, a lower relative abundance of Tannerella forsythia and Treponema denticola at 2 weeks compared to the baseline (p < 0.05). The alpha diversity of plaque microbial community was significantly reduced at the 1-week follow-up (p < 0.05). Furthermore, we observed significant changes in the Actinomyces defective-associated carbohydrate degradation pathway and Streptococcus Gordonii-associated fatty acid biosynthesis pathway. Two immune markers related to adverse birth outcomes significantly differed between baseline and follow-up. ITAC, negatively correlated with preeclampsia severity, significantly increased at 1-week follow-up; MCP-1, positively correlated with gestational age, was elevated at 1-week follow-up. Association modeling between immune markers and microbiome further revealed specific oral microorganisms that are potentially correlated with the host immune response. CONCLUSIONS PTOR is associated with alteration of the oral microbiome and immune response among a cohort of underserved US pregnant women. Future randomized clinical trials are warranted to comprehensively assess the impact of PTOR on maternal oral flora, birth outcomes, and their offspring's oral health.
Collapse
Affiliation(s)
- Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael Sohn
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Samantha Manning
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Robert Beblavy
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Steven Gill
- Immunology and Microbiology, University of Rochester Medical Center, Rochester, NY, USA
| | - Sally Quataert
- Immunology and Microbiology, University of Rochester Medical Center, Rochester, NY, USA
| | - Shruti Vasani
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Hoonji Jang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.,Temple University Maurice H. Kornberg School of Dentistry, Philadelphia, USA
| | - Yan Zeng
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Jennifer Bruno
- Immunology and Microbiology, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Kevin Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
| |
Collapse
|
5
|
Lee H, Marsteller JA, Wenzel J. Dental care utilization during pregnancy by Medicaid dental coverage in 26 states: Pregnancy risk assessment monitoring system 2014-2015. J Public Health Dent 2022; 82:61-71. [PMID: 34904236 DOI: 10.1111/jphd.12483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To examine the association between Medicaid dental coverage for adult pregnant women with dental care utilization during pregnancy. METHODS Pregnancy risk assessment monitoring system (PRAMS) data (2014-2015) and the Medicaid-SCHIP state dental association (MSDA) national profiles (2014-2015) were used in this study. The study sample included 16,612 Medicaid-enrolled women, for a weighted number of 965,046 women from 26 states and New York City. State Medicaid dental coverage was categorized into (1) no coverage for the dental cleaning, (2) coverage for dental cleaning and fillings, (3) extended dental coverage. The adjusted prevalence ratios (aPR) for dental visits for cleaning during pregnancy were examined by Medicaid dental coverage level. RESULTS Medicaid-enrolled women in states with no dental coverage were less likely to visit dentists for cleaning during pregnancy (26.7%) compared with women in states with either limited dental coverage (36.6%) or extended dental coverage (44.9%). Compared with women in state without dental coverage, Medicaid-enrolled women in states with extended dental coverage (aPR = 1.20, 95% CI [1.16-1.23]) and women in states with limited coverage (aPR = 1.10, 95% CI [1.06-1.14]) were more likely to visit dentists for cleaning during pregnancy when adjusted for other sociodemographic variables and adequacy of prenatal care. A similar pattern of association was observed for a dental visit to address dental problems during pregnancy. CONCLUSIONS This study highlights the importance of Medicaid dental coverage for adult pregnant women related to dental service utilization during pregnancy.
Collapse
Affiliation(s)
- Hyewon Lee
- Mount Sinai Hospital, Department of Dentistry, New York, New York, USA
| | - Jill A Marsteller
- Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | | |
Collapse
|
6
|
Barillas W, Lee H. Maternal oral health framework: integration of oral health into perinatal care. J Public Health Policy 2022; 43:696-702. [PMID: 36195649 PMCID: PMC9531211 DOI: 10.1057/s41271-022-00366-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Wendy Barillas
- grid.59734.3c0000 0001 0670 2351Icahn School of Medicine, Mount Sinai, New York, USA
| | - Hyewon Lee
- Seoul National University, School of Dentistry, Seoul, South Korea. .,Seoul National University, Dental Research Institute, Seoul, South Korea.
| |
Collapse
|
7
|
A Successful Dental Care Referral Program for Low-Income Pregnant Women in New York. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312724. [PMID: 34886450 PMCID: PMC8656616 DOI: 10.3390/ijerph182312724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 11/17/2022]
Abstract
Despite evidence-based guidelines that advocate for dental care during pregnancy, dental utilization among pregnant women remains low, especially among low-income and racial-ethnic minority women. We investigated self-reported dental care referral and self-reported dental care attendance among a group of 298 low-income, largely racial-ethnic minority pregnant women attending two suburban prenatal care clinics that had integrated dental care referrals into their prenatal care according to these guidelines. We administered a questionnaire that asked women: (1) whether they had been referred for care by their prenatal care provider; (2) whether they had been seen by a dentist during pregnancy. Among those women who were eligible for a dental care referral (those who reported having dental symptoms, and those not having a recent dental visit), we found that 73.0% reported that they had indeed been referred for dental care by their prenatal provider, while the remaining women reported either no referral (23.5%, n = 67) or were not sure whether they had been referred (3.5%, n = 10). Among those who reported a dental care referral, 67.3% (n = 140) reported that they saw a dentist during their pregnancy, while of those who reported no dental care referral only 35.1% (n = 27) reported a dental visit (Chi-Sq. = 24.1, df = 1, p < 0.001). Having received a dental referral was a significant predictor of reporting a dental visit during pregnancy, with women who received a referral being 4.6 times more likely to report a dental visit during pregnancy compared to those women who did not report a referral. These results demonstrate that vulnerable pregnant women referred for dental care by their prenatal provider will indeed seek and utilize dental care when offered. This dental referral program may serve as a model for improving the utilization of dental care among this population.
Collapse
|
8
|
Wu TT, Xiao J, Sohn MB, Fiscella KA, Gilbert C, Grier A, Gill AL, Gill SR. Machine Learning Approach Identified Multi-Platform Factors for Caries Prediction in Child-Mother Dyads. Front Cell Infect Microbiol 2021; 11:727630. [PMID: 34490147 PMCID: PMC8417465 DOI: 10.3389/fcimb.2021.727630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 07/09/2021] [Indexed: 12/19/2022] Open
Abstract
Untreated tooth decays affect nearly one third of the world and is the most prevalent disease burden among children. The disease progression of tooth decay is multifactorial and involves a prolonged decrease in pH, resulting in the demineralization of tooth surfaces. Bacterial species that are capable of fermenting carbohydrates contribute to the demineralization process by the production of organic acids. The combined use of machine learning and 16s rRNA sequencing offers the potential to predict tooth decay by identifying the bacterial community that is present in an individual’s oral cavity. A few recent studies have demonstrated machine learning predictive modeling using 16s rRNA sequencing of oral samples, but they lack consideration of the multifactorial nature of tooth decay, as well as the role of fungal species within their models. Here, the oral microbiome of mother–child dyads (both healthy and caries-active) was used in combination with demographic–environmental factors and relevant fungal information to create a multifactorial machine learning model based on the LASSO-penalized logistic regression. For the children, not only were several bacterial species found to be caries-associated (Prevotella histicola, Streptococcus mutans, and Rothia muciloginosa) but also Candida detection and lower toothbrushing frequency were also caries-associated. Mothers enrolled in this study had a higher detection of S. mutans and Candida and a higher plaque index. This proof-of-concept study demonstrates the significant impact machine learning could have in prevention and diagnostic advancements for tooth decay, as well as the importance of considering fungal and demographic–environmental factors.
Collapse
Affiliation(s)
- Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, United States
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, United States
| | - Michael B Sohn
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, United States
| | - Kevin A Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, United States
| | - Christie Gilbert
- Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY, United States
| | - Alex Grier
- Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY, United States
| | - Ann L Gill
- Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY, United States
| | - Steve R Gill
- Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY, United States
| |
Collapse
|
9
|
Jang H, Al Jallad N, Wu TT, Zeng Y, Fadaak A, Malmstrom H, Fiscella K, Xiao J. Changes in Candida albicans, Streptococcus mutans and oral health conditions following Prenatal Total Oral Rehabilitation among underserved pregnant women. Heliyon 2021; 7:e07871. [PMID: 34485745 PMCID: PMC8405901 DOI: 10.1016/j.heliyon.2021.e07871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/07/2021] [Accepted: 08/23/2021] [Indexed: 11/28/2022] Open
Abstract
Objectives To assess the oral health condition and oral microbial outcomes from receiving an innovative treatment regimen - Prenatal Total Oral Rehabilitation (PTOR). Methods This prospective cohort study included 15 pregnant women in the PTOR group who had a baseline visit before PTOR and three follow-up visits (immediate after, 2 weeks and 2 months) after receiving PTOR. A historical control group of additional 15 pregnant women was matched from a separate study based on a propensity score. Along with demographic and medical background, oral health conditions and perinatal oral health literacy were assessed. Oral samples (saliva and plaque) were analyzed to identify and quantify Streptococcus mutans and Candida species by culturing-dependent and -independent methods. Results Significant reductions of salivary S. mutans were observed following PTOR, the effect remained until 2-month follow-up (p < 0.05). The carriage of salivary and plaque S. mutans at the 2-month visit of the PTOR group was significantly lower than that of the control group (p < 0.05). Oral health conditions reflected by BOP and PI were significantly improved upon receiving PTOR (p < 0.05). Receiving PTOR significantly improved the perinatal oral health literacy score, and the knowledge retained until 2-month follow-up (p < 0.05). Conclusions PTOR is associated with an improvement in oral health conditions and perinatal oral health literacy, and a reduction in S. mutans carriage, within a 2-month follow-up period. Future clinical trials are warranted to comprehensively assess the impact of PTOR on the maternal oral flora other than S. mutans and Candida, birth outcomes, and their offspring's oral health.
Collapse
Affiliation(s)
- Hoonji Jang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Nisreen Al Jallad
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Yan Zeng
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Ahmed Fadaak
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Hans Malmstrom
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Kevin Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| |
Collapse
|
10
|
Onwuka C, Onwuka CI, Iloghalu EI, Udealor PC, Ezugwu EC, Menuba IE, Ugwu EO, Ututu C. Pregnant women utilization of dental services: still a challenge in low resource setting. BMC Oral Health 2021; 21:384. [PMID: 34353295 PMCID: PMC8340410 DOI: 10.1186/s12903-021-01746-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/17/2021] [Indexed: 11/14/2022] Open
Abstract
Background Poor oral health in pregnancy can be associated with poor pregnancy outcome, however, dental consultation among pregnant women appears to be low. Methods This was a questionnaire-based study of 413 women who attended the antenatal clinic of University of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla, Enugu. The information obtained was analyzed using SPSS version 22. A p-value of less than 0.05 was considered statistically significant. Results Only 36 (8.7%) of the respondents had dental consultations in index pregnancy for complaints such as tooth ache and decay (66.7%) and pain as well as swelling of the gum (33.3%). The most common reason given for not visiting a dentist during the index pregnancy was the visit not being relevant to their pregnancy outcome (69.2%). After counseling them, only 249 (60.3%) agreed to have dental consultation during subsequent pregnancies. The relationship between visiting the dentist and place of residence (< 0.001), occupation (0.019) and frequency of brushing/ changing of brush (0.005, < 0.001 respectively) were statistically significant.
Conclusion The prevalence of dental consultation during pregnancy is very low. Pregnant women should be encouraged to have routine dental consultation with oral health counseling and check-up incorporated as part of routine antenatal care.
Collapse
Affiliation(s)
- Chidozie Onwuka
- Oral and Maxillo-Facial Surgery Department, King Khalid University, Abha, Saudi Arabia
| | - Chidinma Ifechi Onwuka
- Obstetrics and Gynaecology Department, University of Nigeria Nsukka/University of Nigeria Teaching Hospital, Enugu, Nigeria.
| | - Emeka Ifeanyi Iloghalu
- Obstetrics and Gynaecology Department, University of Nigeria Nsukka/University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Peter Chukwudi Udealor
- Obstetrics and Gynaecology Department, University of Nigeria Nsukka/University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Euzebus Chinonye Ezugwu
- Obstetrics and Gynaecology Department, University of Nigeria Nsukka/University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Ifeanyi Emmanuel Menuba
- Obstetrics and Gynaecology Department, University of Nigeria Nsukka/University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Emmanuel Onyebuchi Ugwu
- Obstetrics and Gynaecology Department, University of Nigeria Nsukka/University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Chinyere Ututu
- Department of Child Dental Health, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria
| |
Collapse
|
11
|
Lee H, Tranby E, Shi L. Dental Visits during Pregnancy: Pregnancy Risk Assessment Monitoring System Analysis 2012-2015. JDR Clin Trans Res 2021; 7:379-388. [PMID: 34323108 DOI: 10.1177/23800844211028541] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES This study aimed to update dental service utilization during pregnancy and to evaluate whether there are persistent disparities in dental care during pregnancy by race/ethnicity and Medicaid status. METHODS This retrospective secondary data analysis examined dental service utilization during and prior to pregnancy and met dental or oral health needs using the Pregnancy Risk Assessment Monitoring System (PRAMS) data sets on 75,876 women between 2012 and 2015. RESULTS Only about half of the women (51.7%) reported that they had at least 1 dental visit for cleaning during their most recent pregnancy. One of 5 women (19.7%) experienced dental problems during pregnancy, and 34.4% of these women did not visit dentists to address the problems. Non-Hispanic Black women had 14% lower odds of visiting dentists for cleaning during pregnancy compared to non-Hispanic White women (odds ratio [OR], 0.86; 95% CI confidence interval [CI], 0.80-0.92). There was no difference in dental visits prior to pregnancy between non-Hispanic Black and White women. Women enrolled in Medicaid showed significantly lower odds of visiting dentists for cleaning during pregnancy compared to women covered by private health insurance (OR, 0.55; 95% CI, 0.52-0.58). CONCLUSION FOR PRACTICE Oral health, as an integral part of primary care, needs to be included in the standard prenatal care through oral health education and timely dental care during pregnancy. With mounting evidence of persisting disparities in dental service utilization during pregnancy, both public and private prenatal programs and policies should address specific barriers in accessing and using dental care during pregnancy, especially for women from socially disadvantaged backgrounds. KNOWLEDGE TRANSFER STATEMENT The current study updated the previous findings with more recent multiyear PRAMS data (2012-2015) and found the Black-White disparity and disparity among Medicaid-enrolled women in visiting dentists during pregnancy persist. The results of this study can be used by policymakers and practitioners to integrate oral health into prenatal care for pregnant women from marginalized backgrounds to achieve oral health parity.
Collapse
Affiliation(s)
- H Lee
- Mount Sinai Hospital, Department of Dentistry, New York, NY, USA
| | - E Tranby
- Data and Impact Analytics and Evaluation, DentaQuest Partnership for Oral Health Advancement, Boston, MA, USA
| | - L Shi
- Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD, USA
| |
Collapse
|
12
|
Huang SS, Yang C, Cohen V, Russell SL. What Factors Influence Dental Faculty's Willingness to Treat Pregnant Women? JDR Clin Trans Res 2021; 7:407-414. [PMID: 34286605 DOI: 10.1177/23800844211028132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Despite evidence-based guidelines advocating for the provision of oral health care throughout pregnancy, dentists remain hesitant to provide dental treatment for pregnant women. However, little is known about attitudes toward treating pregnant women among dental school faculty, who may transmit their attitudes and treatment preferences to their students. METHODS We collected cross-sectional survey data at the New York University College of Dentistry, which produces 10% of all US dentists and is the largest US dental school, to understand faculty attitudes and knowledge regarding providing dental treatment to pregnant women. This study was part of an educational effort to improve dental care access by pregnant women and to examine what factors influence willingness to treat pregnant patients among dental faculty members. RESULTS We found that concerns about professional liability outweighed inadequate knowledge regarding treatment of pregnant patients in determining dental faculty's willingness to treat pregnant women. CONCLUSIONS Educational interventions delivered to dental faculty regarding current dental treatment guidelines for pregnant women may not be sufficient to increase faculty's provision of dental care to women during pregnancy. Future work to design effective interventions to increase dental treatment of pregnant women among dental faculty should address liability concerns. KNOWLEDGE TRANSFER STATEMENT Interventions addressing dental clinician and faculty knowledge about dental treatment for pregnant women may be insufficient to increase dental treatment among pregnant women. Instead, policy makers should consider designing, implementing, and evaluating interventions addressing malpractice and liability concerns.
Collapse
Affiliation(s)
- S S Huang
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York City, NY, USA
| | - C Yang
- Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - V Cohen
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York City, NY, USA
| | - S L Russell
- New York University College of Dentistry, New York City, NY, USA
| |
Collapse
|
13
|
Rajabi A, Rahebi D, Valadbeigi T, Hasani J, Hajipour M, Erfanpoor S, Etemad K, Yaghoobi H, Zolfizadeh F, Esmaeilzadeh F, Gholami A. Utilization of dental care in Iranian pregnant women: Findings from a population-based study. Dent Res J (Isfahan) 2021. [DOI: 10.4103/1735-3327.313121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
14
|
Taylor H, Holmes AM, Blackburn J. Prevalence of and factors associated with unmet dental need among the US adult population in 2016. Community Dent Oral Epidemiol 2020; 49:346-353. [PMID: 33274505 DOI: 10.1111/cdoe.12607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 11/12/2020] [Accepted: 11/15/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Understanding and addressing contributing factors to unmet dental need is an important public health challenge. This study investigated the prevalence of, and factors associated with, self-reported unmet dental need using a nationally representative sample of US adults. METHODS This was a cross-sectional study using the Medical Expenditures Panel Survey (MEPS) from 2016. The weighted prevalence of unmet dental need was estimated among individuals aged 18 years or older. Chi-squared and multivariate logit regression with marginal effects (ie absolute risk differences) were used to measure the association of unmet dental need with respondent characteristics. RESULTS The prevalence of adults reporting unmet dental need was 6% (95% CI: 5.5 to 6.5). Adults with dental insurance were 1.7 percentage points (95% CI: -2.8 to -0.6) less likely to report unmet dental needs than adults without dental insurance. Those with middle income were 2.3 percentage points (95% CI: 1.2 to 3.4), those with low income were 3.3 percentage points (95% CI: 1.7 to 5.0), and those with poor/negative/near-poor income were 4.2 percentage points (95% CI: 2.7 to 5.7) more likely to report an unmet dental need than adults with high income. Both Hispanics (-1.7 percentage points [95% CI: -2.8 to -0.6]) and non-Hispanic Blacks (-1.1 percentage points [95% CI: -2.1 to -0.1]) were less likely to report an unmet dental need than whites. Smoking, education, general health status, chronic disease and marital status were also significantly associated with reporting an unmet dental need. CONCLUSIONS Future policies should continue to address cost and coverage barriers to adult dental care, as these remain significant barriers to access, particularly for low-income adults. Future research should evaluate the reasons adults report unmet dental need and explore how adults' judgment of dental need compares to providers' clinical judgment. Additionally, research that explores how race and ethnicity affect perceptions of unmet dental need is warranted.
Collapse
Affiliation(s)
- Heather Taylor
- Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
| | - Ann M Holmes
- Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
| | - Justin Blackburn
- Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
| |
Collapse
|
15
|
Wang L, Ren J, Fiscella KA, Bullock S, Sanders MR, Loomis EL, Eliav E, Mendoza M, Cacciato R, Thomas M, Kopycka-Kedzierawski DT, Billings RJ, Xiao J. Interprofessional collaboration and smartphone use as promising strategies to improve prenatal oral health care utilization among US underserved women: results from a qualitative study. BMC Oral Health 2020; 20:333. [PMID: 33228617 PMCID: PMC7685586 DOI: 10.1186/s12903-020-01327-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/12/2020] [Indexed: 12/12/2022] Open
Abstract
Background Data on barriers and facilitators to prenatal oral health care among low-income US women are lacking. The objective of this study was to understand barriers/facilitators and patient-centered mitigation strategies related to the use of prenatal oral health care among underserved US women.
Methods We used community-based participatory research to conduct two focus groups with eight pregnant/parenting women; ten individual in-depth interviews with medical providers, dental providers and community/social workers; and one community engagement studio with five representative community stakeholders in 2018–2019. Using an interpretive description research design, we conducted semi-structured interviews and focus groups which were audio-recorded, transcribed, and analyzed for thematic content. Results We identified individual and systemic barriers/facilitators to the utilization of prenatal oral health care by underserved US women. Strategies reported to improve utilization included healthcare system-wide changes to promote inter-professional collaborations, innovative educational programs to improve dissemination and implementation of prenatal oral health care guidelines, and specialized dental facilities providing prenatal oral health care to underserved women. Moreover, smartphones have the potential to be an innovative entry point to promote utilization of prenatal oral care at the individual level. Conclusions Low-income women face multiple, addressable barriers to obtaining oral health care during pregnancy. Inter-professional collaboration holds strong promise for improving prenatal oral health care utilization.
Collapse
Affiliation(s)
- Lin Wang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.,Peking University School of Stomatology, Beijing, China
| | - Johana Ren
- University of Rochester River Campus, Rochester, NY, USA
| | - Kevin A Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Mechelle R Sanders
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Elizabeth L Loomis
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Eli Eliav
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael Mendoza
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA.,Monroe County Department of Public Health, Rochester, NY, USA
| | - Rita Cacciato
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Marie Thomas
- University of Rochester River Campus, Rochester, NY, USA
| | | | - Ronald J Billings
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
| |
Collapse
|
16
|
Chattopadhyay A, Christian B, Masood M, Calache H, Carpenter L, Gibbs L, Gussy M. Natural history of dental caries: Baseline characteristics of the VicGen birth cohort study. Int J Paediatr Dent 2020; 30:334-341. [PMID: 31850608 PMCID: PMC9292657 DOI: 10.1111/ipd.12609] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/04/2019] [Accepted: 12/12/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Early-life dental caries is a major global health problem. Children's first dental visit is recommended at 2 years age. The VicGeneration (VicGen) oral health birth cohort study aims to understand the multifactorial nature of early childhood caries. This report describes the baseline characteristics of children in the VicGen study. METHODS We merged data between the first (at birth) and fourth waves (18 month age) to assess dental caries among children (primary outcome) and other oral diseases (secondary outcomes) employing t tests, chi-square tests, Fisher's exact tests, and Cochran-Mantel-Haenszel tests using IBM-SPSS(v25). RESULTS Most children lived in metros with two-parent families. Most guardians were women graduated from high school. Twenty-seven of 389 (6.94%) 18-month-old children experienced dental caries. More children living in rural areas (vs. urban) experienced caries. Females were more likely to experience caries (OR: 2.16). Several children had other oral health problems. In early life, children's oral examination was conducted by midwives, breastfeeding/lactation consultants, hospital nurses, speech pathologists, and breastfeeding clinic staff. CONCLUSION VicGen baseline characteristics show that almost 7% of the 18-month-old children experienced caries. There is a need to advance children's recommended first dental visit date and to train early-life healthcare professionals about oral diseases.
Collapse
Affiliation(s)
- Amit Chattopadhyay
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVICAustralia,School of Dental MedicineCase Western Reserve UniversityClevelandOhio,Manipal College of Dental SciencesMangaloreIndia,Quest Arete ScienceOklahoma CityOklahoma
| | | | - Mohd. Masood
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVICAustralia
| | - Hanny Calache
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVICAustralia,Deakin Health EconomicsCentre for Population Health ResearchFaculty of HealthDeakin UniversityBurwoodVICAustralia
| | - Lauren Carpenter
- Jack Brockhoff Child Health and Wellbeing ProgramCentre for Health EquityThe University of MelbourneMelbourneVICAustralia
| | - Lisa Gibbs
- Jack Brockhoff Child Health and Wellbeing ProgramCentre for Health EquityThe University of MelbourneMelbourneVICAustralia
| | - Mark Gussy
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVICAustralia
| |
Collapse
|
17
|
Xiao J, Fogarty C, Wu TT, Alkhers N, Zeng Y, Thomas M, Youssef M, Wang L, Cowen L, Abdelsalam H, Nikitkova A. Oral health and Candida carriage in socioeconomically disadvantaged US pregnant women. BMC Pregnancy Childbirth 2019; 19:480. [PMID: 31805881 PMCID: PMC6896277 DOI: 10.1186/s12884-019-2618-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 11/21/2019] [Indexed: 12/13/2022] Open
Abstract
Background Despite the well-documented associations between poor maternal oral health and increased risk for adverse birth outcomes and dental caries in children after birth, prenatal oral health care is under-utilized, especially among the underserved population. In addition, oral Candida has recently been suggested as a potential culprit for children’s dental caries, with evident maternal contributions. Therefore, this study aimed to obtain epidemiological data on the oral health and oral Candida carriage in a cohort of underserved US pregnant women, and reveal factors associated with their oral Candida carriage. Methods Demographic-medical-oral hygiene practice data were collected. Comprehensive oral examination was conducted. Caries status and plaque index were recorded. Oral samples (saliva, plaque and swab) were processed to identify Candida species and Streptococcus mutans by culturing-dependent and -independent methods. Multiple logistic regression analyses were used to identify factors associated with oral Candida carriage and caries severity. Results Eighty-two socioeconomically disadvantaged women (48 pregnant and 34 non-pregnant) were enrolled. More pregnant women (79.1%) had > = 1 untreated decayed tooth when compared to their non-pregnant counterparts (47.1%) (p = 0.01). The average number of decayed teeth in pregnant and non-pregnant women was 3.9 and 3.1 (p > 0.05). Caries severity was positively associated with race (African American vs. white), plaque index and salivary Candida albicans level. C. albicans was the most predominant/abundant Candida strain, with cheek and tonsil as the most common colonized sites. The detection of C. albicans was 56%/56% in saliva and 40%/47% in plaque of the pregnant and non-pregnant groups, respectively. Study women’s oral Candida carriage is positively associated with hypertension [p = 0.03, odds ratio = 14.47(1.28, 163.51)], decayed teeth number [p = 0.04, odds ratio = 1.31 (1.01,1.69)] and salivary S. mutans level [p = 0.03, odds ratio = 4.80 (1.18–19.43)]. Conclusions Socioeconomically disadvantaged US women are in need of improved prenatal oral health, a large proportion of them have untreated decayed teeth and high carriage of oral Candida. Due to the observed significant association between the decayed teeth number and oral Candida carriage, providing oral health care during pregnancy (including limiting decayed teeth) will not only improve women’s oral health, but also present as a promising approach to reduce oral Candida carriage in women.
Collapse
Affiliation(s)
- Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA.
| | - Colleen Fogarty
- Department of Family Medicine, University of Rochester Medical Center, Rochester, USA
| | - Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, USA
| | - Naemah Alkhers
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA
| | - Yan Zeng
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA.,Department of Forensic Medicine, North Sichuan Medical College, Nanchong, China
| | - Marie Thomas
- Department of Family Medicine, University of Rochester Medical Center, Rochester, USA
| | - Moustafa Youssef
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA
| | - Lin Wang
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA.,College of Stomatology, Peking University, Beijing, China
| | - Lauren Cowen
- Department of Family Medicine, University of Rochester Medical Center, Rochester, USA
| | - Hossam Abdelsalam
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA
| | - Anna Nikitkova
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA
| |
Collapse
|
18
|
Konzen Júnior DJ, Marmitt LP, Cesar JA. [Non-performance of dental consultation among pregnant women in southern Brazil: a population-based study]. CIENCIA & SAUDE COLETIVA 2019; 24:3889-3896. [PMID: 31577019 DOI: 10.1590/1413-812320182410.31192017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 03/26/2018] [Indexed: 11/21/2022] Open
Abstract
The scope of this study was to measure the prevalence and identify factors associated with the non-use of dental care among pregnant women living in the municipality of Rio Grande, RS. In 2013, previously trained interviewers applied a single, standardized questionnaire within 48 hours after childbirth to all puerperal women living in this city. The chi-square test was used to compare proportions and, for multivariate analysis, Poisson regression with robust variance adjustment was used to obtain the prevalence ratio. Among the 2.653 puerperal women included in this study, 60.1% (95% CI: 58.2% - 61.9%) did not use any type of dental service during gestation. After adjustment, the probability of not using these services was significantly higher among pregnant women of lower age, income and schooling, who lived with more people at home, who performed a smaller number of prenatal consultations, who had prenatal care in the public service, and who were not attended under the Family Health Strategy (FHS). Encouraging pregnant women with this epidemiological profile to look for dental services during prenatal consultations and to expand the FHS on offer are measures with great potential to increase coverage for this type of service in the location studied.
Collapse
Affiliation(s)
- Dionizio José Konzen Júnior
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande. R. Visconde de Paranaguá 102, Campus da Saúde. 96203-900. Rio Grande, RS, Brasil.
| | - Luana Patricia Marmitt
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande. R. Visconde de Paranaguá 102, Campus da Saúde. 96203-900. Rio Grande, RS, Brasil.
| | - Juraci Almeida Cesar
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande. R. Visconde de Paranaguá 102, Campus da Saúde. 96203-900. Rio Grande, RS, Brasil.
| |
Collapse
|
19
|
Gupta A, Feldman S, Perkins RB, Stokes A, Sankar V, Villa A. Predictors of dental care use, unmet dental care need, and barriers to unmet need among women: results from NHANES, 2011 to 2016. J Public Health Dent 2019; 79:324-333. [PMID: 31407356 DOI: 10.1111/jphd.12334] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 06/11/2019] [Accepted: 07/09/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To examine socio-demographic and economic predictors of dental care access among women in the United States. METHODS A total of 52,493,940 women at the US national level aged 20-44 years were identified from the National Health and Nutrition Examination Survey, 2011 to 2016. Weighted multivariate logistic regression models were computed to identify predictors of dental care use, unmet dental-care need, and reported reasons for unmet need. RESULTS Young, Mexican-American, other minority race-ethnicities, less educated, and uninsured women were independently more likely to have never visited a dental clinic (P < 0.025). Mexican-Americanwomen with a poverty income ratio (PIR) <2.00 and less than excellent health status and those uninsured were independently more likely to have unmet dental need (P < 0.025). Women with PIR <1.00 and those uninsured were independently more likely to have an unmet need because of unaffordable cost (P < 0.0008) or lack of procedure coverage by insurance (P < 0.0008). Younger women were more likely to think that the dental problem would go away (P < 0.0001). CONCLUSIONS While young, less educated, and women from minority race-ethnicities were less likely to report ever use of dental care, only low income, poor health, and uninsured women were more likely to report unmet dental care need. Racial-ethnic minority, less educated, and young women may benefit from improved education about the value of dental care. Expanding insurance coverage for dental care and improving access for women with poor health may address racial-ethnic and education-level disparities in unmet dental care need.
Collapse
Affiliation(s)
- Avni Gupta
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
| | - Sarah Feldman
- Division of Gynecological Oncology, Brigham and Women's Hospital, Boston, MA, USA
| | - Rebecca B Perkins
- Department of Obstetrics and Gynecology, Boston University School of Medicine/Boston Medical Center, Boston, MA, USA
| | - Andrew Stokes
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Vidya Sankar
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.,Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.,Division of Oral Medicine and Oncology, Dana Farber Cancer Institute, Boston, MA, USA
| | - Alessandro Villa
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.,Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.,Division of Oral Medicine and Oncology, Dana Farber Cancer Institute, Boston, MA, USA
| |
Collapse
|
20
|
Xiao J, Kopycka-Kedzierawski DT, Billings RJ. Intergenerational task: Helping expectant mothers obtain better oral health care during pregnancy. J Am Dent Assoc 2019; 150:565-566. [PMID: 31248477 DOI: 10.1016/j.adaj.2019.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/01/2019] [Accepted: 04/03/2019] [Indexed: 11/27/2022]
|
21
|
Neumann A, Obadan-Udoh E, Bangar S, Kumar SV, Tokede O, Kim A, Yansane A, Mertz E, Panwar S, Gharpure A, Kookal KK, Mullins J, Even JB, Simmons K, White JM, Walji MF, Kalenderian E. Number of Pregnant Women at Four Dental Clinics and the Care They Received: A Dental Quality eMeasure Evaluation. J Dent Educ 2019; 83:1158-1165. [PMID: 31235503 DOI: 10.21815/jde.019.123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 05/07/2019] [Indexed: 12/15/2022]
Abstract
Process-of-care quality measure research can be used to identify gaps in the delivery of dental services to pregnant patients. The aim of this study was to evaluate the types of dental services that pregnant patients received in four dental clinics over five years as documented in the electronic health record (EHR). To accomplish this objective, the authors modified and validated a previously published claims-based dental quality measure for EHR use. After the electronic dental quality measure specifications were defined, the number of pregnant patients was calculated at three academic dental institutions and one large accountable care organization, and the types of dental care services they received over a five-year period (2013-17) were determined. Calibrated reviewers at each institution independently reviewed a sub-sample of patient charts to validate the information obtained from EHR queries, and the concordance between manual chart reviews and EHR query reports was analyzed. Of the 335,078 women aged 15-44 years who received care at the four clinics for the five reporting years, 3.9% (n=13,026) were pregnant. Among these pregnant patients, 48.9% (n=6,366) received a periodic dental examination; 30.0% (n=3,909) received a comprehensive dental exam; and 21.5% (n=2,799) received additional dental services, irrespective of comprehensive or periodic oral evaluations. Overall, the mean proportion of pregnant patients seeking care in these academic dental and group practice clinics was low, but 78.9% of them received either a periodic or comprehensive oral evaluation. Given the importance of oral health care during pregnancy, these findings suggest a need for curriculum development to incorporate prenatal oral health education in the training of dental students.
Collapse
Affiliation(s)
- Ana Neumann
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Enihomo Obadan-Udoh
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Suhasini Bangar
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Shwetha V Kumar
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Oluwabunmi Tokede
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Aram Kim
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Alfa Yansane
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Elizabeth Mertz
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Sapna Panwar
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Arti Gharpure
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Krisha Kumar Kookal
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Joanna Mullins
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Joshua B Even
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Kristen Simmons
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Joel M White
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Muhammad F Walji
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Elsbeth Kalenderian
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco.
| |
Collapse
|
22
|
Deghatipour M, Ghorbani Z, Ghanbari S, Arshi S, Ehdayivand F, Namdari M, Pakkhesal M. Oral health status in relation to socioeconomic and behavioral factors among pregnant women: a community-based cross-sectional study. BMC Oral Health 2019; 19:117. [PMID: 31208377 PMCID: PMC6580553 DOI: 10.1186/s12903-019-0801-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 05/31/2019] [Indexed: 12/15/2022] Open
Abstract
Background Oral health of women during pregnancy is an important issue. Not only it can compromise pregnancy outcomes, but also it may affect their newborn’s overall health. The aim of this study was to assess the oral health status and associated factors in pregnant women. Methods A cross-sectional study was conducted amongst 407 pregnant women in the second and third trimester of pregnancy in Varamin, Iran. Oral health status was examined, and demographic, socioeconomic status and dental care behavior data were collected. Oral health indices included periodontal pocket, bleeding on probing (BOP) and decayed, missed, filled teeth (DMFT). Regression analysis of DMFT was used to study the association between demographic, dental care behaviors indicators and outcome variables using the count ratios (CR) and 95% confidence intervals (CI). Results The mean (SD, Standard Deviation) age of participants was 27.35 (5.57). Daily brushing, flossing habit were observed in 64.1, and 20.6% of mothers, respectively. Mean (SD) of DMFT, D, M, F were 10.34(5.10), 6.94(4.40), 2.22 (2.68) and 1.19(2.23), respectively. Women older than 35 years had significantly more DMFT [CR = 1.35 (95% CI 1.13; 1.60)], less D [CR = 0.75 (95% CI 0.59; 0.94)], and more M [CR = 3.63 (95% CI 2.57; 5.14)] compared to women under 25 years after controlling for education and dental care behaviors. Women with academic education had significantly less decayed teeth [CR = 0.63 (95% CI 0.48; 0.84)], compared to women with under 12 years of education. Conclusions Oral health status of pregnant women was not satisfactory, having an average of seven decayed teeth in their mouth.
Collapse
Affiliation(s)
- Marzie Deghatipour
- Dental Research Center, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Ghorbani
- Community Oral Health Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blvd, Tehran, IR, 19834, Iran.
| | - Shahla Ghanbari
- Department of Health Education and Health Promotion, Deputy for Health affairs, Shahid Beheshti University of Medical sciences, Tehran, Iran
| | - Shahnam Arshi
- Deputy for Health affairs, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farnaz Ehdayivand
- Obstetrician and gynecologist, Deputy of Health Affairs, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahshid Namdari
- Of Biostatistics, Department Of Community Oral Health, School Of Dentistry, Shahid Beheshti University Of Medical Sciences, Tehran, Iran
| | - Mina Pakkhesal
- Community Oral Health Department, School of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran
| |
Collapse
|
23
|
Choi JW, Choi Y, Lee TH, Lee HJ, Ju YJ, Park EC. Employment status and unmet dental care needs in South Korea: a population-based panel study. BMJ Open 2019; 9:e022436. [PMID: 30928921 PMCID: PMC6475345 DOI: 10.1136/bmjopen-2018-022436] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This study was designed to evaluate whether employment status is associated with the experience of unmet dental care needs. METHODS A total of 4620 workers were retrieved from Korea Health Panel data (2010-2013), and potential relationships were explored among their income levels, changes in employment and unmet dental care needs. RESULTS Among the 4620 workers, 17.3% said they had failed at least once to get dental treatment or check-up, despite their needs. Precarious workers and those not in employment were more likely to experience unmet dental care needs due to economic burden compared with permanent workers (OR 1.36, 1.40, respectively). In addition, people in low-income group were 4.46 times more likely to experience unmet dental care needs caused by economic burden, compared with those with the highest income. CONCLUSION This disparity means that precarious workers and those not in employment are more likely to face barriers in obtaining needed health services. Given the insecure employment status of low income people, meeting their healthcare needs is an important consideration.
Collapse
Affiliation(s)
- Jae Woo Choi
- Department of Health Administration, Dongseo University, Busan, South Korea
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, South Korea
| | - Young Choi
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, South Korea
| | - Tae-Hoon Lee
- HIRA Research Institute, Health Insurance Review and Assessment Service, Wonju, South Korea
| | - Hyo Jung Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea
| | - Yeong Jun Ju
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, South Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| |
Collapse
|
24
|
Xiao J, Alkhers N, Kopycka-Kedzierawski DT, Billings RJ, Wu TT, Castillo DA, Rasubala L, Malmstrom H, Ren Y, Eliav E. Prenatal Oral Health Care and Early Childhood Caries Prevention: A Systematic Review and Meta-Analysis. Caries Res 2019; 53:411-421. [PMID: 30630167 PMCID: PMC6554051 DOI: 10.1159/000495187] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 10/31/2018] [Indexed: 11/19/2022] Open
Abstract
Despite the advancement of early childhood caries (ECC) prediction and treatment, ECC remains a significant public health burden in need of more effective preventive strategies. Pregnancy is an ideal period to promote ECC prevention given the profound influence of maternal oral health and behaviors on children's oral health. However, studies have shown debatable results with respect to the effectiveness of ECC prevention by means of prenatal intervention. Therefore, this study systematically reviewed the scientific evidence relating to the association between prenatal oral health care, ECC incidence, and Streptococcus mutans carriage in children. Five studies (3 randomized control trials, 1 prospective cohort study, and 1 nested case-control study) were included for qualitative assessment. Tested prenatal oral health care included providing fluoride supplements, oral examinations/cleanings, oral health education, dental treatment referrals, and xylitol gum chewing. Four studies that assessed ECC incidence reduction were included in meta-analysis using an unconditional generalized linear mixed effects model with random study effects and age as a covariate. The estimated odds ratio and 95% confidence intervals suggested a protective effect of prenatal oral health care against ECC onset before 4 years of age: 0.12 (0.02, 0.77) at 1 year of age, 0.18 (0.05, 0.63) at 2 years of age, 0.25 (0.09, 0.64) at 3 years of age, and 0.35 (0.12, 1.00) at 4 years of age. Children's S. mutans carriage was also significantly reduced in the intervention group. Future studies should consider testing strategies that restore an expectant mother's oral health to a disease-free state during pregnancy.
Collapse
Affiliation(s)
- Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA,
| | - Naemah Alkhers
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | | | - Ronald J Billings
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, USA
| | - Daniel A Castillo
- Miner Library, University of Rochester Medical Center, Rochester, New York, USA
| | - Linda Rasubala
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Hans Malmstrom
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Yanfang Ren
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Eli Eliav
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| |
Collapse
|
25
|
Rocha JS, Arima L, Chibinski AC, Werneck RI, Moysés SJ, Baldani MH. Barriers and facilitators to dental care during pregnancy: a systematic review and meta-synthesis of qualitative studies. CAD SAUDE PUBLICA 2018; 34:e00130817. [PMID: 30208187 DOI: 10.1590/0102-311x00130817] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 06/11/2018] [Indexed: 11/21/2022] Open
Abstract
Some barriers to dental treatment during pregnancy are poorly understood, especially those related to psychosocial factors, which are better explored in qualitative studies. The aim of this systematic review was to explore the barriers and facilitators to dental care during pregnancy through a thematic synthesis of qualitative studies. Qualitative or mixed-methods studies published in English, Portuguese, Spanish and French, from 2000 to 2016, were included. The search strategies were conducted in PubMed, Scopus, Web of Science, LILACS, BBO and CINAHL. To evaluate the quality of the studies, we used the Critical Appraisal Skills Programme tool. Thematic synthesis was performed in order to interpret and summarize the results. From 2,581 screened studies, ten were included in the synthesis. We found 14 analytical themes related to barriers and facilitators to dental care during pregnancy that interacted in complex ways: physiological conditions, low importance of oral health, negative stigma regarding dentistry, fear of/anxiety toward dental treatment, mobility and safety, financial barriers, employment, time constraints, social support, lack of information, health professionals' barriers, family and friends' advice, beliefs and myths about the safety of dental treatment. Myths and beliefs about oral health and dental treatment during pregnancy appear to be the most frequent barriers, both to pregnant women and to dentists or other health professionals. The findings of this review may support new studies, especially to test intervention protocols and to guide effective public policies for the promotion of oral health during pregnancy.
Collapse
Affiliation(s)
- Juliana Schaia Rocha
- Universidade Estadual de Ponta Grossa, Ponta Grossa, Brasil.,Pontifícia Universidade Católica do Paraná, Curitiba, Brasil
| | - Letícia Arima
- Pontifícia Universidade Católica do Paraná, Curitiba, Brasil
| | | | | | | | | |
Collapse
|
26
|
Rocha JS, Arima LY, Werneck RI, Moysés SJ, Baldani MH. Determinants of Dental Care Attendance during Pregnancy: A Systematic Review. Caries Res 2018; 52:139-152. [DOI: 10.1159/000481407] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 09/08/2017] [Indexed: 12/14/2022] Open
Abstract
Despite the fact that dental care attendance during pregnancy has been recommended by guidelines and institutions, the demand for dental services is still low among pregnant women. The aim of this study was to identify and analyze the determinants of dental care attendance during pregnancy. We performed a systematic literature search in the electronic databases PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature, Brazilian Library in Dentistry, Cumulative Index to Nursing and Allied Health Literature, and Medline using relevant keywords. Studies were filtered by publication year (2000-2016) and language (English, Portuguese, Spanish, and French). The included studies were assessed for quality. Their characteristics and statistically significant factors were reported. Fourteen papers were included in the review. The prevalence of dental service usage during pregnancy ranged from 16 to 83%. Demographic factors included women's age, marital status, parity, and nationality. The socioeconomic factors were income, educational level, and type of health insurance. Many psychological and behavioral factors played a role, including oral health practices, oral health and pregnancy beliefs, and health care maintenance. Referred symptoms of gingivitis, dental pain, or dental problems were perceived need. Demographic, socioeconomic, psychological, behavioral factors and perceived need were associated with the utilization of dental services during pregnancy. More well-designed studies with reliable outcomes are required to confirm the framework described in this review.
Collapse
|
27
|
Pregnant Women's Infant Oral Health Knowledge and Beliefs: Influence of Having Given Birth and of Having a Child in the Home. Matern Child Health J 2017; 20:1288-95. [PMID: 26961141 DOI: 10.1007/s10995-016-1930-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Introduction Prenatal oral health interventions can positively impact maternal and child oral health, yet limited information exists concerning how to best educate pregnant women about infant oral health. Our objective was to examine the influence of having given birth on pregnant women's infant oral health knowledge and beliefs. Methods We conducted a secondary analysis of data collected from a cross-sectional survey of pregnant women ≥18 years old attending UNC's Ultrasound Clinic. Four binomial items were categorized as infant knowledge (IK) and five rated on a Likert scale (1-5) as infant belief (IB). Overall IK and IB scores were calculated, averaging the items within each construct. Respondents were categorized into two groups: multiparous (N = 268), women having at least one previous live birth and a child between 2 and 6 years old, or nulliparous (N = 186), women with no previous live births or a child between 2 and 6 years old. Regression models for IK and IB were conducted using SAS 9.2 with maternal demographic characteristics, dental utilization, and birth history as explanatory variables (p ≤ 0.05). Results IK was affected by race (p = 0.04), mother's oral health self-rating (p = 0.0002), and birth history (p < 0.0001). On average, IK was 0.12 units higher in subjects with a history of giving birth, adjusting for explanatory variables. IB was influenced by maternal oral health beliefs (p = 0.002) and history of access to dental care (p = 0.0002). IB did not differ based on birth history (p = 0.17). Discussion The influence of birth history on pregnant women's infant oral health knowledge and beliefs can be considered in future intervention designs to maximize available resources.
Collapse
|
28
|
Riedy CA, Weinstein P, Mancl L, Garson G, Huebner CE, Milgrom P, Grembowski D, Shepherd-Banigan M, Smolen D, Sutherland M. Dental attendance among low-income women and their children following a brief motivational counseling intervention: A community randomized trial. Soc Sci Med 2015; 144:9-18. [PMID: 26372934 DOI: 10.1016/j.socscimed.2015.09.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 08/19/2015] [Accepted: 09/04/2015] [Indexed: 11/29/2022]
Abstract
UNLABELLED This study tested a behavioral intervention to increase dental attendance among rural Oregonian low-income women and their children. It utilized a multi-site, single-blind, randomized trial design. Four hundred women were randomized into one of four conditions to receive prenatal or postpartum motivational interviewing/counseling (MI) or prenatal or postpartum health education (HE). Counselors also functioned as patient navigators. Primary outcomes were dental attendance during pregnancy for the mother and for the child by age 18 months. Attendance was obtained from the Oregon Division of Medical Assistance Programs and participant self-report. Statewide self-reported utilization data were obtained from the Oregon Pregnancy Risk Assessment Monitoring System (PRAMS). Maternal attendance was 92% in the prenatal MI group and 94% in the prenatal HE group (RR = 0.98; 95% CI = 0.93-1.04). Children's attendance was 54% in postpartum MI group and 52% in the postpartum HE group (RR = 1.03; 95% CI = 0.82-1.28). Compared to statewide PRAMS, attendance was higher during pregnancy for study mothers (45% statewide; 95% CI = 40-50%) and for their children by 24 months (36% statewide; 95% CI = 27-44%). MI did not lead to greater attendance when compared to HE alone and cost more to implement. High attendance may be attributable to the counselors' patient navigator function. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT01120041.
Collapse
Affiliation(s)
- Christine A Riedy
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Philip Weinstein
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Lloyd Mancl
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Gayle Garson
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Colleen E Huebner
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Peter Milgrom
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - David Grembowski
- University of Washington School of Public Health, Box 357660, 1959 NE Pacific St, Seattle, WA 98195-7660, USA.
| | - Megan Shepherd-Banigan
- University of Washington School of Public Health, Box 357660, 1959 NE Pacific St, Seattle, WA 98195-7660, USA.
| | - Darlene Smolen
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Marilynn Sutherland
- Klamath County Department of Public Health, 305 Main Street, Klamath Falls, OR 97601, USA.
| |
Collapse
|