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Panda A, Silk H, Hayes C, Savageau JA. An Assessment of Oral Health Training in Obstetrical Care in Massachusetts. Matern Child Health J 2024; 28:1168-1177. [PMID: 38367150 DOI: 10.1007/s10995-024-03905-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 02/19/2024]
Abstract
PURPOSE Oral health (OH) has significant effects on pregnancy and infant outcomes. This study assesses the perspectives of obstetrical clinicians about OH education and promotion. METHODS A fifteen-item survey was developed and circulated to obstetrics and gynecology (OBGYN) and family medicine (FM) physicians, and other prenatal health clinicians in Massachusetts (MA). Additionally, eight physicians were purposively sampled for in-depth interviews to discuss their experience with prenatal OH training and practice. Bivariate relationships between outcome variables from the survey (e.g., previous OH training, awareness of OH guidelines, asking about OH during prenatal visits) were analyzed along with coding and analysis of the qualitative interview data. RESULTS The majority (77%) of the 86 survey respondents did not feel well-trained in OH. We found significant associations between being well-trained in OH and: (1) awareness of state guidelines (X2 = 11.85, p < 0.001); (2) asking about OH during prenatal visits (X2 = 9.21, p = 0.002); and (3) routinely referring patients for dental care (X2 = 15.35, p < 0.001). Lack of access to dental insurance and dental professionals were found to be major perceived barriers to care. Responses from the interviews reinforced these findings.
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Affiliation(s)
- Ashwin Panda
- Department of Family Medicine and Community Health, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA.
| | - Hugh Silk
- Department of Family Medicine and Community Health, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA
| | - Catherine Hayes
- Department of Oral Health Policy & Epidemiology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, 02115, USA
| | - Judith A Savageau
- Department of Family Medicine and Community Health, UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA, 01655, USA
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2
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Liang L, Aris IM. Association between Age at First Birth and Long-Term Dental Caries Experience among Women in the United States. J Womens Health (Larchmt) 2024. [PMID: 38853662 DOI: 10.1089/jwh.2023.0846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024] Open
Abstract
Background: Pregnant women are at a higher risk of caries compared to nonpregnant women, and higher parity is a risk factor for untreated caries and tooth loss. However, it is unknown whether the timing of birth is associated with dental caries experience over time. Materials and Methods: This study is a cross-sectional study using the National Health and Nutrition Examination Survey (NHANES), 2011-2018. The study population included nonpregnant women 20 years of age or older, who had available data on the oral health examination and age at first birth (AFB). Dental caries experience was defined as the DMFT score (sum of the number of decayed, missing due to caries, and filled permanent teeth). The associations between AFB and DMFT scores were assessed using Poisson regression to compute incidence rate ratios (IRRs) and the associated 95% confidence intervals (CIs). Results: This study included 6,553 women (mean age 53.4 years, SD 15.7). The mean DMFT index score was 13.1 ± 7.4, with younger AFB groups generally having higher mean scores. After adjusting for sociodemographic variables, time since last dental visit, and reproductive health factors, women with an AFB of <18 years (IRR, 1.10; 95% CI, 1.01-1.21) or 18-20 years (IRR, 1.11; 95% CI, 1.01-1.21) had significantly higher DMFT index scores compared to those with an AFB of 30-32 years. Conclusions: This study suggests that younger maternal AFB may be associated with greater dental caries experience. More rigorous studies are necessary to determine how to improve oral health outcomes during pregnancy and postpartum.
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Affiliation(s)
- Lang Liang
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Izzuddin M Aris
- Department of Population Medicine, Division of Chronic Disease Research Across the Lifecourse, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
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3
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Phoosuwan N, Bunnatee P, Lundberg PC. Oral health knowledge, literacy and behavior of pregnant women: a qualitative study in a northeastern province of Thailand. BMC Oral Health 2024; 24:653. [PMID: 38834970 DOI: 10.1186/s12903-024-04414-3] [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: 02/09/2024] [Accepted: 05/27/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Pregnancy is a unique period of women's lives, and oral health is an important public health indicator during this period. Pregnant women have increased vulnerability to oral health problems. The study aimed to describe oral health knowledge, literacy and behavior of pregnant women in a northeastern province of Thailand. METHODS A descriptive study was used. Twenty pregnant women who attended antenatal care clinics of eight public hospitals in the province were recruited by use of purposive sampling. They participated voluntarily in individual interview. The Health Belief Model was used as conception framework. All data were transcribed and subjected to content analysis. RESULTS Five categories emerged: Misbelief and lack of knowledge, Oral health problems and dental care seeking, Oral health information from different persons, Self-care management of oral health, and Fear of and anxiety towards dental treatment. The findings showed that low knowledge of need for treatment, little importance to oral health and low priority of dental needs affect the demand for dental care. Fear of and anxiety towards dental treatment were the results of negative past experiences of neglecting dental care. Some women perceived health benefits of practicing self-care of oral health during pregnancy. CONCLUSION The findings help to better understand the oral health issues of pregnant women and provide baseline information for oral health promotion. Such promotion and culturally appropriate care should be integrated in maternal health education classes.
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Affiliation(s)
- Nitikorn Phoosuwan
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Box 564, Uppsala, SE-751 22, Sweden
- Department of Community Health, Faculty of Public Health, Kasetsart University, Chalermphrakiat Sakonnakhon Province Campus, Sakonnakhon Province, Thailand
| | | | - Pranee C Lundberg
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Box 564, Uppsala, SE-751 22, Sweden.
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Abdollahi M, Tehrani H, Jamali J, Nemati-Karimooy A, Gholian-Aval M. Design and psychometric evaluation of organizational determinants of prenatal dental services questionnaire in Iran. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38838048 DOI: 10.1111/scd.13019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/06/2024] [Accepted: 05/09/2024] [Indexed: 06/07/2024]
Abstract
AIMS The quality of prenatal dental services is essential for improving the oral health of both mothers and children. However, a lack of a reliable tool to assess the quality of prenatal oral care has hindered research in this area. To address this gap, the study aimed to validate the Organizational Determinants of Prenatal Dental Services Questionnaire (OD_PDS) in Iranian pregnant women. METHODS Literature reviews, interviews, and a cross-sectional survey with 300 pregnant women were conducted. To evaluate the validity; face, content and construct validity were assessed. Cronbach's alpha coefficient and the Test-retest method were used for reliability assessment. RESULTS The final version of the OD_PDS comprises 12 items, and four subscales, which are Costs (four items), Access to Equipment and services (three items), Review of the service delivery process (two items), and Professional Behavior (three items). Questions with a factor loading of less than 0.3 were excluded. The obtained fit indices were acceptable (X2/pdf = 3.383, RMSEA: 0.089, CFI = 0.869, and TLI = 0.820). The content reliability was demonstrated by Cronbach's α = 0.702 and 0.713 and the ICC = 0.724. CONCLUSION The current study indicates that the OD_PDS is a valid and reliable tool for Prenatal Dental Services assessment in health centers.
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Affiliation(s)
- Monireh Abdollahi
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jamshid Jamali
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atefeh Nemati-Karimooy
- Department of Restorative and Cosmetic Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Gholian-Aval
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Meto A, Sula A, Peppoloni S, Meto A, Blasi E. Leveraging Dental Stem Cells for Oral Health during Pregnancy: A Concise Review. Dent J (Basel) 2024; 12:127. [PMID: 38786525 PMCID: PMC11120089 DOI: 10.3390/dj12050127] [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: 02/29/2024] [Revised: 04/12/2024] [Accepted: 05/01/2024] [Indexed: 05/25/2024] Open
Abstract
Pregnancy induces significant changes in oral health because of hormonal fluctuations, making it a crucial period for preventive measures. Dental stem cells (DSCs), particularly those derived from the dental pulp and periodontal ligaments, offer promising avenues for regenerative therapies and, possibly, preventive interventions. While the use of DSCs already includes various applications in regenerative dentistry in the general population, their use during pregnancy requires careful consideration. This review explores recent advancements, challenges, and prospects in using DSCs to address oral health issues, possibly during pregnancy. Critical aspects of the responsible use of DSCs in pregnant women are discussed, including safety, ethical issues, regulatory frameworks, and the need for interdisciplinary collaborations. We aimed to provide a comprehensive understanding of leveraging DSCs to improve maternal oral health.
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Affiliation(s)
- Aida Meto
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, 1007 Tirana, Albania;
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, Laboratory of Microbiology and Virology, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.P.); (E.B.)
- Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Ana Sula
- Department of Obstetrics and Gynecology, American Hospital, 1060 Tirana, Albania;
| | - Samuele Peppoloni
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, Laboratory of Microbiology and Virology, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.P.); (E.B.)
| | - Agron Meto
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, 1007 Tirana, Albania;
| | - Elisabetta Blasi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, Laboratory of Microbiology and Virology, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.P.); (E.B.)
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Gilani SI, Niaz A, Afridi S. Maternal periodontitis as a risk factor for preterm birth: A cross-sectional study. J Dent Res Dent Clin Dent Prospects 2024; 18:72-76. [PMID: 38881641 PMCID: PMC11179145 DOI: 10.34172/joddd.40860] [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: 11/25/2023] [Accepted: 01/03/2024] [Indexed: 06/18/2024] Open
Abstract
Background Preterm birth is a heterogeneous condition with multiple underlying causes, and periodontal diseases are one of them. Approximately 900000 preterm births are reported in Pakistan each year. Oral infections such as periodontitis during pregnancy are associated with adverse pregnancy outcomes such as low birth weight and preterm births. However, different studies have reported contradictory findings. We conducted a cross-sectional study to assess the association of preterm birth with oral infection in pregnancy. Methods We conducted a cross-sectional analytical study on 400 postpartum pregnant women in Khyber Teaching Hospital, Peshawar. Only women within the age bracket of 18‒40 years were recruited. Data were collected by an interview-based structured questionnaire. The extent and severity index were used to assess the periodontal health of participants. Frequency tables were generated, and the chi-squared test was used to determine associations between different categorical variables. Results The mean age of the participants was 25.8±4.9 years. Approximately 87.5% of the women had generalized periodontitis. Approximately 68% of mothers had moderate severity of periodontitis. The extent index showed no notable difference between the preterm and full-term birth groups. In contrast, the severity index displayed a statistically significant difference between the preterm and full-term birth groups. Conclusion The majority of women had generalized periodontitis. The severity index demonstrated a significant association between maternal periodontitis and preterm births. There was no association between the age of mothers and preterm births. Complications in pregnancy were not associated with preterm births.
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Affiliation(s)
- Syed Imran Gilani
- Department of Community & Preventive Dentistry, Sardar Begum Dental College, Peshawar, Pakistan
| | - Aiman Niaz
- Department of Community & Preventive Dentistry, Sardar Begum Dental College, Peshawar, Pakistan
| | - Saira Afridi
- Department of Community & Preventive Dentistry, Sardar Begum Dental College, Peshawar, Pakistan
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Byrd M, Davis E, Blostein F, Bhaumik D, Shaffer JR, McNeil DW, Marazita ML, Foxman B. Risk of Postpartum Dental Caries: Survival Analysis of Black/African American and White Women in Appalachia. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:108-119. [PMID: 38404680 PMCID: PMC10890941 DOI: 10.1089/whr.2023.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/13/2024] [Indexed: 02/27/2024]
Abstract
Background Pregnancy is associated with increased risk of caries, but the extent this increase extends into the postpartum period is poorly understood. Study Objective Describe the epidemiology of dental decay in the postpartum period among Black/African American and White American women and explore associations with potentially modifiable risk factors. Materials and Methods We analyzed data from 1,131 Black/African American and White women participating in Center for Oral Health Research in Appalachia cohorts. Women were enrolled during the first two trimesters of pregnancy. Calibrated dental professionals completed dental examinations at the prenatal enrollment visit, and 2-month, 1-year, 2-year, and 3-year postpartum visits. Results Between the prenatal visit and 2-month visit, the incidence of decayed, missing, and filled teeth (DMFT) increase was 6.92/100 person-months, compared to 3.6/100 person-months between the 2-month and 1-year visit. In a multivariate Cox proportional hazard regression predicting incidence of caries up to 3-years postpartum, being younger, having less than college education, a household income <$50,000, smoking cigarettes, a DMFT >0, a very poor or poor Oral hygiene Rating Index, lower salivary pH at enrollment, or frequently drinking 100% juice increased the hazard of new dental caries. Adjusting for race/ethnic group did not affect the direction or magnitude of observed associations. Conclusions The strong associations of prior DMFT and Oral Rating Index with occurrence of new dental caries postpartum suggests that targeting young women for interventions to improve oral health may be more valuable for reducing caries incidence during pregnancy and in the postpartum period than targeting women only during pregnancy.
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Affiliation(s)
- Morgan Byrd
- Department of Epidemiology, Center of Molecular and Clinical Epidemiology of Infectious Diseases, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Elyse Davis
- Department of Epidemiology, Center of Molecular and Clinical Epidemiology of Infectious Diseases, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Freida Blostein
- Department of Epidemiology, Center of Molecular and Clinical Epidemiology of Infectious Diseases, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Deesha Bhaumik
- Department of Epidemiology, Center of Molecular and Clinical Epidemiology of Infectious Diseases, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - John R. Shaffer
- Department of Oral and Craniofacial Sciences, Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pennsylvania, Pennsylvania, USA
| | - Daniel W. McNeil
- Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Mary L. Marazita
- Department of Oral and Craniofacial Sciences, Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pennsylvania, Pennsylvania, USA
- Clinical Translational Science, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Betsy Foxman
- Department of Epidemiology, Center of Molecular and Clinical Epidemiology of Infectious Diseases, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Subedi K, Shrestha A, Bhagat T. Oral health status and barriers to utilization of dental services among pregnant women in Sunsari, Nepal: A cross-sectional study. Int J Dent Hyg 2024; 22:209-218. [PMID: 37635438 DOI: 10.1111/idh.12728] [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: 07/23/2021] [Revised: 06/17/2023] [Accepted: 08/06/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVES This study was conducted to assess oral hygiene practices, oral health status and barriers to utilization of oral health care services among pregnant mothers attending two family health care clinics in Sunsari, Nepal. METHODS A cross-sectional study was conducted among 139 women using a purposive sampling technique. The data collection was done using a pretested standard semi-structured questionnaire. Face-to-face interviews of the participants were done by a single investigator in the local language (Nepali). The examination was done using a mouth mirror and CPI probe for periodontal status, loss of attachment and dentition status, and treatment needs. RESULTS The majority of pregnant mothers brushed their teeth once a day or less than once a day (n = 106, 76.3%) and self-reported perceived oral health status was poor/fair (n = 93, 66.9%). The prevalence of dental caries was found to be 69.8%. Bleeding on probing was present in all participants. DMFT, presence of bleeding on probing and increased periodontal pocket was significantly high among women who had self-reported their oral health problems in comparison to those who had not reported any problem. The most common barriers reported by the participants were a lack of knowledge of dental checkups and a lack of perceived need for dental care during pregnancy. CONCLUSIONS There was a high prevalence of dental caries and periodontal disease. Lack of knowledge and perceived need for dental care were the major barriers found in this study. Hence, this directs towards the utmost need for improvement in awareness level as well as oral hygiene practices.
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Affiliation(s)
- Krishna Subedi
- Dental Department, Pokhara Academy of Health Sciences, Pokhara, Nepal
| | - Ashish Shrestha
- Department of Public Health Dentistry, CODS, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Tarakant Bhagat
- Department of Public Health Dentistry, CODS, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Abdollahi M, Tehrani H, Mahdizadeh M, Nemati-Karimooy A, Gholian-Aval M. Perceptions and determinants of oral health care among Iranian pregnant women: a qualitative study. BMJ Open 2024; 14:e080033. [PMID: 38286690 PMCID: PMC10826535 DOI: 10.1136/bmjopen-2023-080033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/28/2023] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVES This study aimed to gain a comprehensive understanding of the determinants that influence oral healthcare behaviours among Iranian pregnant women. STUDY DESIGN Qualitative study. SETTING Comprehensive health service centres. PARTICIPANTS A sample consisting of all people involved in the process of oral care during pregnancy, 18 pregnant women, 7 midwives/healthcare workers, 3 supervisors of prenatal care services and 3 dentists) were purposefully sampled in terms of demographic characteristics. METHODS The qualitative content analysis study conducted 31 semistructured individual interviews in 2022, utilising MAXQDA V.10. RESULTS The participants identified 3 main categories and 11 subcategories: individual and physiological determinants (care needs, perceived importance, motivation, oral health literacy and inherent pregnancy limitations), organisational determinants (costs, access to equipment and services, review of service delivery process and professional behaviour) and social-cultural determinants (educational services and support from family and friends). CONCLUSIONS The results can be used in interventions to improve oral healthcare for pregnant women. This study highlights the importance of addressing individual, organisational and social-cultural determinants to improve oral healthcare during pregnancy.
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Affiliation(s)
- Monireh Abdollahi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehrsadat Mahdizadeh
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atefeh Nemati-Karimooy
- Restorative and Cosmetic Dentistry,School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Gholian-Aval
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Al Agili D. Trends in maternal oral health services at primary healthcare centers in Saudi Arabia: a cross-sectional study. BMC Oral Health 2023; 23:1031. [PMID: 38129865 PMCID: PMC10740224 DOI: 10.1186/s12903-023-03712-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND During pregnancy, many complex physiological changes and increased levels of pregnancy hormones are associated with adverse oral health and increased prevalence of periodontal disease. Our study aimed to assess the oral health needs of pregnant women and describe the patterns of dental services provided to them before, during, and after pregnancy. Assessing the oral health needs of pregnant women and understanding the patterns of dental services provided to them are important to facilitate efficient utilization of oral health services to promote better health outcomes for the mother and baby. METHODS Our study utilized a cross-sectional design to examine the prevalence of dental problems and use of dental services among a sample of postpartum women who visited primary healthcare centers (PHCs) in Jeddah for antenatal care, between 2018 and 2019. A link to a questionnaire adapted from the Pregnancy Risk Assessment Monitoring System (PRAMS) was sent to participants via the WhatsApp messaging platform. A total of 1350 postpartum women responded to the online survey. We estimated the prevalence of dental problems among women before and during pregnancy and assessed the association between their dental problems and their respective demographic characteristics. We calculated the prevalence of each dental service received before, during, and after pregnancy and examined the trends in dental services over these three periods. All bivariate associations were tested using Pearson's chi-squared test. RESULTS We found that significantly fewer women visited a dental clinic during pregnancy (31.0%) compared to pre-pregnancy (38.2%) and post-pregnancy (47.3%). The prevalence of toothache, dental caries, gum disease, and dental extraction need before pregnancy was 45.9%, 57.0%, 27.3%, and 40.0%, respectively. These percentages remained the same during pregnancy, except for the need for dental extraction, which significantly decreased to 35.3%. Check-up dental visits increased significantly to 70.6% during pregnancy compared to pre-pregnancy (51.7%) and post-pregnancy (59.9%). CONCLUSION Increasing women's awareness of the importance and safety of oral healthcare during pregnancy, training dental students and primary healthcare dentists in the practice guidelines for the dental management of pregnant women, and developing and monitoring key performance indicators for maternal oral healthcare are the starting steps for improving the oral health and well-being of women and their children.
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Affiliation(s)
- Dania Al Agili
- Department of Dental Public Health, King Abdulaziz University, P.O. Box 80200, 21589, Jeddah, Saudi Arabia.
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El Hassan NK, Ramadan AM. Interleukin 1 beta and its association with the periodontal health of pregnant women. J Taibah Univ Med Sci 2023; 18:1376-1383. [PMID: 37332485 PMCID: PMC10275976 DOI: 10.1016/j.jtumed.2023.05.012] [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: 02/16/2023] [Revised: 04/18/2023] [Accepted: 05/12/2023] [Indexed: 06/20/2023] Open
Abstract
Objectives In this study, we measured and compared serum and gingival crevicular fluid (GCF) levels of interleukin 1 beta (IL-1β) in pregnant women with periodontitis and pregnant women with a healthy periodontium. We also determined the prevalence of periodontitis among pregnant women attending Omdurman Midwifery Hospital. Materials This was a hospital-based clinical study and laboratory investigation using ELISA tests of 80 pregnant women in the third trimester conducted at the Omdurman Midwifery Hospital in Khartoum, Sudan. The study group consisted of 50 women while the control group consisted of 30 women. Results Independent samples t-tests were used to compare serum and GCF levels of IL-1β between the study and control groups. Pearson's correlation analysis was also used to compare gingival parameters and IL-1β levels in the GCF. For each comparison, the p-value was fixed at 0.05. The GCF in the research group showed a considerable increase in IL-1β levels. There was also a strong positive association between high IL-1β levels in the research group's GCF and probing pocket depth (PPD) and clinical attachment level (CAL) levels. Conclusions Our study provides further evidence that periodontitis, as measured by a PD ≥4 mm and a CAL ≥3 mm, is associated with an increased level of IL-1β in the GCF of pregnant women with active periodontal disease during pregnancy and may include the transient translocation of oral organisms to the utero-placental unit, inciting placental inflammation or oxidative stress early in pregnancy, ultimately resulting in placental damage and clinical manifestations.
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Affiliation(s)
- Nawal K.B. El Hassan
- Department of Periodontics, Faculty of Dental Medicine and Surgery, El Razi University, Khartoum, Sudan
| | - AbdelRahman M. Ramadan
- Department of Oral and Basic Clinical Sceinces, Ibn Sina National College for Medical Sciences, Jeddah, KSA
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Gil-Montoya JA, Rivero-Blanco T, Leon-Rios X, Exposito-Ruiz M, Pérez-Castillo I, Aguilar-Cordero MJ. Oral and general health conditions involved in periodontal status during pregnancy: a prospective cohort study. Arch Gynecol Obstet 2023; 308:1765-1773. [PMID: 36512113 PMCID: PMC10579146 DOI: 10.1007/s00404-022-06843-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 11/02/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Pregnancy is a period in a woman's life that has important consequences on oral health, particularly for gingival health. Present study aims to identify women at higher risk of developing periodontal disease (gingivitis and periodontitis) during late pregnancy and evaluate how this condition evolves during this period. METHODS Prospective cohort study was designed with pregnant women who were assessed during the first and third trimesters of gestation in a southern Spanish public hospital. Data regarding gingival and periodontal health, oral hygiene, and overall health status (obesity and diabetes mellitus) were collected. Reporting followed STROBE checklist. RESULTS Significantly higher number of women had the periodontal and gingival disease in the third trimester of gestation compared with in early pregnancy. In the third trimester of gestation, 42 (28.6%) and 63 (42.9%) of women presented symptoms of periodontal disease and gingival disease, respectively. Obesity (OR 2.834; 95%CI 0.919-8.741), worse oral hygiene during the first trimester of gestation (OR: 4.031; 95%CI 2.12-7.65), and periodontal disease during early pregnancy (OR: 15.104; 95%CI 3.60-63.36) most effectively predicted periodontal disease during late pregnancy. CONCLUSIONS Pregnancy is associated with exacerbated periodontal and gingival disease symptoms throughout the different trimesters of gestation. Obesity and oral hygiene during early pregnancy were the risk factors that most contributed to the aforementioned changes in periodontal disease.
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Affiliation(s)
- J A Gil-Montoya
- Granada School of Dentistry, Institute of Biomedical Research of Granada, University of Granada, c/ Paseo de Cartuja S/N, 18071, Granada, Spain.
| | - T Rivero-Blanco
- Granada School of Dentistry, Institute of Biomedical Research of Granada, University of Granada, c/ Paseo de Cartuja S/N, 18071, Granada, Spain
| | - X Leon-Rios
- Granada School of Dentistry, University of Granada, Granada, Spain
- School of Dentistry, Universidad Peruana de Ciencias Aplicadas, Santiago de Surco, Perú
| | - M Exposito-Ruiz
- Faculty of Health Sciences, University of Granada, Granada, Spain
| | - I Pérez-Castillo
- Faculty of Health Sciences, Department of Nursing, University of Granada, Granada, Spain
- Andalusian Plan for Research Development and Innovation, University of Granada, CTS 367, Granada, Spain
| | - M J Aguilar-Cordero
- Faculty of Health Sciences, Department of Nursing, University of Granada, Granada, Spain
- Andalusian Plan for Research Development and Innovation, University of Granada, CTS 367, Granada, Spain
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Tenenbaum A, Borsa L, Lupi L, Germa A. Child oral health: A plea for interdisciplinarity. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 35:83-91. [PMID: 38040649 DOI: 10.3917/spub.hs1.2023.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
A child’s oral health has major implications both for their general health and for their quality of life. Even before birth, the mother’s oral health can affect the development of the baby and pregnancy outcomes. From the very first months of life, feeding habits together with non-nutritive sucking ones, early transmission of pathogenic bacteria, and oral hygiene practices prefigure the child’s future health. The aim of this article is to provide a comprehensive overview of our current knowledge regarding the main oral health issues affecting children, namely dental caries, erosive tooth wear, developmental defects of enamel, maxillofacial growth anomalies, and traumatic dental injuries. Additionally, it aims to examine the oral health prevention and promotion programs that have been implemented in France over several decades. These prevention and promotion initiatives are not only part of a national program but are also being organized at a territorial level, although, unfortunately, they often remain limited to regional, departmental, or municipal scopes. It is essential for all those involved with children, whether they are health care professionals or not, to collaborate effectively to enhance both oral health and overall well-being. This requires fostering an interdisciplinary approach that involves various contributors working together in a complementary way.
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Affiliation(s)
- Annabelle Tenenbaum
- UFR d’Odontologie, Université Paris Cité
- Laboratoire Éducations et Promotion de la santé UR 3412, UFR Santé, Médecine, Biologie Humaine, Université Paris Sorbonne Paris Nord
- AP-HP, Groupe Hospitalier Pitié Salpêtrière, Service d’Odontologie, Département de santé publique orale, F-75651, Paris, France
| | - Leslie Borsa
- Université Côte d’Azur, Faculté de Chirurgie Dentaire-Odontologie Nice, France Département de Santé Publique
- Laboratoire Microbiologie orale, Immunothérapie et Santé (Micoralis), Université Côte d’Azur, Nice, France
- Pôle Odontologie, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France
| | - Laurence Lupi
- Université Côte d’Azur, Faculté de Chirurgie Dentaire-Odontologie Nice, France Département de Santé Publique
- Laboratoire Microbiologie orale, Immunothérapie et Santé (Micoralis), Université Côte d’Azur, Nice, France
- Pôle Odontologie, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France
| | - Alice Germa
- UFR d’Odontologie, Université Paris Cité
- Université Paris Cité Centre de Recherche en Épidémiologie et Statistiques/CRESS, INSERM, INRA, Paris, France
- Service de médecine bucco-dentaire, APHP, hôpital Charles Foix, Ivry-sur-Seine, France
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14
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Brame JL, Quinonez RB, Ciszek BP, Weintraub JA. Implementing a Prenatal Oral Health Program for Dental Students: Lessons Learned. Health Promot Pract 2023:15248399231207070. [PMID: 37904487 DOI: 10.1177/15248399231207070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
The Prenatal Oral Health Program (pOHP) was developed to educate dental students on prenatal oral health and promote access to dental care for pregnant women. Program advancement has occurred in support of quality improvement. This mixed-methods design combined quantitative data from fourth-year dental students who participated the pOHP (N = 81) and qualitative data from a student-faculty-staff focus group discussion (N = 7). Different clinical structures, appropriate leveling in the curriculum, management with a patient care coordinator, and inclusion of interprofessional learning experiences (IPE) were compared. The survey response rate was 96.4% (N = 81). Trends were noted between students who provided clinical care for a pregnant patient (31%) versus those who did not. Results indicated that an integrated clinic was preferred, though students who had treated a pOHP patient showed greater support for a standalone clinic model. Survey and focus group data agreed that pOHP should occur during the third-year dental school training; however, students with patient experience favored second-year placement. Survey and focus group data emphasize the importance of a patient care coordinator for clinical management and IPE as an essential learning element. Innovating new clinical models requires a period of evolution to determine preferred and sustainable infrastructure. Results reveal the advantages and disadvantages of various program implementation models and demonstrate that student perceptions were influenced by their clinical experiences. Study findings will inform implementation and guide other programs as they create and modify existing curricula to enhance prenatal oral health.
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Affiliation(s)
- Jennifer L Brame
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rocio B Quinonez
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brittney P Ciszek
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- The University of Utah, Salt Lake City, UT, USA
| | - Jane A Weintraub
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Testa A, Lee JG, Jackson DB, Mungia R, Ganson KT, Nagata JM. Physical intimate partner violence and prenatal oral health experiences in the United States. BMC Oral Health 2023; 23:749. [PMID: 37828499 PMCID: PMC10568803 DOI: 10.1186/s12903-023-03491-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/04/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a significant public health issue, and when experienced during pregnancy, IPV substantially harms maternal health. Still, limited research has examined how IPV may influence prenatal oral health and dental care utilization. This study investigates the relationship between IPV during pregnancy and women's oral health experiences. DATA Data are from 31 states from 2016-2019 in the United States that participated in the Pregnancy Risk Assessment Monitoring System (N = 85,289)-a population-based surveillance system of live births conducted annually by the Centers for Disease Control and Prevention and state health departments. Multivariable logistic regression analyses were used to examine the association between physical IPV during pregnancy (measured by being pushed, hit, slapped, kicked, choked, or physically hurt any other way by a current or ex-husband/partner) and various oral health experiences. FINDINGS Women who experienced prenatal physical IPV reported worse oral health experiences during pregnancy, including being more likely to report not knowing it was important to care for their teeth, not talking about dental health with a provider, needing to see a dentist for a problem, going to see a dentist for a problem, as well as having more unmet dental care needs. CONCLUSIONS Together, these findings indicate that women who experience physical IPV during pregnancy have lower knowledge of prenatal oral health care, more oral health problems, and greater unmet dental care needs. Given the risk of IPV and oral health problems for maternal and infant health, the study findings point to greater attention toward the oral health needs of IPV-exposed pregnant women.
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Affiliation(s)
- Alexander Testa
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jacqueline G Lee
- Department of Criminal Justice, Boise State University, Boise, ID, USA
| | - Dylan B Jackson
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Rahma Mungia
- School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
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Testa A, Lee J, Jackson DB, Mungia R, Ganson KT, Nagata JM. Intimate Partner Violence and Prenatal Oral Health Experiences. RESEARCH SQUARE 2023:rs.3.rs-3137055. [PMID: 37503249 PMCID: PMC10371134 DOI: 10.21203/rs.3.rs-3137055/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Background Intimate partner violence (IPV) is a significant public health issue, and when experienced during pregnancy, IPV poses substantial harms for maternal health. Still, limited research has examined how IPV may influence prenatal oral health and dental care utilization. This study aims to investigate the relationship between IPV during pregnancy and women's oral health experiences. Data Data are from the Pregnancy Risk Assessment Monitoring System from 2016 through 2019 (N = 85,289). Multivariable logistic regression analyses were used to examine the association between physical IPV during pregnancy and various oral health experiences. Findings Women who experienced prenatal physical IPV reported worse oral health experiences during pregnancy, including being more likely to report not knowing it was important to care for their teeth, not talking about dental health with a provider, needing to see a dentist for a problem, going to see a dentist for a problem, as well as having more unmet dental care needs. Conclusions Together, these findings indicate that women who experience physical IPV during pregnancy have lower knowledge of prenatal oral health care, more oral health problems, and greater unmet dental care needs. Given the risk associated with IPV and oral health problems for maternal and infant health, the study findings point to greater attention toward the oral health needs of IPV-exposed pregnant women.
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Affiliation(s)
| | | | | | - Rahma Mungia
- The University of Texas Health Science Center at San Antonio
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17
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Hassan GS, Helal MB, Ibrahim HF. Immunohistochemical expression of estrogen receptor alpha in the maxillary sinus, pulp, and periodontal ligament of adjacent teeth in late pregnancy in rats. Odontology 2023; 111:608-617. [PMID: 36434465 PMCID: PMC10238294 DOI: 10.1007/s10266-022-00770-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 11/15/2022] [Indexed: 11/27/2022]
Abstract
This study aimed to assess the histological changes in the maxillary sinus and its adjacent dental tissues as pulp and periodontal ligament during pregnancy and investigate the role of estrogen hormone in these changes through the detection of estrogen receptors in these tissues. Sixteen adult female rats were used and were allocated into two groups: control non-pregnant (n = 8) and pregnant (n = 8). They were sacrificed and their heads were prepared for histological and immunohistochemical examination for estrogen receptor alpha. Our results revealed that pregnant rats revealed inflammatory changes in the sinus as thick epithelial lining, loss of cilia, swollen goblet cells, intraepithelial and interstitial edema. The lamina propria demonstrated considerable infiltration of inflammatory cells, glandular hyperplasia with vacuolar degeneration, and vascular congestion. Periodontal ligament and pulp revealed hyperemia and vascular congestion. Immunohistochemical examination of estrogen receptor alpha in the maxillary sinus and adjacent dental tissues (Periodontal ligament and pulp) in pregnant rats revealed a significant increase in its expression in all examined tissues. In conclusion, there was an increase in expression of ERα in the sinus mucosa and dental tissues during pregnancy together with slight inflammatory changes in these tissues. Hence, dentists should be aware of the effect of these changes on the pregnant women avoiding teeth extraction due to misdiagnosis of dental, periodontal or sinus pain after exclusion of true pathologies.
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Affiliation(s)
- Gihan S. Hassan
- Faculty of Dentistry, Tanta University, El-Giesh St., Tanta, Gharbia Egypt
| | - Mai B. Helal
- Faculty of Dentistry, Tanta University, El-Giesh St., Tanta, Gharbia Egypt
| | - H. F. Ibrahim
- Faculty of Dentistry, Tanta University, El-Giesh St., Tanta, Gharbia Egypt
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18
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Testa A, Jackson DB, Simon L, Ganson KT, Nagata JM. Stressful life events, oral health, and barriers to dental care during pregnancy. J Public Health Dent 2023; 83:275-283. [PMID: 37294070 DOI: 10.1111/jphd.12576] [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: 02/08/2023] [Revised: 04/02/2023] [Accepted: 05/17/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Poor oral health during pregnancy poses risks to maternal and infant well-being. However, limited research has documented how proximate stressful life events (SLEs) during the prenatal period are associated with oral health and patterns of dental care utilization. METHODS Data come from 13 states that included questions on SLEs, oral health, and dental care utilization in the Pregnancy Risk Assessment Monitoring System for the years 2016-2020 (n = 48,658). Multiple logistic regression analyses were used to assess the association between levels of SLE (0, 1-2, 3-5, or 6+) and a range of (1) oral health experiences and (2) barriers to dental care during pregnancy while controlling for socio-demographic and pregnancy-related characteristics. RESULTS Women with more SLEs in the 12 months before birth-especially six or more-reported worse oral health experiences, including not having dental insurance, not having a dental cleaning, not knowing the importance of caring for teeth and gums, needing to see a dentist for a problem, going to see a dentist for a problem, and unmet dental care needs. Higher levels of SLEs were also associated with elevated odds of reporting barriers to dental care. CONCLUSIONS SLEs are an essential but often understudied risk factor for poor oral health, unmet dental care needs, and barriers to dental care services. Future research is needed to understand better the mechanisms linking SLEs and oral health.
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Affiliation(s)
- Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lisa Simon
- Department of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, California, USA
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19
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Radwan-Oczko M, Hirnle L, Szczepaniak M, Duś-Ilnicka I. How much do pregnant women know about the importance of oral health in pregnancy? Questionnaire-based survey. BMC Pregnancy Childbirth 2023; 23:348. [PMID: 37179351 PMCID: PMC10182644 DOI: 10.1186/s12884-023-05677-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Although pregnancy is a physiological process it causes hormonal changes that can also affect the oral cavity. Pregnancy increases the risk of gum disease inflammation and tooth caries which could affect the health of the developing baby. Proper oral health is crucial both for mother and her babies and is related with mothers' awareness of this connection. The aim of this study was the self-assessment of women's both oral health and oral health literacy as well as mothers' awareness of the connection of oral health and pregnancy. MATERIAL AND METHODS In the study anonymous questionnaire was prepared and provided to be filled in by 200 mothers at the age from 19 to 44 y.o. who gave birth in the gynecological clinic. The questionnaire included demographic, and concerning the areas of oral health before and during pregnancy and after the childbirth questions. RESULTS Only 20% of the investigated women underwent the oral examination before the pregnancy and the next 38.5% underwent it intentionally when the pregnancy had been confirmed. As much as 24% of women pointed out lack of awareness of the importance of proper oral hygiene during pregnancy. 41.5% of investigated women declared complaints during the pregnancy concerning teeth or gums and 30.5% underwent dental treatment; 68%, brushed their teeth properly-twice a day; 32% of women observed deterioration of oral health state during the pregnancy. The knowledge of the importance of oral health during pregnancy presented by the majority of mothers was relatively proper, which was strongly connected with higher education status and living in big cities. A significant correlation between higher birth weight and more frequent daily tooth brushing was observed. Both higher frequency of problems concerning the oral cavity and dental treatment during pregnancy were significantly related to the younger age of mothers. CONCLUSIONS The knowledge of women concerning of oral health on the management of pregnancy and development of fetus is still insufficient. Gynecologists should inquire pregnant women if they have done dental examination, and provide wider education about importance of oral health in pregnancy.
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Affiliation(s)
- Małgorzata Radwan-Oczko
- Department of Oral Pathology, Wrocław Medical University, Ul. Krakowska 26, 50-425, Wrocław, Poland
| | - Lidia Hirnle
- 1st Department and Clinic of Gynecology and Obstetrics, Wrocław Medical University, Wrocław, Poland
| | - Marta Szczepaniak
- Department of Oral Pathology, Wrocław Medical University, Ul. Krakowska 26, 50-425, Wrocław, Poland
| | - Irena Duś-Ilnicka
- Department of Oral Pathology, Wrocław Medical University, Ul. Krakowska 26, 50-425, Wrocław, Poland.
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Flores-Montalvo E, Córdova-Limaylla N, Ladera-Castañeda M, López-Gurreonero C, Echavarría-Gálvez A, Cornejo-Pinto A, Cervantes-Ganoza L, Cayo-Rojas C. Factors associated with knowledge about pharmacological management of pregnant women in Peruvian dental students: a logistic regression analysis. BMC MEDICAL EDUCATION 2023; 23:89. [PMID: 36739393 PMCID: PMC9898690 DOI: 10.1186/s12909-023-04068-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Clinical management to maintain or restore oral health through the use of drugs during pregnancy is crucial, since at this stage physiological changes significantly influence the absorption, distribution and elimination of the drug, considering also that excessive administration of drugs during this period may have adverse effects on the mother and/or fetus. Therefore, the aim of the present study was to evaluate the factors associated with knowledge of pharmacological management of pregnant women in dental students of a Peruvian university located in the capital and province. METHODS This analytical, cross-sectional, prospective and observational study assessed 312 Peruvian dental students from third to fifth year of study between February and April 2022. A validated questionnaire of 10 closed questions was used to measure knowledge about pharmacological management in pregnant women. A logit model was used to assess the influence of the variables: gender, age, year of study, marital status, place of origin and area of residence. A significance of p < 0.05 was considered. RESULTS The 25.96, 55.13 and 18.91% of the dental students showed poor, fair and good knowledge about pharmacological management in pregnant women; respectively. In addition, it was observed that students under 24 years of age and those from the capital were significantly (p < 0.05) 44% less likely to have poor knowledge of pharmacological management in pregnant women compared to those aged 24 years or older (OR = 0.56; CI: 0.34-0.92) and those from the province (OR = 0.56; CI: 0.32-0.98); respectively. Finally, those in their third and fourth year of study were significantly three times more likely to have poor knowledge (OR = 3.17; CI: 1.68-5.97 and OR = 3.88; CI: 2.07-7.31; respectively) compared to fifth year dental students. CONCLUSION The knowledge of dental students about pharmacological management in pregnant women was predominantly of fair level. In addition, it was observed that being under 24 years of age and being from the capital city were protective factors against poor knowledge, while being a third- and fourth-year student was a risk factor. Finally, gender, marital status and area of residence were not influential factors in the level of knowledge.
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Affiliation(s)
- Elizabeth Flores-Montalvo
- Universidad Privada San Juan Bautista, School of Stomatology, Av. Jose Antonio Lavalle Avenue s/n (Ex Hacienda Villa); Chorrillos, 15066 Lima, Peru
| | - Nancy Córdova-Limaylla
- Universidad Peruana de Ciencias Aplicadas, Academic Program of Dentistry, 15066 Lima, Peru
| | - Marysela Ladera-Castañeda
- Universidad Nacional Federico Villarreal, Faculty of Dentistry and Postgraduate School, Research team “Salud Pública - Salud Integral”, 15084 Lima, Peru
| | | | - Alí Echavarría-Gálvez
- Universidad Privada San Juan Bautista, School of Stomatology, Av. Jose Antonio Lavalle Avenue s/n (Ex Hacienda Villa); Chorrillos, 15066 Lima, Peru
| | - Alberto Cornejo-Pinto
- Universidad Privada San Juan Bautista, School of Stomatology, Av. Jose Antonio Lavalle Avenue s/n (Ex Hacienda Villa); Chorrillos, 15066 Lima, Peru
- Universidad Nacional Federico Villarreal, Faculty of Dentistry and Postgraduate School, Research team “Salud Pública - Salud Integral”, 15084 Lima, Peru
| | | | - César Cayo-Rojas
- Universidad Privada San Juan Bautista, School of Stomatology, Av. Jose Antonio Lavalle Avenue s/n (Ex Hacienda Villa); Chorrillos, 15066 Lima, Peru
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Pereira PR, Storniolo de Souza JM, Foratori-Junior GA. Knowledge, attitudes and practices of undergraduate students and dentists about dental prenatal care. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:36-45. [PMID: 35051303 DOI: 10.1111/eje.12774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/05/2021] [Accepted: 01/15/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Prenatal care is a fundamental moment for health promotion to be carried out, since at that moment women are more receptive to new knowledge, with the aim of providing better healthcare for the baby. This study aimed to evaluate the knowledge, attitudes and practices of undergraduate students and professionals, both from the public and from private sectors in Brazil, regarding dental prenatal care. MATERIALS AND METHODS This study corresponded to an online questionnaire survey, via Google Forms, consisting of 17 general questions for undergraduates (n = 103) and 16 for professionals (n = 227) for demographic and school mapping, and 18 specific questions about the importance and protocol of dental prenatal care. T-test, Mann-Whitney U-test and multiple linear regression were adopted (p < .05). RESULTS The average total score of the questionnaire for students and professionals was 12.40 and 15.65, respectively (p < .0001), indicating moderate knowledge. Professionals showed a higher prevalence of moderate (77%) and high (2%) knowledge of the subject when compared to undergraduate students (51% and 0% respectively). The graduation period in which the students were enrolled was a predictor of the total score of the questionnaire [F (1, 101) = 21.21; p < .0001; R2 = .165]. The female gender and the lower weekly workload were the main predictors of the total score of the questionnaire for professionals [F (3, 223) = 6.74; p < .0001; R2 = .083]. CONCLUSIONS Although professionals have greater knowledge about dental prenatal care than students, there are still deficiencies in the knowledge and practices of them in respect of dental management during pregnancy. Higher education institutions need to change the teaching-learning plan regarding the holistic dental approach for women during pregnancy.
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Affiliation(s)
| | | | - Gerson Aparecido Foratori-Junior
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
- Centre for Host-microbiome Interactions, Faculty of Dental, Oral and Craniofacial Sciences, King's College London, London, UK
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22
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Vamos CA, Griner SB, Daley EM, Cayama MR, Beckstead J, Boggess K, Quinonez RB, Damschroder L. Prenatal oral health guidelines: a theory- and practice-informed approach to survey development using a modified-Delphi technique and cognitive interviews. Implement Sci Commun 2022; 3:126. [PMID: 36443891 PMCID: PMC9703729 DOI: 10.1186/s43058-022-00363-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/15/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Pregnancy presents an opportune time for oral health promotion and intervention; however, implementation of the prenatal oral health guidelines remains a challenge among prenatal and oral health providers. The purpose of this study was twofold: To employ a theory-based approach to identify high-priority Consolidated Framework for Implementation Research (CFIR) constructs with the greatest potential to impact prenatal oral health guideline implementation, and to operationalize and pre-test survey items based on the prioritized CFIR constructs. Identifying barriers and facilitators to guideline implementation will inform the development of targeted interventions that address gaps in adherence which can positively impact oral-systemic health. METHODS The online survey development process employed three rounds of a modified-Delphi technique with prenatal (i.e., MD/DO, CNM) and oral health (i.e., DMD) Practice Advisory Board Members, cognitive interviews with prenatal and oral health providers, and deliberations among the research team and a Scientific Advisory Board (OBGYN, pediatric dentist, and researchers). High-impact CFIR constructs were identified and translated into survey items that were subsequently piloted and finalized. RESULTS During three modified-Delphi rounds, a total of 39 CFIR constructs were evaluated with final input and deliberations with the Practice Advisory Board, Scientific Advisory Board, and the research team achieving consensus on 19 constructs. The instrument was pre-tested with four prenatal and two oral health providers. Overall, participants reported that the survey items were feasible to respond to, took an appropriate length of time to complete, and were well-organized. Participants identified specific areas of improvement to clarify CFIR items. The final survey instrument included 21 CFIR items across four domains, with five constructs included from the intervention characteristics domain, two from the process domain, two from the outer setting domain, and 12 from the inner setting domain. CONCLUSIONS Lessons learned from the survey development process include the importance of soliciting diverse scientific and practice-based input, distinguishing between importance/impact and direction of impact (barrier/facilitator), and the need for additional qualitative methods during interdisciplinary collaborations. Overall, this study illustrated an iterative approach to identifying high-priority CFIR constructs that may influence the implementation of the prenatal oral health guidelines into practice settings.
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Affiliation(s)
- Cheryl A. Vamos
- grid.170693.a0000 0001 2353 285XCollege of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL 33612 USA
| | - Stacey B. Griner
- grid.266871.c0000 0000 9765 6057School of Public Health, The University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd, Fort Worth, TX 76107 USA
| | - Ellen M. Daley
- grid.170693.a0000 0001 2353 285XCollege of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL 33612 USA
| | - Morgan Richardson Cayama
- grid.170693.a0000 0001 2353 285XCollege of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL 33612 USA
| | - Jason Beckstead
- grid.170693.a0000 0001 2353 285XCollege of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL 33612 USA
| | - Kim Boggess
- grid.10698.360000000122483208Department of Obstetrics and Gynecology, School of Medicine, University of North, Carolina at Chapel Hill, CB 7516, Chapel Hill, NC 27599 USA
| | - Rocio B. Quinonez
- grid.10698.360000000122483208Department of Pediatric Dentistry, Schools of Dentistry, Pediatrics and Public Health, University of North Carolina at Chapel Hill, CB 7450, Chapel Hill, NC 27599 USA
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Schröter U, Ziebolz D, Stepan H, Schmalz G. Oral hygiene and oral health behavior, periodontal complaints and oral health-related quality of life in pregnant women. BMC Oral Health 2022; 22:476. [DOI: 10.1186/s12903-022-02508-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Objectives
This questionnaire-based cross-sectional study aimed in the evaluation of oral hygiene and oral health behavior, periodontal complaints and oral health-related quality of life (OHRQoL) in pregnant women in southwest-Saxony, Germany.
Materials and methods
Consecutive patients attending the clinics for Obstetrics and Gynecology, Heinrich-Braun-Klinikum Zwickau, Germany, were recruited in the years 2020 and 2021. The evaluation consisted of three parts: (I) dental and oral hygiene behavior, (II) periodontal complaints and (III) German short form of oral health impact profile (OHIP G14) to assess OHRQoL.
Results
853 out of 1056 participants were included in the study. The pregnant women reported that they have received information on oral health during pregnancy more often from gynecologists than from dentists. Slightly more than half of the participants (51.5%) rated to regularly undergo a professional tooth cleaning. Similarly, nearly half of the women stated to perform interdental cleaning (55.8%). The most common periodontal complaint was bleeding of the gums (45.4%). The OHIP G14 findings of all questions as well as sum scores showed a median of 0. Regression analysis revealed that regular professional tooth cleaning was a predictor of better OHRQoL (β – 0.698, CI95 0.049–1.299; p < 0.04).
Conclusion
Oral hygiene and oral health behavior of pregnant women in southwest-Saxony requires improvement. While the overall OHRQoL of the cohort was not reduced, professional tooth cleaning and thus professional preventive measures can support OHRQoL during pregnancy. Improved interdisciplinary oral health care concepts for pregnant women should be fostered. These concepts can also positively influence OHRQoL issues.
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Kranz AM, Estrada-Darley I. Racial/Ethnic Differences in Receipt of Dental Cleanings During Pregnancy. Womens Health Issues 2022; 32:615-622. [PMID: 35918241 PMCID: PMC9722532 DOI: 10.1016/j.whi.2022.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION We aimed to examine racial/ethnic differences in receipt of dental cleanings during pregnancy, overall and by health insurance type, using 2016-2018 Pregnancy Risk Assessment Monitoring System survey data from 39 states and New York City. METHODS We used a weighted linear probability model to estimate receipt of a dental cleaning during pregnancy. Key explanatory variables included race/ethnicity (Hispanic, White, Black, Asian and Pacific Islander (API), and other racial groups) and health insurance type (Medicaid, private, and other). RESULTS Among a weighted sample of 5,301,753 individuals, 45.9% received a dental cleaning during pregnancy. Regression-adjusted predicted rates of dental cleanings were significantly higher among White than non-White individuals, with the lowest rates observed among Black (43.2%; 95% confidence interval [CI], 40.6%-45.9%) and API individuals (30.6%; 95% CI, 28.5%-32.7%). When comparing rates by health insurance type, adjusted rates were highest among privately insured White individuals (57.4%; 95% CI, 56.1%-58.7%) and lowest among Medicaid-enrolled API individuals (25.4%; 95% CI, 21.5%-29.2%). CONCLUSIONS Fewer than one-half of pregnant individuals received dental cleanings, with the lowest rates observed for non-White individuals and Medicaid-enrolled individuals. Efforts are needed to increase dental visits among publicly insured, Black, Hispanic, and API pregnant individuals.
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Naavaal S, Harless DW. Comprehensive pregnancy dental benefits improved dental coverage and increased dental care utilization among Medicaid-enrolled pregnant women in Virginia. FRONTIERS IN ORAL HEALTH 2022; 3:989659. [PMID: 36204196 PMCID: PMC9530928 DOI: 10.3389/froh.2022.989659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesTo evaluate the changes in dental insurance and utilization among pregnant women before and after the pregnancy Medicaid dental benefit policy implementation in 2015 in Virginia.MethodsWe used pooled cross-sectional data from six cycles of the Virginia Pregnancy Risk Assessment Monitoring System on women aged ≥21 years. Using logistic regression models and a difference-in-difference design, we compared the effects of policy implementation on dental insurance and utilization between pre-policy (2013–2014) and post-policy period (2016–2019) among women enrolled in Medicaid (treatment, N = 1,105) vs. those with private insurance (control, N = 2,575). A p-value of 0.05 was considered significant.ResultsAmong Medicaid-enrolled women, the report of dental insurance (71.6%) and utilization (37.7%) was higher in the post-period compared to their pre-period (44.4% and 30.3%, respectively) estimates but still remained lower than the post-period estimates among women with private insurance (88.0% and 59.9%, respectively). Adjusted analyses found that Medicaid-enrolled women had a significantly greater change in the probability of reporting dental insurance in all post-period years than women with private insurance, while the change in the probability of utilization only became statistically significant in 2019. In 2019, there was a 16 percentage point increase (95% CI = 0.05, 0.28) in the report of dental insurance and a 17 percentage point increase (95% CI = 0.01–0.33) in utilization in treatment group compared to controls.ConclusionsThe 2015 pregnancy Medicaid dental benefit increased dental insurance and dental care utilization among Medicaid-enrolled women and reduced associated disparities between Medicaid and privately insured groups.
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Affiliation(s)
- Shillpa Naavaal
- Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, VA, United States
- OralHealth Core, Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA, United States
- Correspondence: Shillpa Naavaal
| | - David W. Harless
- Department of Economics, School of Business, Virginia Commonwealth University, Richmond, VA, United States
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Bombana M, Wensing M, Wittenborn L, Ullrich C. Health Education about Lifestyle-Related Risk Factors in Gynecological and Obstetric Care: A Qualitative Study of Healthcare Providers' Views in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11674. [PMID: 36141943 PMCID: PMC9517227 DOI: 10.3390/ijerph191811674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/05/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Lifestyle-related risk factors (LRRFs) during pregnancy and lactation are associated with a range of health problems. However, previous studies have shown a large knowledge gap among pregnant women regarding the effects of LRRFs. This study aimed to investigate the role of health education about LRRFs during pregnancy and lactation in gynecological and obstetric care from healthcare providers' (HCPs) point of view. METHODS To explore the views of healthcare providers, a qualitative study was performed. In 2019, 22 in-depth interviews were conducted with a purposive sample of 9 gynecologists and 13 midwives. Participants came from different inpatient and outpatient care settings and from rural, urban, and socially deprived areas in southern Germany. All the interviews were tape-recorded and transcribed verbatim. A combined inductive and deductive approach was applied for data analysis. RESULTS Interviews with HCPs showed that they were aware of the possible impacts of LRRFs during pregnancy and lactation. They noted the importance of action, specifically among women with low socioeconomic status (SES), migrants, and women with a concerning medical history or other specific needs. However, the interviews showed that, at present, there is no standardized practice of educating patients on LRRFs in routine care. This was attributed to a lack of guidelines and time, unfavorable regulations, and undefined responsibilities. The priority of health education is lower in inpatient healthcare settings as compared to outpatient healthcare settings. HCPs apply a demand-driven healthcare approach, focusing on a woman's medical history, needs, and personal circumstances. HCPs voiced the importance of implementing pre-conception education across different healthcare settings, garnering support from other health organizations, and setting out clearly defined responsibilities among HCPs. CONCLUSIONS This qualitative study explored HCPs' perspectives on health education about LRRFs during pregnancy and lactation. The results from this study emphasize the need for a central strategy for health education about LRRFs during pregnancy and lactation in gynecological and obstetric care.
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Affiliation(s)
- Manuela Bombana
- Department of General Medicine and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
- Department of Prevention, AOK Baden-Württemberg, Presselstrasse 19, 70191 Stuttgart, Germany
| | - Michel Wensing
- Department of General Medicine and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Lisa Wittenborn
- Department of General Medicine and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Charlotte Ullrich
- Department of General Medicine and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
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Oral Microbiome Profiles and Inflammation in Pregnant Women Who Used Orthodontic Appliances. Dent J (Basel) 2022; 10:dj10070118. [PMID: 35877392 PMCID: PMC9321247 DOI: 10.3390/dj10070118] [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: 05/06/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 12/10/2022] Open
Abstract
It is common for women to undergo orthodontic treatment during pregnancy, especially through the use of fixed orthodontic devices. In changing the oral microbiome profile, it is crucial to increase the immune responses of pregnant women using fixed orthodontics; however, changes in the microbiomes of pregnant women with orthodontic appliances can be adjusted. Therefore, we aimed to conduct research on the oral cavity microbiome profiles, specifically IL-6 and TNF-α, of pregnant women using fixed orthodontic appliances. We proposed an observational analysis of 30 third-trimester pregnant women. OHI-S was recorded, saliva collection was performed using the passive drool method for IL-6 and TNF-α, and analysis and mucosal swabs were used to determine the oral microbiome profile. Kruskal−Wallis and post hoc Bonferroni tests were used to identify any significant differences with values of p < 0.05. Of these pregnant women, those with orthodontic appliances developed 10 types of bacteria at similar levels (>80%) from the genera Streptococcus, Lactobacillus, and Veillonella. There was no difference between the oral microbiomes of the control group and the pregnant women with a history of orthodontic appliance use. While the level of TNF-α in the women with orthodontic appliances was higher compared with the control group who had never used orthodontic appliances (p < 0.05), there was no difference in the IL-6 levels. The IL-6 and microbiome profile produced normal results, so the use of orthodontic appliances during pregnancy should be allowed with conditions. Pregnant women with orthodontic appliances must keep the oral cavity clean and their appliances well-maintained to avoid oral problems.
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Ramírez-Trujillo MÁ, Villanueva-Vilchis MC, Gaitán-Cepeda LA, Aguilar-Díaz FC, Rojas-Russell ME, Fuente-Hernández J. Impact of a Maternal Motivational Interviewing on Oral Health in the Mother-Child Dyad. Healthcare (Basel) 2022; 10:healthcare10061044. [PMID: 35742095 PMCID: PMC9222260 DOI: 10.3390/healthcare10061044] [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: 04/16/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 02/04/2023] Open
Abstract
Motivational Interviewing (MI) has been included in dentistry programs. There exists a need for interventions in the mother-child dyad. The aim of this paper was to compare the effects of a MI-based educational program on oral care knowledge, attitudes, and practices (KAP) in the mother-child dyad to a Traditional Education-based program (TE). A community intervention trial was carried out. The experimental and control groups were made up of women between 18 and 45 years of age in the sixth month of gestation. Both groups were provided with TE. The experimental group additionally received a session based on the principles of the MI. Socio-demographic data, children’s oral health KAP (COHKAP), that of the mother (MOHKAP), and maternal self-efficacy (MSE) in relation to children’s oral health (COHMSE) were recorded. A baseline measurement was made, as well as a six-month follow up. The participants included 135 women with an average age of 24.88 ± 6.00. After intervention, the experimental group’s COHKAP, MOHKAP, and COHMSE all increased (p < 0.001). When MI-based interventions are combined with TE, MSE and dental care KAP for the mother-child dyad in pregnant women can be improved.
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Affiliation(s)
- M. Á. Ramírez-Trujillo
- Department of Public Health, National School of Higher Studies, Leon Unit, National Autonomus University of Mexico, Leon CP 37684, Mexico; (M.Á.R.-T.); (F.C.A.-D.); (J.F.-H.)
| | - M. C. Villanueva-Vilchis
- Department of Public Health, National School of Higher Studies, Leon Unit, National Autonomus University of Mexico, Leon CP 37684, Mexico; (M.Á.R.-T.); (F.C.A.-D.); (J.F.-H.)
- Correspondence: ; Tel.: +52-477-194-0800 (ext. 43444)
| | - L. A. Gaitán-Cepeda
- Department of Oral pathology and Oral Medicine, Graduate and Research Division, Dental School, National Autonomous University of Mexico, Mexico City CP 04360, Mexico;
| | - F. C. Aguilar-Díaz
- Department of Public Health, National School of Higher Studies, Leon Unit, National Autonomus University of Mexico, Leon CP 37684, Mexico; (M.Á.R.-T.); (F.C.A.-D.); (J.F.-H.)
| | - M. E. Rojas-Russell
- School of Higher Studies (F.E.S.) Zaragoza, National Autonomous University of Mexico, Mexico City CP 09230, Mexico;
| | - J. Fuente-Hernández
- Department of Public Health, National School of Higher Studies, Leon Unit, National Autonomus University of Mexico, Leon CP 37684, Mexico; (M.Á.R.-T.); (F.C.A.-D.); (J.F.-H.)
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Testa A, Ganson KT, Jackson DB, Bojorquez-Ramirez P, Weiser SD, Nagata JM. Food insecurity and oral health care experiences during pregnancy: Findings from the Pregnancy Risk Assessment Monitoring System. J Am Dent Assoc 2022; 153:503-510. [PMID: 35303979 DOI: 10.1016/j.adaj.2021.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/11/2021] [Accepted: 12/10/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Food insecurity has emerged as a salient risk factor for poor oral health in adult populations. A separate area of research also details that both poor oral health and food insecurity during pregnancy can have adverse consequences for maternal and infant well-being. The authors examine the connection between food insecurity and women's oral health care experiences during pregnancy. METHODS Data from 2016 through 2019 came from the Pregnancy Risk Assessment Monitoring System (N = 21,080). Multivariable logistic regression analyses were used to assess the association between food insecurity and 6 indicators of oral health care experiences during pregnancy. RESULTS Food-insecure women reported worse oral health care experiences during pregnancy, including being more likely to need to see a dentist for a problem, going to see a dentist for a problem, not receiving dental prophylaxis, not talking with an oral health care provider about dental health, not knowing it was important to care for teeth, and having unmet oral health care needs. CONCLUSIONS Food-insecure women exhibit worse overall oral health outcomes and unmet oral health care needs during pregnancy. PRACTICAL IMPLICATIONS Considering the risk that both food insecurity and oral health problems pose for maternal and infant health, interventions that can reduce food insecurity and improve oral health and oral health care access among pregnant women are important steps in promoting greater health equity.
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Haber J, Dolce MC, Hartnett E, Altman S, Silk H. Improving Oral Health During Pregnancy: A Call to Action. J Midwifery Womens Health 2022; 67:166-169. [PMID: 35390222 DOI: 10.1111/jmwh.13357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/19/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Judith Haber
- Rory Meyers College of Nursing, New York University, New York, New York
| | - Maria C Dolce
- College of Nursing and Health Sciences, University of Massachusetts Dartmouth, North Dartmouth, Massachusetts
| | - Erin Hartnett
- Rory Meyers College of Nursing, New York University, New York, New York
| | - Susan Altman
- Rory Meyers College of Nursing, New York University, New York, New York
| | - Hugh Silk
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts
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Park JJ, Corwin E, Dunlop AL, Yang I. Initial Psychometric Testing of a Brief Maternal Oral Symptom Survey. J Midwifery Womens Health 2022; 67:258-263. [DOI: 10.1111/jmwh.13343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 01/03/2022] [Accepted: 01/03/2022] [Indexed: 12/21/2022]
Affiliation(s)
- Joy JooHee Park
- Penn Nursing University of Pennsylvania Philadelphia Pennsylvania
| | | | - Anne L. Dunlop
- Nell Hodgson Woodruff School of Nursing Emory University Atlanta Georgia
| | - Irene Yang
- Nell Hodgson Woodruff School of Nursing Emory University Atlanta Georgia
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Esposti CDD, Santos-Neto ETD, Oliveira AE, Travassos C, Pinheiro RS. [Adequacy of prenatal dental care: social and geographical inequalities in a metropolitan region of Brazil]. CIENCIA & SAUDE COLETIVA 2021; 26:4129-4144. [PMID: 34586265 DOI: 10.1590/1413-81232021269.10542020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 06/26/2020] [Indexed: 11/22/2022] Open
Abstract
This study set out to analyze social and geographical inequalities in the adequacy of prenatal dental care in the Unified Health System (SUS) of the Greater Vitória Metropolitan Region, Espírito Santo, Brazil. A cross-sectional study was carried out with 1209 postpartum women living in the region admitted to hospital at SUS facilities for childbirth between 2010 and 2011. Data were collected on prenatal medical-dental care, the impact of oral health on the quality of life of pregnant women (Oral Health Impact Profile-14), and predisposing characteristics. Prenatal care was adequate when care corresponded to the recommended treatment. The adequacy of dental care during prenatal care was analyzed using a multivariate logistic model. Oral health was found to have an impact on the quality of life of 102 (8.4%) pregnant women and the adequacy of dental care during prenatal care was only 15.4% (n=156). There was a greater chance of adequacy of prenatal dental care in Vitória (OR=2.44; IC=1.63-3.66), in regions covered by the family health strategy (OR=1.88; IC=1.22-2.89), and in areas with a higher proportion of pregnant women with access to quality prenatal care (OR=3.59; IC=1.64-7.84). Contextual inequalities were decisive for the inadequacy of dental care in prenatal care.
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Affiliation(s)
- Carolina Dutra Degli Esposti
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo. Av. Marechal Campos 1.468. 29043-900 Vitória ES Brasil.
| | - Edson Theodoro Dos Santos-Neto
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo. Av. Marechal Campos 1.468. 29043-900 Vitória ES Brasil.
| | - Adauto Emmerich Oliveira
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo. Av. Marechal Campos 1.468. 29043-900 Vitória ES Brasil.
| | - Claudia Travassos
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil
| | - Rejane Sobrino Pinheiro
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro. Rio de Janeiro RJ Brasil
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Duarte da Silva K, Vargas-Ferreira F, Dâmaso Bertoldi A, Celso Lopes Fernandes de Barros F, Fernando Demarco F, Britto Correa M, Beatriz Chaves Tarquinio S. Oral mucosal lesions in pregnant women: A population-based study. Oral Dis 2021; 28:1891-1900. [PMID: 34333827 DOI: 10.1111/odi.13981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/29/2021] [Accepted: 07/13/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate the prevalence of oral mucosal lesions (OML) and oral self-examination and their associated factors among pregnant women from the 2015 Pelotas Birth Cohort Study, Brazil. METHODS Pregnant women who would deliver babies in 2015 were included in the antenatal study. Data related to demographic, socio-economic and behavioural conditions were collected using questionnaires. Participants were also clinically assessed for oral health outcomes. The outcomes were the presence of OMLs and oral self-examination. Size, location, time of onset and symptomatology of the lesions were collected. Descriptive and bivariate analysis, and Poisson regression were performed. p-Value <0.05 was set to indicate statistical significance. RESULTS Data from 2481 pregnant women were analysed. Four hundred and nine (16.5%) had at least one OML. The most prevalent lesions were exostosis (80/16.6%), coated tongue (70/14.5%) and benign oral brownish pigmentation (68/14.1%). Non-white skin colour was associated with a higher prevalence of OMLs (PR 1.3; 95% CI 1.1-1.6), while daily use of dental floss was positively associated with the prevalence of oral self-examination (PR 1.4; 95% CI 1.2; 1.5). CONCLUSIONS Almost 20% of pregnant women presented OML, which were more prevalent in non-white individuals. Women with better oral care were more likely to perform oral self-examination.
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Affiliation(s)
| | - Fabiana Vargas-Ferreira
- Department of Social and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Flávio Fernando Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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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.
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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
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Inequalities in dental prenatal control in Colombia: An analysis based on the IV National Oral Health Study, 2013-2014. ACTA ACUST UNITED AC 2021; 41:271-281. [PMID: 34214268 PMCID: PMC8386945 DOI: 10.7705/biomedica.5705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Indexed: 11/21/2022]
Abstract
Introducción. La atención odontológica es esencial para garantizar el derecho a una maternidad saludable. En Colombia, las políticas de atención prenatal incorporan la promoción, prevención y atención en salud bucal como parte de la atención integral que deben recibir las mujeres gestantes en el sistema de salud, sin embargo, no se hace un seguimiento sistemático del cumplimiento de estas directrices. Objetivo. Explorar la atención efectiva y las desigualdades sociales en la prestación y el uso del control odontológico prenatal en Colombia. Materiales y métodos. Estudio descriptivo con datos de las mujeres gestantes reportadas en el Cuarto Estudio Nacional de Salud Bucal, 2013-2014. Se estimaron las desigualdades sociales absolutas y relativas, según zona de residencia, pertenencia étnica, nivel educativo, régimen de afiliación a los servicios de salud y estrato socioeconómico. Resultados. Se analizaron los datos de 1.050 mujeres gestantes. El 88,37 % recibió control prenatal y, el 57,19 %, control odontológico. Se observó un patrón general de brechas sociales en el uso efectivo de este último servicio, principalmente en función del aseguramiento. Las mujeres gestantes con mayor posibilidad de recibir atención odontológica prenatal fueron aquellas con algún aseguramiento en salud (razón de prevalencias, RP=2,62; IC95% 2,12-3,12), residentes en zonas urbanas (RP=1,37; IC95% 1,18-1,56), con nivel educativo técnico o superior (RP=1,20; IC95% 1,02-1,38) o de estratos sociales medios o altos (RP=1,15; IC95% 1,01-1,29). Conclusiones. En Colombia, la prestación efectiva del control odontológico a mujeres gestantes como parte de la atención prenatal integral, sigue siendo un reto. Se requieren importantes esfuerzos para cumplir las normas y reducir las desigualdades sociales en el acceso a este servicio.
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Tjahajawati S, Rafisa A, Gumilar KN, Nurzanah F, Rikmasari R. The Impact of Pregnancy and Menopause on the Correlation Between Salivary Calcium Levels, Calcium Intake, and Bleeding on Probing (BOP). J Int Soc Prev Community Dent 2021; 11:324-331. [PMID: 34268195 PMCID: PMC8257019 DOI: 10.4103/jispcd.jispcd_14_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 01/25/2021] [Accepted: 03/08/2021] [Indexed: 11/08/2022] Open
Abstract
Aims: Evaluate the impact of pregnancy and menopause on the correlation between salivary calcium levels, calcium intake, and bleeding on probing (BOP), so it can be used as indicators to determine the oral health status of pregnant and menopausal women. Materials and Methods: This was a descriptive study using a cross-sectional approach. Participants included 26 menopausal women, 24 pregnant women, and 35 control subjects. Salivary calcium levels were measured using an atomic absorption spectrophotometer, and calcium intake was assessed using a semi-quantitative food frequency questionnaire. Other supporting data included height, weight, blood pressure, blood glucose level, salivary pH, and volume. Results: The mean salivary calcium levels of pregnant women (0.72 ± 0.61 mmol/L) were lower than those of control subjects (1.69 ± 0.81 mmol/L), but the mean salivary calcium levels of menopausal women were higher (1.99 ± 1.24 mmol/L). Most of the subjects in all three groups had inadequate calcium intake. The mean BOP values of pregnant and menopausal women were higher than those of the control subjects. This study found the only variable that correlated with the salivary calcium level was the menopausal group’s blood glucose level (P = 0.009). Conclusions: Pregnancy and menopause did not have an impact on the relationship between salivary calcium levels and BOP but had an impact on the relationship between salivary calcium levels and calcium intake. Calcium intake did not affect salivary calcium levels in both conditions when compared with the control group.
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Affiliation(s)
- Sri Tjahajawati
- Department of Oral Biology, Faculty of Dentistry, Padjadjaran University, Bandung, Indonesia
| | - Anggun Rafisa
- Department of Oral Biology, Faculty of Dentistry, Padjadjaran University, Bandung, Indonesia
| | | | - Fitri Nurzanah
- School of Dentistry, Faculty of Dentistry, Padjadjaran University, Bandung, Indonesia
| | - Rasmi Rikmasari
- Department of Prosthodontics, Faculty of Dentistry, Padjadjaran University, Bandung, Indonesia
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Touriño S, Suárez-Cotelo MDC, Núñez-Iglesias MJ, Domínguez-Martís EM, Mosteiro-Miguéns DG, López-Ares D, Novío S. Knowledge, Attitudes, and Practices of Spanish Midwives and Midwifery Students toward Oral Healthcare during Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116089. [PMID: 34200062 PMCID: PMC8200230 DOI: 10.3390/ijerph18116089] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/25/2021] [Accepted: 06/01/2021] [Indexed: 11/16/2022]
Abstract
Pregnancy can affect the mother's oral health, increasing their susceptibility to oral diseases that have been associated with harmful effects on the newborn. Despite the severity of oral diseases during pregnancy, the demand for dental care during the gestational period is low, which may improve with the participation of midwives in promoting oral health activities. The objectives of this study were: (i) to determine the knowledge, attitudes, and practices of Spanish midwives and midwifery students regarding oral health in pregnant women; and (ii) to identify the barriers faced by these healthcare professionals in addressing oral health promotion during pregnancy. An observational cross-sectional descriptive study was conducted. A total of 128 midwives and/or midwifery students ≥ 18 years old and of both sexes were invited to self-complete a questionnaire between January and April 2020. A total of 85 people participated in the study. Participants had a regular level of knowledge about oral health during pregnancy (overall knowledge score: 6.53), and although they were interested in activities that promote oral healthcare, their oral healthcare practices during pregnancy were limited. As midwives play an important role in promoting health, their training in oral healthcare could help to improve pregnant women's oral health.
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Affiliation(s)
- Sara Touriño
- Faculty of Nursing, University of Santiago de Compostela, 15782 A Coruña, Spain;
| | | | - María Jesús Núñez-Iglesias
- Department of Psiquiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, 15782 A Coruña, Spain;
| | - Eva María Domínguez-Martís
- Galician Public Healthcare Service, Healthcare Centre of Concepción Arenal, C/Santiago León de Caracas 12, 15701 A Coruña, Spain;
| | - Diego Gabriel Mosteiro-Miguéns
- Galician Public Healthcare Service, University Hospital Complex of Santiago de Compostela (CHUS), 15706 A Coruña, Spain;
| | - David López-Ares
- Galician Public Healthcare Service, University Hospital Complex of A Coruña (CHUAC), 15006 A Coruña, Spain;
| | - Silvia Novío
- Department of Psiquiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, 15782 A Coruña, Spain;
- Correspondence: ; Tel.: +34-881-812-374
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Gil-Montoya JA, Leon-Rios X, Rivero T, Expósito-Ruiz M, Perez-Castillo I, Aguilar-Cordero MJ. Factors associated with oral health-related quality of life during pregnancy: a prospective observational study. Qual Life Res 2021; 30:3475-3484. [PMID: 33978891 DOI: 10.1007/s11136-021-02869-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the evolution of perceived quality of life in relation to oral health during pregnancy and to determine the risk factors involved in this process. METHODS A follow-up study was carried out with pregnant Spanish women. Two oral examinations and an oral health-related quality of life (OHRQoL) assessment, using the OHIP-14 questionnaire, were performed in the first and third trimester of pregnancy. Data on sociodemographic characteristics, medical history, O'Sullivan Test measures, oral hygiene habits, history of caries, and periodontal status of participants were collected through structured medical-dental questionnaires. RESULTS A complete dataset comprising 246 pregnant women was available for analysis. Overall scores for negative impacts on the OHIP questionnaire were significantly higher during late pregnancy (74%). This indicated a deterioration in oral health-related quality of life amongst participants. Items describing "painful aching", "self-consciousness", "unsatisfactory diet", and "interrupted meals" showed the greatest increase between the first and third trimester of gestation. Multivariate analysis showed that pre-gestational/gestational diabetes mellitus and poor oral hygiene habits during the first trimester of gestation were directly associated with worse oral health-related quality of life during the third trimester of gestation (hyperglycemia: OR 2.86; 95% CI 1.019-8.050: p = 0.043 / oral hygiene: OR 1.33; 95% CI 0.970-1.836; p = 0.076). CONCLUSIONS In the present research, hyperglycemia during pregnancy and poor oral hygiene habits during the first trimester of gestation led to a higher risk of poor oral quality of life during late pregnancy.
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Affiliation(s)
- J A Gil-Montoya
- School of Dentistry, University of Granada, c/Paseo de Cartuja S/N, 18071, Granada, Spain. .,Institute of Biomedical Research of Granada, Granada, Spain.
| | - X Leon-Rios
- School of Dentistry, University of Granada, c/Paseo de Cartuja S/N, 18071, Granada, Spain.,School of Odontology, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - T Rivero
- School of Dentistry, University of Granada, c/Paseo de Cartuja S/N, 18071, Granada, Spain
| | - M Expósito-Ruiz
- Faculty of Health Sciences, University of Granada, Granada, Spain
| | - I Perez-Castillo
- Faculty of Health Sciences, University of Granada, Granada, Spain.,Andalusian Plan for Research Development and Innovation, CTS 367, University of Granada, Granada, Spain
| | - M J Aguilar-Cordero
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain.,Andalusian Plan for Research Development and Innovation, CTS 367, University of Granada, Granada, Spain
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Sampaio JRF, Vidal SA, de Goes PSA, Bandeira PFR, Cabral Filho JE. Sociodemographic, Behavioral and Oral Health Factors in Maternal and Child Health: An Interventional and Associative Study from the Network Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083895. [PMID: 33917677 PMCID: PMC8067955 DOI: 10.3390/ijerph18083895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/04/2021] [Accepted: 04/05/2021] [Indexed: 01/10/2023]
Abstract
Oral healthcare during pregnancy needs to be part of the assistance routine given to pregnant women by health professionals as a way to encourage self-care and strengthen the general health of the mother and the baby. The aim of this study was to evaluate the effectiveness of an integrated oral healthcare intervention for pregnant women and to analyze the association of sociodemographic, behavioral, oral health and general maternal and child health factors in prenatal care at usual risk in primary care in a city in the northeast of Brazil, in 2018–2019. A controlled, randomized, single-blinded community trial was conducted. The intervention group (IG) received dental assistance and collective health education actions in conversation circles, while the control group (CG) received the usual assistance. All pregnant women (146 in total, 58 from IG and 88 from CG) that took part in the trial answered a questionnaire and underwent a dental examination at the beginning of prenatal care and at the puerperal visit. To assess the effect of the intervention, a network analysis was used. The results have shown that being in the control group was associated with neonatal complications (0.89) and prematurity (0.54); the use of tobacco and alcohol are associated with high risk in initial and final oral health; lower educational level of the pregnant women implicates high risk for initial oral health (−0.19), final oral health (−0.26), pregnancy complications (−0.13), low birth weight (−0.23), prematurity (−0.19) and complications in the newborn (−0.14). Having a low family income (≤261.36 USD) has shown a high risk for initial oral health (−0.14), final oral health (−0.20) and prematurity (−0.15). The intervention based on integrated oral healthcare for pregnant women indicated that socioeconomic and behavioral factors must be considered as determinants for the quality of women and children’s health and that multi-professional performance during prenatal care contributes to the positive outcomes of pregnancy.
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Affiliation(s)
| | - Suely Arruda Vidal
- Study Group on Health Management and Evaluation at IMIP/Pernambuco, Institute of Integral Medicine Fernando Figueira—IMIP, Recife, PE 50070-550, Brazil;
- Post-Graduation Stricto Sensu, Institute of Integral Medicine Professor Fernan-do Figueira—IMIP, Recife, PE 50070-550, Brazil;
| | - Paulo Savio Angeiras de Goes
- Child and Adolescent Health Program, Department of Clinic and Preventive Dentistry, Federal University of Pernambuco—UFPE, Recife, PE 50670-901, Brazil;
| | - Paulo Felipe R. Bandeira
- Center for Biological and Health Sciences, Regional University of Cariri-URCA/Ceará, Northeastern Family Health Training Network—RENASF, Crato, CE 63105-000, Brazil;
| | - José Eulálio Cabral Filho
- Post-Graduation Stricto Sensu, Institute of Integral Medicine Professor Fernan-do Figueira—IMIP, Recife, PE 50070-550, Brazil;
- Brazilian Journal of Maternal and Child Health of IMIP, Recife, PE 50070-550, Brazil
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Naavaal S, Claiborne DM. Oral Health Knowledge, Practices, and Awareness of Oral Health Guidelines and Dental Coverage Policies among Midwives. J Midwifery Womens Health 2020; 66:88-95. [PMID: 33325642 DOI: 10.1111/jmwh.13191] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/28/2020] [Accepted: 10/13/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Good oral health during the prenatal period translates into better oral and overall health for women and their infants. Although the importance of oral health during pregnancy is well established, oral health assessments are not routinely included in prenatal care visits. The purpose of this study was to explore prenatal care providers' practices regarding oral health assessments and identify reasons for the gap in oral health integration in prenatal care. Data were gathered from midwives in Virginia, United States. Information on midwives' knowledge about oral health, education, practices, and awareness of oral health guidelines and the pregnancy-related Medicaid dental benefit policy in Virginia was collected. METHODS An online survey was distributed to midwives practicing in Virginia through their state-level professional organization. The data were collected online, and descriptive data analyses were conducted. RESULTS A total of 30 midwives (mean age 51.9 years) participated in the survey for an overall response rate of 13.6%. Among survey participants, knowledge of oral health was high (score of 4.69 out of 5). Nearly 20% of participants reported receiving no education about oral health during professional training, and 72.4% reported no receipt of continuing education about oral health in the past year. Although 86% of the participants reported discussing oral health in clinical practice, only 10.3% reported conducting oral health assessments. Awareness of Virginia's Medicaid dental benefit policy was high (75.9%), but less than half of the participants were aware of oral health guidelines (44.1%). Although many midwives did not conduct oral health assessments, 79.3% reported that they provided oral health referrals to pregnant patients. DISCUSSION Enhancing and integrating education about oral health in the academic curriculum for midwives and providing them with opportunities for continuing education about oral health can improve their engagement with oral health. Sharing of evidence-based guidelines through organizational newsletters, meetings, and other venues can be ways to increase awareness of new guidelines and health coverage benefits among midwives.
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Affiliation(s)
- Shillpa Naavaal
- Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia.,Oral Health in Childhood and Adolescence Core, Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, Virginia
| | - Denise M Claiborne
- Gene W. Hirschfeld School of Dental Hygiene, Old Dominion University, Norfolk, Virginia
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Stockbridge EL, Dhakal E, Griner SB, Loethen AD, West JF, Vera JW, Nandy K. Dental visits in Medicaid-enrolled youth with mental illness: an analysis of administrative claims data. BMC Health Serv Res 2020; 20:1138. [PMID: 33308226 PMCID: PMC7730780 DOI: 10.1186/s12913-020-05973-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/25/2020] [Indexed: 12/03/2022] Open
Abstract
Background State Medicaid plans across the United States provide dental insurance coverage to millions of young persons with mental illness (MI), including those with attention deficit hyperactivity disorder (ADHD), depression, anxiety, bipolar disorder, and schizophrenia. There are significant oral health challenges associated with MI, and providing dental care to persons with MI while they are young provides a foundation for future oral health. However, little is known about the factors associated with the receipt of dental care in young Medicaid enrollees with MI. We aimed to identify mental and physical health and sociodemographic characteristics associated with dental visits among this population. Methods We retrospectively analyzed administrative claims data from a Medicaid specialty health plan (September 2014 to December 2015). All enrollees in the plan had MI and were ≥ 7 years of age; data for enrollees aged 7 to 20 years were analyzed. We used two-level, mixed effects regression models to explore the relationships between enrollee characteristics and dental visits during 2015. Results Of 6564 Medicaid-enrolled youth with MI, 29.0% (95% CI, 27.9, 30.1%) had one or more visits with a dentist or dental hygienist. Within youth with MI, neither anxiety (Adjusted odds ratio [AOR] = 1.15, p = 0.111), post-traumatic stress disorder (AOR = 1.31, p = 0.075), depression (AOR = 1.02, p = 0.831), bipolar disorder (AOR = 0.97, p = 0.759), nor schizophrenia (AOR = 0.83, p = 0.199) was associated with dental visits in adjusted analyses, although having ADHD was significantly associated with higher odds of dental visits relative to not having this condition (AOR = 1.34, p < 0.001). Age, sex, race/ethnicity, language, and education were also significantly associated with visits (p < 0.05 for all). Conclusions Dental utilization as measured by annual dental visits was lower in Medicaid-enrolled youth with MI relative to the general population of Medicaid-enrolled youth. However, utilization varied within the population of Medicaid-enrolled youth with MI, and we identified a number of characteristics significantly associated with the receipt of dental services. By identifying these variations in dental service use this study facilitates the development of targeted strategies to increase the use of dental care in – and consequently improve the current and long-term wellbeing of – the vulnerable population of Medicaid-enrolled youth with MI.
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Affiliation(s)
- Erica L Stockbridge
- Department of Health Behavior & Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA. .,Department of Advanced Health Analytics and Solutions, Magellan Health, Inc., 4800 N Scottsdale Rd #4400, Scottsdale, AZ, 85251, USA.
| | - Eleena Dhakal
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Stacey B Griner
- Department of Health Behavior & Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Abiah D Loethen
- Department of Advanced Health Analytics and Solutions, Magellan Health, Inc., 4800 N Scottsdale Rd #4400, Scottsdale, AZ, 85251, USA
| | - Joseph F West
- Florida Institute for Health Innovation, 2701 N. Australian Avenue Suite 204, West Palm Beach, Florida, 33407, USA.,Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1600 NW 10th Ave #1140, Miami, Florida, 33136, USA
| | - Joseph W Vera
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Karabi Nandy
- Department of Population and Data Sciences, UT Southwestern Medical Center, South Campus, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
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Fakheran O, Keyvanara M, Saied-Moallemi Z, Khademi A. The impact of pregnancy on women's oral health-related quality of life: a qualitative investigation. BMC Oral Health 2020; 20:294. [PMID: 33109149 PMCID: PMC7590741 DOI: 10.1186/s12903-020-01290-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 10/21/2020] [Indexed: 12/13/2022] Open
Abstract
Background Complex psychological and physiological changes occur in women’s body during pregnancy. These changes affect both oral health status and oral health-related quality of life (OHRQoL). In almost all of the previous cross-sectional design studies on pregnant women, generic OHRQoL instruments have been used to measure OHRQoL. While such instruments may be reliable, they may not be appropriate to evaluate the OHRQoL in special populations like pregnant women. The purpose of this study was to investigate the self-perceived factors affecting the OHRQoL among pregnant women. Methods In this qualitative descriptive study, twenty- seven pregnant women were recruited from four healthcare centers located in Isfahan city, Iran. The interpretative phenomenological analysis was used to collect and analyze the data. Four criteria of credibility, dependability, transferability, and confirmability were implemented through established procedures to confirm the study rigor.
Results Three major themes and six sub-themes capturing the impacts of pregnancy on women’s OHRQoL were identified. They covered all areas of life, including daily life, psychological well-being, social life, physical impact, and also barriers to utilization of dental care services. Some new domains such as “dentists’ refusal to treat pregnant women”, “negative feelings about pregnancy” and “concerns about fetal health” were found as important factors which could influence the OHRQoL during pregnancy. Conclusion The findings help to better understand the oral health issues impacting women during pregnancy and to achieve person-centered care and improved oral health outcomes in pregnant women. The conceptual framework created based on the results of this study may help health care workers and policy makers for improving the health of pregnant women.
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Affiliation(s)
- Omid Fakheran
- Department of Oral Health and Community Dentistry, Dental Implant Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahmoud Keyvanara
- Department of Health Services Management, Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Saied-Moallemi
- Department of Oral Health and Community Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbasali Khademi
- Dental Research Center, Department of Endodontics, Dental Research Institute, Faculty of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
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Costantinides F, Vettori E, Conte M, Tonni I, Nicolin V, Ricci G, Di Lenarda R. Pregnancy, oral health and dental education: an overview on the northeast of Italy. J Perinat Med 2020; 48:829-835. [PMID: 32710719 DOI: 10.1515/jpm-2020-0032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/02/2020] [Indexed: 02/07/2023]
Abstract
Objectives To evaluate the level of knowledge of pregnant women and puerpers about oral health and prevention during and after gestation. Methods One hundred women aged 18-49 years (mean age 33±6 years) were included in this cross-sectional study. An anonymous questionnaire with 24 items related to oral health has been administered during or just after pregnancy. Firstly, answers have been analyzed on the full population and then subdividing the sample on the base of age ranges (G1: 18-25 years, G2: 26-35 years and G3: >35 years) and number of pregnancies (FP: first pregnancy; SP: second or more pregnancies). Parametric tests have been chosen for the statistical analysis; in particular, Anova test for independent samples was used to evaluate differences of baseline demographic characteristics among subgroups G1, G2, G3 while chi-square test was used for FP and SP subgroups. Anova test was also used to intercept differences on answers given to the questionnaire among G1, G2 and G3 group; for FP and SP group was used t-test. Results Level of information and knowledge of the full sample was medium-low and no significant differences have been observed between groups regarding awareness of the own level of the oral hygiene and knowledge of oral care. Conclusions Results of this survey underline the high necessity of educational programs regarding oral care in pregnant and puerpers women. A strict collaboration between medical figures (dentist, oral hygienist, gynecologist and obstetric) is strongly encouraged to spread the concept of prevention.
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Affiliation(s)
| | - Erica Vettori
- School of Dental Sciences, University of Trieste, Trieste, Italy
| | - Martina Conte
- School of Dental Sciences, University of Trieste, Trieste, Italy
| | - Ingrid Tonni
- School of Dental Sciences, University of Brescia, Brescia, Italy
| | - Vanessa Nicolin
- School of Dental Sciences, University of Trieste, Trieste, Italy
| | - Giuseppe Ricci
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.,Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
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Affiliation(s)
- E Vigarios
- Oral Medicine Department, Institut Claudius Regaud, Institut Universitaire du Cancer Toulouse-Oncopole, Toulouse Cedex 9 31059, France
| | - D Maret
- Faculté de Chirurgie Dentaire, Université Paul Sabatier, Centre Hospitalier Universitaire, Toulouse, France and Laboratoire Anthropologie Moléculaire et Imagerie de Synthèse, Université Paul Sabatier, Toulouse, France
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Adeniyi A, Donnelly L, Janssen P, Jevitt C, von Bergman H, Brondani M. A Qualitative Study of Health Care Providers' Views on Integrating Oral Health into Prenatal Care. JDR Clin Trans Res 2020; 6:409-419. [PMID: 32996370 DOI: 10.1177/2380084420961998] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Providing preventive oral health during prenatal care is a recognized strategy for improving pregnant women's access to oral health care. This study sought to qualitatively explore the views of health care providers in British Columbia (BC), Canada, on strategies for integrating preventive oral health into prenatal care. METHODS Twenty-four purposefully selected health care providers (13 oral health and 11 prenatal care providers) in Vancouver and Surrey BC participated in audio-recorded semistructured interviews. Interviews lasted from 31 to 61 min, were transcribed verbatim, and were analyzed using an inductive thematic analysis with N-Vivo software. Study validity was ensured via memoing, fieldnotes, member checking, and external audit. RESULTS Thematic analysis revealed 5 major themes: perception of integrated care, relevance of integrated prenatal oral health, strategies for achieving integrated prenatal oral health, drivers of the integration process, and barriers to integrating oral health during pregnancy. Interprofessional collaboration based on information sharing and communication was identified as a critical factor for integrated care. Oral health checks should be a component of prenatal assessments for achieving integrated prenatal oral health. Participants recommended that prenatal providers should offer oral health education and use screening questions to identify the pregnant woman's oral health needs. The establishment of referral systems was advocated, while dental assessments and oral prophylaxis via the medical services plan were proposed. The inclusion of dental providers in prenatal teams and educating health care providers on interprofessional collaboration were also supported. CONCLUSION Oral health and prenatal providers in BC are positively disposed to adopting integrated preventive prenatal oral health care based on interprofessional collaborative practices. The inclusion of oral health providers in prenatal teams was suggested. KNOWLEDGE TRANSFER STATEMENT The results of this study can be used by policymakers for advocacy and decision making when planning care delivery programs for women during pregnancy. Including the suggested strategies could lead to increased access to, and utilization of, oral health services among pregnant women.
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Affiliation(s)
- A Adeniyi
- Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - L Donnelly
- Department of Oral and Biological Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - P Janssen
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - C Jevitt
- Midwifery Program, Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - H von Bergman
- Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - M Brondani
- Dental Public Health, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
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Sociodemographic Differences in Health Awareness and Oral Health in Pregnant Women. Geburtshilfe Frauenheilkd 2020; 80:834-843. [PMID: 32817990 PMCID: PMC7428374 DOI: 10.1055/a-1205-0601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/22/2020] [Indexed: 10/25/2022] Open
Abstract
Abstract
Objective The aim of this study was to determine the present oral health status of pregnant women depending on selected sociodemographic differences and deduce any resulting consequences for health prevention.
Methods The participantsʼ data of relevance to the study such as age, school leaving qualification, migration background, smoking habits or last dentist visit were recorded using a questionnaire. The subsequent dental check-up concentrated on open carious lesions, any initiated root canal treatments and missing teeth. Finally, the Periodontal Screening Index was recorded to diagnose the presence of any gingivitis or periodontitis. The subsequent biometric evaluation comprised descriptive data analysis, χ2 test and logistical regression.
Results The higher the school leaving qualification, the lower the probability that a pregnant woman smoked prior to pregnancy (OR 0.291; 95% CI 0.114 – 0.743) and that tartar was diagnosed (OR 0.424; 95% CI 0.185 – 0.973). Regular dentist visits (OR 4.026; 95% CI 1.613 – 10.049) increase with the attained school leaving qualification. There is a greater chance that women born in Germany taking part in the study were aware of dental risks in pregnancy (OR 2.652; 95% CI 1.285 – 5.472) and attended the dentist during pregnancy (OR 2.507; 95% CI 1.281 – 4.907).
Conclusion The rate of awareness of the risks and consequences of pregnancy for oral health must be increased. The main aim for primary prophylaxis should be a reduction in the periodontal bacteria and caries of the mother and father.
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Abstract
PurposeIntegrating preventive oral care into prenatal care is suggested as a strategy for reducing the burden of oral diseases among pregnant women and their offspring. This scoping review sought to synthesize available information and identify knowledge gaps on integrating oral health into prenatal care.Design/methodology/approachThe scoping review was conducted based on the Joanna Briggs Institute scoping review framework using the following databases: CINAHL, Cochrane Database of Systematic Reviews, Medline, ProQuest Dissertation and theses Global, Psychinfo and Web of Science®. No search limits were used. Content analysis of the included articles was performed to identify conceptual frameworks, types of integration used, study designs, study objectives and outcomes.FindingsOverall, 2,861 references were obtained from the databases search; and based on the inclusion and exclusion criteria 35 references were included in the final analysis. Of these 35 references, one document presented a conceptual model, six documents reviewed guidelines for integrating oral health in prenatal care, two were policy documents aimed at interprofessional collaboration for oral health during pregnancy, eight documents described programs focused on providing oral care during pregnancy, five of the references were literature reviews and the remaining 13 evaluated the impact of integration. Linkages between healthcare professionals were the most common type of integration used.Research limitations/implicationsDespite advances in understanding integrated care concepts for healthcare delivery, there is little evidence available on the impact of the various types of, and strategies for, integrating oral health into prenatal care. Future research to bridge the identified gaps is recommended.Originality/valueThe originality of this study is to provide evidence on integrated oral healthcare during pregnancy.
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Ait Addi R, Benksim A, Bahije L, Cherkaoui M. Sociodemographic Disparities and Self-reported Oral Health Problems Associated with Pregnancy: A Case-control Study in Morocco. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2020. [DOI: 10.29333/ejgm/8238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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George A, Kong AC, Villarosa A, Duff M, Sheehan A, Burns E, Priddis H, Chua C, Dahlen HG. Implementing and evaluating the effectiveness of an oral health module for the bachelor of midwifery program at an Australian university. NURSE EDUCATION TODAY 2020; 90:104457. [PMID: 32388200 DOI: 10.1016/j.nedt.2020.104457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 03/17/2020] [Accepted: 04/26/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Although guidelines recommend antenatal care providers such as midwives promote oral health during pregnancy, oral health training is not routinely provided in undergraduate midwifery curricula. The aim of this study was to implement an oral health module into an Australian undergraduate midwifery program, and evaluate its effectiveness in improving the oral health knowledge and confidence of midwifery students. DESIGN Pre-test post-test study (2015-2017). SETTING An undergraduate midwifery program within an Australian university. PARTICIPANTS All first-year undergraduate midwifery students enrolled in two core units at the above university (N = 56). METHODS Oral health modules were implemented into each of the two core units within the first year of the Bachelor of Midwifery course. Changes in knowledge and confidence were measured using a standardised questionnaire, administered at baseline, immediately following module completion, and at 2 and 3 years following module completion. RESULTS 44 students participated in the baseline survey (79% response rate), of which 41 completed the first post-module questionnaire, 21 completed the second post-questionnaire, and 24 completed the third post-questionnaire. Knowledge scores significantly increased from baseline (mean 13.12) to follow-up (mean 17.78, p < 0.001), with increases being retained through to the 3-year mark (mean 18.29, p < 0.001). Confidence scores also showed a sustained increase following the module, particularly regarding introducing oral health in the first antenatal appointment (62.1% increase, p < 0.001) and referring pregnant women to a dentist (48.2% increase, p < 0.001). However, the 48.2% increase (p < 0.001) in confidence in conducting a visual mouth check on a pregnant woman following the module was not sustained at subsequent time points, reducing to a 31.5% increase (p = 0.118) by the third year post-module. CONCLUSIONS The module is effective in improving and sustaining the knowledge and confidence of midwifery students to promote maternal oral health. Ongoing updates may be required to keep confidence high regarding visual mouth checks.
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Affiliation(s)
- Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia; Translational Health Research Institute, Campbelltown, NSW 2560, Australia.
| | - Ariana C Kong
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
| | - Amy Villarosa
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
| | - Margaret Duff
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Athena Sheehan
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Elaine Burns
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Holly Priddis
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Clarity Chua
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Hannah G Dahlen
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
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Abstract
In the United States, people are more likely to have poor oral health if they are low-income, uninsured, and/or members of racial/ethnic minority, immigrant, or rural populations who have suboptimal access to quality oral health care. As a result, poor oral health serves as the national symbol of social inequality. There is increasing recognition among those in public health that oral diseases such as dental caries and periodontal disease and general health conditions such as obesity and diabetes are closely linked by sharing common risk factors, including excess sugar consumption and tobacco use, as well as underlying infection and inflammatory pathways. Hence, efforts to integrate oral health and primary health care, incorporate interventions at multiple levels to improve access to and quality of services, and create health care teams that provide patient-centered care in both safety net clinics and community settings may narrow the gaps in access to oral health care across the life course.
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Affiliation(s)
- Mary E Northridge
- NYU Langone Dental Medicine-Brooklyn, Postdoctoral Residency Program, Brooklyn, New York 11220, USA; , ,
- Hansjörg Wyss Department of Plastic Surgery, NYU School of Medicine, Brooklyn, New York 11220, USA
| | - Anjali Kumar
- NYU Langone Dental Medicine-Brooklyn, Postdoctoral Residency Program, Brooklyn, New York 11220, USA; , ,
| | - Raghbir Kaur
- NYU Langone Dental Medicine-Brooklyn, Postdoctoral Residency Program, Brooklyn, New York 11220, USA; , ,
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