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Monsef E, Goodman X, Patil R, White SN. Dentists' knowledge of non-surgical root canal treatment, a systematic review. J Dent 2024; 145:104975. [PMID: 38580057 DOI: 10.1016/j.jdent.2024.104975] [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: 09/25/2023] [Revised: 03/06/2024] [Accepted: 03/26/2024] [Indexed: 04/07/2024] Open
Abstract
OBJECTIVES Dental practice is based upon dentists' cognitions, knowledge being foundational. Knowledge is attained through education and perception. Although knowledge is modulated by beliefs, attitudes, preferences, and behaviors, it is essential to evidence-based practice. Cross-sectional studies uniformly demonstrate that community NSRCT is of sub-optimal quality worldwide, is lack of knowledge a problem? Our purpose was to measure dentists' knowledge of root canal treatment (NSRCT). DATA Quantitative and qualitative data were extracted: purpose, topics assessed, authors cited knowledge sources, number of dentists studied, number of questions, authors descriptors of knowledge level,% correct answers by question, authors recommendations. SOURCES OVID Medline, EMBASE, Web of Science, and hand-searching. STUDY SELECTION Studies which had measured dentists' knowledge of non-surgical root canal treatment that was valuable, reliable, and had practical implications which could be implemented. A total of 51 papers from 19 countries measured the knowledge of 15,580 dentists using 445 questions on 29 root canal treatment topics. CONCLUSIONS 'Gold standards' were from literature, external bodies, or expert consensus in 47, 31, and 2 papers respectively. Levels of knowledge by percentage correct answers among studies were poor to moderate and varied considerably. The mean, for the 50 studies where overall study percentages could be calculated, was 57 %, standard deviation 17 %, and a range of 16 % to 82 %. Authors' adjectives describing knowledge levels were generally negative. Additional education was advised in 49 papers, but without evidence that education was inadequate; 6 papers recommended increased use of protocols; only 5 papers advocated research on the cause of lack of knowledge. CLINICAL SIGNIFICANCE Dentists' root canal treatment knowledge was found to be poor to moderate, as well variable. This may constrain quality of care. However, provision of information without attention to dentists' cognitions and motivations may not be successful. Educational strategies and goals should be re-evaluated. Evidence-based practice faces many barriers.
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Affiliation(s)
| | | | - Rucha Patil
- UCLA School of Dentistry, Los Angeles, CA, USA
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Byrappagari D, Cohn L, Sailor L, Clark S. Association between dental visits during pregnancy and setting for prenatal care. J Public Health Dent 2024; 84:21-27. [PMID: 38173182 DOI: 10.1111/jphd.12596] [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: 03/10/2023] [Revised: 09/06/2023] [Accepted: 11/25/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES Federally Qualified Health Centers (FQHCs) may be well positioned to facilitate dental visits during pregnancy for low-income women. We sought to compare receipt of dental visits during pregnancy for women who received prenatal care at an FQHC versus a non-FQHC setting. METHODS We analyzed Michigan Medicaid administrative data for all live birth deliveries between April 2018 and December 2020. We used billing data to categorize the predominant setting for prenatal care as occurring at a FQHC or a non-FQHC and claims data to identify dental visits during pregnancy (in the 9 months prior to delivery). We employed bivariate and multivariate analyses to explore the relationship between setting for prenatal care and dental visits during pregnancy. RESULTS Women who received prenatal care at an FQHC versus non-FQHC had a higher proportion of dental visits during pregnancy (31.85% vs. 19.37%, p < 0.0001). In multivariate analyses, the strongest predictors of having a dental visit during pregnancy were FQHC prenatal care setting, having a dental emergency visit, having ≥3 prenatal visits, and having Medicaid coverage throughout pregnancy. Hispanic or Black race/ethnicity and 2020 delivery year were predictors of a lower likelihood of a dental visit. These predictors were consistent for the overall population and for the subset who had no dental visits pre-pregnancy. CONCLUSION Medicaid-enrolled women who receive prenatal care at an FQHC are more likely to have a dental visit during pregnancy than their counterparts who receive prenatal care in a non-FQHC setting.
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Affiliation(s)
- Divesh Byrappagari
- Dental Public Health and Outreach, University of Detroit Mercy School of Dentistry, Detroit, Michigan, USA
| | - Lisa Cohn
- Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Lindsay Sailor
- Integrated Health Program, Michigan Primary Care Association, Michigan Primary Care Association, Lansing, Michigan, USA
| | - Sarah Clark
- Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, Michigan, USA
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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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AlHalal H, Albayyat RM, Alfhaed NK, Fatani O, Fatani B. Knowledge, Attitude, and Practice Regarding Periodontal and Dental Diseases During Pregnancy Among Obstetricians and Dentists in King Saud University Medical City. Cureus 2023; 15:e47098. [PMID: 38022243 PMCID: PMC10646510 DOI: 10.7759/cureus.47098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Providing effective dental treatment during pregnancy is related to controlling oral diseases and helps maintain a healthy oral cavity. One of the possible treatment options for endodontic disease is to treat the odontogenic infection, maintain a healthy oral environment, and minimize the expected complications that can occur later in pregnancy or during the postpartum period. Sufficient awareness among obstetricians and dentists is essential to delivering appropriate preventive and curative care to pregnant patients. OBJECTIVE The aim of this cross-sectional study is to assess knowledge, attitudes, and behaviors regarding oral health care and providing dental treatment among King Saud University Medical City obstetricians and dentists during pregnancy and the association of dental and periodontal disease with adverse pregnancy outcomes. METHODS This study was conducted in Saudi Arabia, Riyadh, from December 2022 to June 2023 (six months). The data were collected from 381 participants in Riyadh, Saudi Arabia, from January 2023 to June 2023. The study targeted male and female general dentists and obstetricians living in Riyadh, Saudi Arabia, and excluded those who are not dentists and obstetricians or not living in Riyadh, Saudi Arabia. RESULT Out of a total of 381 completed responses, 281 (73.8%) of the participants were dentists, while 100 (26.2%) were obstetricians. It was observed that the majority of the participants agreed that oral health is a part of prenatal care, while the minority did not agree (0.3%). Of the 281 (73.8%) respondents, most of them reported periodontal disease can cause preterm birth, low birth weight, and gestational diabetes (73.2%), while only 0.5% answered no. Two hundred and seventy-eight of the participants answered that it is essential to consult with an obstetrician before treating pregnant patients. CONCLUSION The overall knowledge of dentists and obstetricians was adequate regarding dental disease during pregnancy. However, more education should be assessed and continuously improved regarding the treatment options, as well as future recommendations regarding the medications used in dental clinics and awareness programs promoting dental health care in pregnant patients.
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Affiliation(s)
- Hani AlHalal
- Obstetrics and Gynecology, King Saud University, College of Medicine, King Saud University Medical City, Riyadh, SAU
| | - Rawan M Albayyat
- Medicine, King Saud University, College of Medicine, Riyadh, SAU
| | - Nawaf K Alfhaed
- Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
| | - Omar Fatani
- Obstetrics and Gynecology, King Saud University Medical City, Riyadh, SAU
| | - Bader Fatani
- Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
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Zhou X, Zhong Y, Pan Z, Zhang J, Pan J. Physiology of pregnancy and oral local anesthesia considerations. PeerJ 2023; 11:e15585. [PMID: 37404472 PMCID: PMC10315135 DOI: 10.7717/peerj.15585] [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: 02/02/2023] [Accepted: 05/26/2023] [Indexed: 07/06/2023] Open
Abstract
Background Safe and effective local anesthesia is a prerequisite for emergency oral surgeries and most dental treatments. Pregnancy is characterized by complex physiological changes, and increased sensitivity to pain. Pregnant women are particularly vulnerable to oral diseases, such as caries, gingivitis, pyogenic granuloma and third molar pericoronitis. Maternally administered drugs can affect the fetus through the placenta. Therefore, many physicians and patients are reluctant to provide or accept necessary local anesthesia, which leads to delays in the condition and adverse consequences. This review is intended to comprehensively discuss the instructions for local anesthesia in the oral treatment of pregnant patients. Methodology An in-depth search on Medline, Embase, and the Cochrane Library was performed to review articles concerned with maternal and fetal physiology, local anesthetic pharmacology, and their applications for oral treatment. Results Standard oral local anesthesia is safe throughout the pregnancy. At present, 2% lidocaine with 1:200,000 epinephrine is considered to be the anesthetic agent that best balances safety and efficacy for pregnant women. Maternal and fetal considerations must be taken into account to accommodate the physiological and pharmacological changes in the gestation period. Semi-supine position, blood pressure monitoring, and reassurance are suggested for high-risk mothers to reduce the risk of transient changes in blood pressure, hypoxemia, and hypoglycemia. For patients with underlying diseases, such as eclampsia, hypertension, hypotension, and gestational diabetes, the physicians should use epinephrine cautiously and control the dose of anesthetic. New local anesthesia formulations and equipment, which contribute to minimizing injection pain and relieving the anxiety, have and are being developed but remain understudied. Conclusions Understanding the physiological and pharmacological changes during pregnancy is essential to ensure the safety and efficiency of local anesthesia. Optimal outcomes for the mother and fetus hinge on a robust understanding of the physiologic alterations and the appropriate selection of anesthetic drugs and approaches.
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Affiliation(s)
- Xueer Zhou
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yunyu Zhong
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Zijian Pan
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jiankang Zhang
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Chengdu Advanced Medical Science Center, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jian Pan
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Chengdu Advanced Medical Science Center, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Zhang F, Cheng R, Yang X, Lian X, Wen P. Pain Relief Effects and Safety of Transitional Therapy in the Treatment of Posterior Teeth of Pregnant Women with Symptomatic Irreversible Pulpitis and Symptomatic Apical Periodontitis. Int J Womens Health 2022; 14:1897-1904. [PMID: 36605256 PMCID: PMC9809172 DOI: 10.2147/ijwh.s378358] [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: 09/01/2022] [Accepted: 12/06/2022] [Indexed: 12/30/2022] Open
Abstract
Purpose To assess the pain relief effects and safety of transitional therapy (TT) in the treatment of posterior teeth of pregnant women with symptomatic irreversible pulpitis and symptomatic apical periodontitis. Methods A prospective cohort clinical study was conducted in the Department of Stomatology at Shenzhen Maternity & Child Healthcare Hospital, China, from January 2017 to December 2019. We enrolled 62 pregnant women with acute dental pain caused by posterior teeth with symptomatic irreversible pulpitis or symptomatic apical periodontitis. Among the 62 participants, 34 received TT, and 28 chose nontreatment during pregnancy. We evaluated the pain relief with the verbal numerical rating scale (VNRS) scores of pain perception in the clinical study, as well as the anti-bacterial medicament filling conditions of canals of in vitro models. Moreover, we investigated the safety outcomes, such as gestational age, neonatal head circumstance, birth weight, and body length. Results The VNRS scores of the participants treated with TT were significantly lower than those of the nontreatment group 2 days after treatment (P<0.001). TT treated pregnant women experienced significantly more pain decreases in VNRS scores than their counterparts(P<0.05). The optimal anti-bacterial medicament filling conditions of canals of in vitro models by TT method were comparable with those of canals instrumented with traditional RCT method. Moreover, no significant differences of safety outcomes were observed between pregnant women of these two groups. Conclusion The transitional therapy is efficient in alleviating acute dental pain of posterior teeth of pregnant women with symptomatic irreversible pulpitis and symptomatic apical periodontitis, and maintaining painless chains throughout pregnancy with no adverse effects on neonatal birth outcomes.
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Affiliation(s)
- Feng Zhang
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People’s Republic of China
| | - Rongfeng Cheng
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People’s Republic of China
| | - Xiuqiao Yang
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People’s Republic of China
| | - Xiaohui Lian
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People’s Republic of China
| | - Ping Wen
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People’s Republic of China,Correspondence: Ping Wen, Department of Science and Education, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People’s Republic of China, Email
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Javed MQ, Bhatti UA, Riaz A, Chaudhary FA. Predictors of periodontal and caries related perinatal oral healthcare, investigation of dentists' practices: a cross-sectional study. PeerJ 2021; 9:e12080. [PMID: 34557351 PMCID: PMC8418217 DOI: 10.7717/peerj.12080] [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: 01/28/2021] [Accepted: 08/06/2021] [Indexed: 11/30/2022] Open
Abstract
Background The objectives of the study were to assess the knowledge, attitude, and practice of dentists towards providing oral health care to pregnant women and to identify barriers and predictors of periodontal and caries related perinatal oral healthcare practices. Methods A cross-sectional analytical survey was conducted on dentists by using a random sampling technique, and a pre-validated questionnaire was delivered to 350 dentists from May 2018 to October 2018. Data were analyzed by utilizing SPSS software. Frequencies and percentages were recorded for descriptive variables. Binary logistic regression was used to analyze the probability of predicting group membership to the dependent variable using different independent variables determined from contingency tables. Results Overall response rate was 41%. The mean knowledge score of respondents was 15.86 ± 3.34. The lowest correct responses were noted in the questions related to periodontal health. It was found that the advice to delay dental visits until after pregnancy was eight times more likely to be observed among dentists who lacked the knowledge of importance of oral health during pregnancy (P = 0.04, OR = 8.75). Dentists were more likely to consult obstetricians regarding dental procedures when they fear a risk of labor in the dental practice (P < 0.05, OR = 3.72). Dentists who had the knowledge of periodontal disease association with preterm delivery were about four times more likely to treat periodontal disease during pregnancy (P = 0.01, OR = 3.95). Dentists knowing the association between maternal oral health and childhood decay were more likely to counsel pregnant patients regarding caries prevention (P > 0.05, OR = 3.75). Conclusions Collectively the results indicated few gaps in knowledge among some dentists and a need to improve existing attitudes towards perinatal oral health. Dentists failing to recognize the importance of perinatal oral health are more likely to be hesitant in treating pregnant patients. Failing to recognize the link between periodontal disease and obstetric complications increases the possibility of hesitance to counsel pregnant patients regarding the same. The appreciation of the evidence for poor perinatal oral health and risk of early childhood caries increases the likelihood of counseling by dentists on caries prevention.
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Affiliation(s)
- Muhammad Qasim Javed
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Usman Anwer Bhatti
- Department of Operative Dentistry, College of Dentistry, Riphah International University, Islamabad, Pakistan
| | - Arham Riaz
- Community Dentistry, Academy of Continuing Health Education and Research, Islamabad, Pakistan
| | - Farooq Ahmad Chaudhary
- School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
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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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AlRatroot S, Alotaibi G, AlBishi F, Khan S, Ashraf Nazir M. Dental Anxiety Amongst Pregnant Women: Relationship With Dental Attendance and Sociodemographic Factors. Int Dent J 2021; 72:179-185. [PMID: 34253341 PMCID: PMC9275180 DOI: 10.1016/j.identj.2021.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/06/2021] [Accepted: 05/13/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction : Access to oral care during pregnancy is important for the maintenance of optimal oral health. Objective : The aim of this study was to estimate dental anxiety (DA) and its association with previous dental visits and sociodemographic factors amongst pregnant women. Methods : A cross-sectional study was conducted (June through August 2019) amongst pregnant women (N = 825) attending hospitals and health centres in Dhahran, Khobar, and Dammam cities in the Eastern province of Saudi Arabia. The Modified Dental Anxiety Scale (MDAS) was used to assess DA and the World Health Organization Oral Health Survey for Adults was administered to evaluate patterns of dental attendance. Results : DA was found in 90.9% of the pregnant women. The mean DA score of the sample was 12.53 ± 5.33 (range, 5 to 25) and it was significantly higher amongst non-Saudi (13.21 ± 5.24) vs Saudi women (12.15 ± 5.34) (P = .006), those who had negative dental experience (13.99 ± 5.62) vs those without such experience (12.2 ± 5.21) (P < .001), and those with dental pain or discomfort (13.18 ± 5.46) vs without pain or discomfort (11.94 ± 5.14) (P = .001). The study found a significant relationship between DA and reasons for dental attendance before pregnancy (P = .002) and time since the last dental visit (P = .009). Multiple logistic regression analysis showed significantly increased odds (OR, 1.69; 95% CI, 1.25 to 2.27) of experiencing moderate to extreme DA amongst pregnant women who visited the dentist after a year/never visited compared to those who visited in less than a year. Similarly, participants with negative dental experience were significantly more likely to have moderate to extreme DA (OR, 1.49; 95% CI, 1.02 to 2.20) than those without negative experience after adjusting for sociodemographic factors. Conclusions : DA was highly prevalent amongst pregnant women, which was significantly associated with negative dental experience, dental pain or discomfort, and reasons for and time since the last dental visit.
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Affiliation(s)
- Soha AlRatroot
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Gadah Alotaibi
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fai AlBishi
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Shahd Khan
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Muhammad Ashraf Nazir
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
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Favero V, Bacci C, Volpato A, Bandiera M, Favero L, Zanette G. Pregnancy and Dentistry: A Literature Review on Risk Management during Dental Surgical Procedures. Dent J (Basel) 2021; 9:dj9040046. [PMID: 33921608 PMCID: PMC8072957 DOI: 10.3390/dj9040046] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/02/2021] [Accepted: 04/15/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Pregnancy is a unique moment in a woman’s life, accompanied with several physiologic changes that have an impact on oral health. Aim of the study: The purpose of the present study was to conduct a critical review of published literature regarding pregnancy and dentistry, the most frequent oral diseases that are encountered during pregnancy, their correlation to adverse pregnancy events, and safe dental treatments that can be performed during pregnancy. Methods: A Medline/COCHRANE search was carried using specific keywords and MeSH terms, combined with the boolean operators “OR” and “AND”. Results: The search led to 146 publications including guidelines, meta-analyses, systematic and non-systematic reviews, published between 2000 and 2021. Discussion and conclusions: Due to the increased inflammatory and immune body response that characterizes pregnancy, periodontal conditions are often aggravated during pregnancy and periodontal disease encountered frequently in pregnant patients. There are conflicting study results in the literature regarding the association between periodontitis and adverse pregnancy outcomes. Periodontal treatment did not show a significant reduction in the adverse outcomes. Many dentists, often due to lack of information, are reluctant to provide dental treatment to pregnant women. However, preventive and restorative dental treatment is safe during pregnancy. Diagnostic radiographs may be performed after the first trimester if absolutely necessary. Analgesics (such as paracetamol) and anesthetics (such as lidocaine) are also considered safe. In case of infection, antibacterial drugs such as amoxicillin, ampicillin, and some cephalosporines and macrolides can also be prescribed. Organogenesis takes place in the first trimester, the time during which the fetus is susceptible to severe malformations (teratogenesis). The ideal time to perform dental treatment is the second trimester (week 17 to 28). However, acute pain or infections make the intervention of the dentist absolutely necessary and emergency treatment can be performed during the whole pregnancy period.
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Affiliation(s)
- Vittorio Favero
- Unit of Maxillofacial Surgery and Dentistry, University of Verona, 37129 Verona, Italy;
| | - Christian Bacci
- Dental Clinic, Department of Neuroscience, University of Padua, 35129 Padua, Italy; (C.B.); (M.B.); (L.F.); (G.Z.)
| | - Andrea Volpato
- Dental Clinic, Department of Neuroscience, University of Padua, 35129 Padua, Italy; (C.B.); (M.B.); (L.F.); (G.Z.)
- Correspondence: or
| | - Michela Bandiera
- Dental Clinic, Department of Neuroscience, University of Padua, 35129 Padua, Italy; (C.B.); (M.B.); (L.F.); (G.Z.)
| | - Lorenzo Favero
- Dental Clinic, Department of Neuroscience, University of Padua, 35129 Padua, Italy; (C.B.); (M.B.); (L.F.); (G.Z.)
| | - Gastone Zanette
- Dental Clinic, Department of Neuroscience, University of Padua, 35129 Padua, Italy; (C.B.); (M.B.); (L.F.); (G.Z.)
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Wang L, Ren J, Fiscella KA, Bullock S, Sanders MR, Loomis EL, Eliav E, Mendoza M, Cacciato R, Thomas M, Kopycka-Kedzierawski DT, Billings RJ, Xiao J. Interprofessional collaboration and smartphone use as promising strategies to improve prenatal oral health care utilization among US underserved women: results from a qualitative study. BMC Oral Health 2020; 20:333. [PMID: 33228617 PMCID: PMC7685586 DOI: 10.1186/s12903-020-01327-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/12/2020] [Indexed: 12/12/2022] Open
Abstract
Background Data on barriers and facilitators to prenatal oral health care among low-income US women are lacking. The objective of this study was to understand barriers/facilitators and patient-centered mitigation strategies related to the use of prenatal oral health care among underserved US women.
Methods We used community-based participatory research to conduct two focus groups with eight pregnant/parenting women; ten individual in-depth interviews with medical providers, dental providers and community/social workers; and one community engagement studio with five representative community stakeholders in 2018–2019. Using an interpretive description research design, we conducted semi-structured interviews and focus groups which were audio-recorded, transcribed, and analyzed for thematic content. Results We identified individual and systemic barriers/facilitators to the utilization of prenatal oral health care by underserved US women. Strategies reported to improve utilization included healthcare system-wide changes to promote inter-professional collaborations, innovative educational programs to improve dissemination and implementation of prenatal oral health care guidelines, and specialized dental facilities providing prenatal oral health care to underserved women. Moreover, smartphones have the potential to be an innovative entry point to promote utilization of prenatal oral care at the individual level. Conclusions Low-income women face multiple, addressable barriers to obtaining oral health care during pregnancy. Inter-professional collaboration holds strong promise for improving prenatal oral health care utilization.
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Affiliation(s)
- Lin Wang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.,Peking University School of Stomatology, Beijing, China
| | - Johana Ren
- University of Rochester River Campus, Rochester, NY, USA
| | - Kevin A Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Mechelle R Sanders
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Elizabeth L Loomis
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Eli Eliav
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael Mendoza
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA.,Monroe County Department of Public Health, Rochester, NY, USA
| | - Rita Cacciato
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Marie Thomas
- University of Rochester River Campus, Rochester, NY, USA
| | | | - Ronald J Billings
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
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12
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Aboalshamat K, Abdulrahman S, Alowadi J, Al-Mutairy N, Fairak M, Alraithi N, Alsolami A, Alshahrani A, Almansouri W. Endodontic Treatment in Pregnancy: Knowledge, Attitudes, and Practices of Dentists and Interns in Jeddah, Saudi Arabia. Open Dent J 2020. [DOI: 10.2174/1874210602014010211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim:
Pregnant women require special consideration in dental treatment due to physiological changes during their pregnancy. The aim of this study is to assess the knowledge, attitudes, and practices of dentists and dental interns in Jeddah, Saudi Arabia, regarding endodontic treatment during pregnancy.
Methods:
A cross-sectional study was conducted using validated self-report questionnaires completed by 450 dental interns and dentists who treat pregnant women in governmental and private dental clinics in Jeddah, Saudi Arabia. The questionnaire measured participants’ knowledge, beliefs, and actual practices regarding behavioral counseling and the treatment of pregnant patients. Descriptive statistics were generated, and significance was set at 0.05.
Results:
A total of 86.4% of the participants acknowledged the importance of endodontic treatment for pregnant patients and responded that most endodontic procedures are considered safe during the second trimester, including periapical radiographs (67.11%), endodontic treatment (81.11%), local anesthesia with and without epinephrine (70.67%), open access (83.78%), drainage of abscesses (76.89%), prescribing acetaminophen (75.56%), and prescribing antibiotics (61.11%). In addition, 57.8% knew that Nonsteroidal Anti-inflammatory Drugs (NSAIDs) are contraindicated. However, 69.33% considered panoramic radiographs contraindicated. Knowledgeable participants were significantly more likely to practice appropriate endodontic procures. The majority (70.9%) were interested in more education about pregnant patients.
Conclusion:
Dental interns and dentists in Saudi Arabia have fair levels of knowledge about endodontic treatment of pregnant patients, and need to improve their knowledge, especially regarding radiographs and NSAIDs.
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13
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Mayberry ME, Gonik B, Trombly RM. Perinatal Oral Health: A Novel Collaborative Initiative to Improve Access, Attitudes, Comfort Level, and Knowledge of Pregnant Women and Dental Providers. AJP Rep 2020; 10:e54-e61. [PMID: 32140293 PMCID: PMC7056404 DOI: 10.1055/s-0040-1702927] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/15/2019] [Indexed: 11/23/2022] Open
Abstract
Objectives The objectives of this program were to increase access to dental care among pregnant women and to improve dental students' exposure, comfort level, and knowledge of the potential impact of poor oral health on pregnancy outcomes. Study Design Through collaborative efforts of a School of Dentistry and a School of Medicine, the Oral Health Pregnancy Day Initiative (OHPDI) was developed. Dental students were educated on the impact poor oral health may have on pregnancy outcomes and the importance of access to care. Pregnant women received perinatal oral health education and needed dental care. Results Thirty-four pregnant women presented for the OHPDI. Thirty-nine dental students participated. Eighty-five percent of students reported they learned how poor oral health may have a negative impact on pregnancy and birth outcomes; 79% agreed as a result of the event they were more likely to treat pregnant women. Ninety-four percent of pregnant women reported not having a dentist and 100% received perinatal oral health education and needed dental care. Eighty-eight pregnant women were seen subsequent to the OHPDI. Conclusion This initiative resulted in increased students' knowledge, exposure, and comfort level to treating pregnant women and pregnant women received needed oral health care education and dental treatment.
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Affiliation(s)
- Melanie E Mayberry
- Division of Practice Essentials and Interprofessional Education, University of Detroit Mercy School of Dentistry, Detroit, Michigan
| | - Bernard Gonik
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan
| | - Robert M Trombly
- A. T. Still University Arizona School of Dentistry & Oral Health, Mesa, Arizona
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14
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Ajwani S, Sousa MS, Villarosa AC, Bhole S, Johnson M, Dahlen HG, Hoolsema J, Blinkhorn A, Srinivas R, Yaacoub A, Milat A, Skinner J, George A. Process evaluation of the midwifery initiated oral health-dental service program: Perceptions of dental professionals. Health Promot J Austr 2018; 30:333-343. [PMID: 30512207 DOI: 10.1002/hpja.224] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 11/30/2018] [Indexed: 01/31/2023] Open
Abstract
ISSUE ADDRESSED All pregnant women should have a comprehensive oral health evaluation. Unfortunately, many pregnant women seldom seek dental care and some dentists are hesitant to treat during pregnancy. To address these issues, the Midwifery Initiated Oral Health Dental Service (MIOH-DS) program was developed in Australia. The aim of this study was to undertake a process evaluation and explore the perceptions of dental professionals involved in the program to determine the acceptability, feasibility and effectiveness of the program if it were to be upscaled. METHODS A qualitative approach using content analysis was conducted on data from two focus groups involving 12 dental professionals. RESULTS All participants were supportive of the MIOH-DS program. They thought pregnant women were receptive to their care, and reported markedly improved oral health. The provision of free dental care and the involvement of midwives were cited as major factors that improved the uptake of the program. Some of the challenges encountered were the prevailing misconceptions about the safety of dental treatment and pregnancy-related impairments. CONCLUSIONS Dental professionals found the MIOH-DS to be acceptable, feasible and effective in improving oral health of pregnant women and their uptake of dental services. However, some challenges need to be addressed as the MIOH-DS program is upscaled into a cost-effective model. SO WHAT?: Dental professionals are important stakeholders in the MIOH-DS model. The process evaluation of the successful dental intervention is necessary to understand how and why such interventions work, and is an important step in scaling up to a population-wide intervention.
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Affiliation(s)
- Shilpi Ajwani
- Sydney Local Health District Oral Health Services/Sydney Dental Hospital/University of Sydney, Sydney Research, Sydney, NSW, Australia
| | - Mariana S Sousa
- Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University/South Western Sydney Local Health District/Ingham Institute Applied Medical Research/Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Ariana C Villarosa
- COHORT, Western Sydney University/South Western Sydney Local Health District/Ingham Institute Applied Medical Research, Liverpool, NSW, Australia
| | - Sameer Bhole
- Sydney Local Health District Oral Health Services/Sydney Dental Hospital/University of Sydney, Sydney Research, Sydney, NSW, Australia
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University/Ingham Institute Applied Medical Research, Sydney, NSW, Australia
| | - Hannah G Dahlen
- School of Nursing & Midwifery, Western Sydney University/Ingham Institute Applied Medical Research, Parramatta, NSW, Australia
| | - Julia Hoolsema
- COHORT, Western Sydney University/South Western Sydney Local Health District/Ingham Institute Applied Medical Research, Liverpool, NSW, Australia
| | | | - Ravi Srinivas
- COHORT, South Western Sydney Local Health District Oral Health Services, Western Sydney University/Ingham Institute Applied Medical Research/University of Sydney, Liverpool, NSW, Australia
| | - Albert Yaacoub
- Nepean Blue Mountains Local Health District Oral Health Services, Penrith, NSW, Australia
| | - Andrew Milat
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - John Skinner
- Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia
| | - Ajesh George
- COHORT, Western Sydney University/South Western Sydney Local Health District/University of Sydney/Ingham Institute Applied Medical Research, Translational Health Research Institute, Liverpool, NSW, Australia
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15
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Characterizing the Subgingival Microbiome of Pregnant African American Women. J Obstet Gynecol Neonatal Nurs 2018; 48:140-152. [PMID: 30597136 DOI: 10.1016/j.jogn.2018.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To generate preliminary data about the subgingival microbiome of pregnant African American women to calculate power for a future larger study and to explore associations among the microbiome, periodontal inflammation, and preterm birth. DESIGN Comparative descriptive pilot study design. SETTING Urban area in the southeastern United States. PARTICIPANTS Thirty-four African American women in the third trimester of pregnancy. METHODS Based on visual assessment, participants were placed in two groups: healthy gingiva and gingivitis. Saliva samples were analyzed for interleukin-1β (IL-1β), matrix metalloproteinase-8 (MMP-8), and C-reactive protein (CRP). DNA was extracted from subgingival plaque samples, and amplicons of the fourth hypervariable region were sequenced. RESULTS We found no differences in overall microbiome diversity between the healthy gingiva (n = 22) and the gingivitis (n = 12) groups although significant differences were found among the bacterial taxa present. The gingivitis group had greater levels of salivary IL-1β and MMP-8, whereas CRP was not different between groups. Overall microbiome diversity was positively associated with the CRP level. We found no significant relationships among the subgingival microbiome, periodontal inflammation, and preterm birth. CONCLUSION Gingivitis in pregnancy did not appear to shift the overall composition or diversity of the subgingival microbiome although differences in several bacterial taxa suggest that inflamed gingiva in pregnant women are associated with a disruption in the stability of the subgingival microbiome. A correlation between the abundance of bacteria and CRP also suggests an association between the microbiome and systemic inflammation. These findings provide support for future research about how the oral microbiome and progression of periodontal disease in pregnant women link with adverse pregnancy outcomes.
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16
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George A, Ajwani S, Bhole S, Dahlen HG, Reath J, Korda A, Ng Chok H, Miranda C, Villarosa A, Johnson M. Knowledge, attitude and practises of dentists towards oral health care during pregnancy: A cross sectional survey in New South Wales, Australia. Aust Dent J 2017; 62:301-310. [DOI: 10.1111/adj.12505] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2017] [Indexed: 01/23/2023]
Affiliation(s)
- A George
- Collaboration for Oral Health Outcomes, Research Translation and Evaluation (COHORTE) Research Group; Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, University of Sydney; Liverpool New South Wales Australia
| | - S Ajwani
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney; Sydney New South Wales Australia
| | - S Bhole
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital/University of Sydney; Sydney New South Wales Australia
| | - HG Dahlen
- School of Nursing and Midwifery; Western Sydney University/Ingham Institute Applied Medical Research; Parramatta New South Wales Australia
| | - J Reath
- Peter Brennan Chair of General Practice, School of Medicine, Western Sydney University; Campbelltown New South Wales Australia
| | - A Korda
- Obstetrics and Gynaecology, School of Medicine, Western Sydney University; Campbelltown New South Wales Australia
| | - H Ng Chok
- Centre for Nursing Research and Practice Development; Western Sydney University/Nepean Blue Mountains Local Health District; Penrith New South Wales Australia
| | - C Miranda
- College of Professional Psychology; Crows Nest New South Wales Australia
| | - A Villarosa
- COHORTE Research Group; Western Sydney University/South Western Sydney Local Health District/Ingham Institute Applied Medical Research; Liverpool New South Wales Australia
| | - M Johnson
- Faculty of Health Sciences; Australian Catholic University, Ingham Institute Applied Medical Research; Sydney New South Wales Australia
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17
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Mattheus D, Shannon M, Lim E, Gandhi K. The Association Between Socio-demographic Factors, Dental Problems, and Preterm Labor for Pregnant Women Residing in Hawai'i. HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2016; 75:219-227. [PMID: 27563498 PMCID: PMC4982327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Periodontal disease during pregnancy has the potential to increase the risk of adverse perinatal outcomes including preterm labor (PTL), prematurity, and low birth weight (LBW). Despite professional recommendations on the importance and safety of dental assessments and treatments, the rate of dental care utilization during pregnancy remains low. The purpose of this study was to document the utilization of dental services and explore the relationships among socio-demographic factors, dental problems, and PTL in pregnant women residing in Hawai'i. Hawai'i Pregnancy Risk Assessment Monitoring System (PRAMS) survey results were analyzed from 4,309 women who experienced live births between the years 2009-2011. Results revealed that 2 in 5 women in Hawai'i had their teeth cleaned during pregnancy, while 1 in 5 reported seeing a dentist for a dental problem. Women who reported having a dental problem during pregnancy were more likely to experience PTL (OR=1.46, 95% CI=1.10-1.94, P=.008) compared to women without a dental problem. In addition, Native Hawaiian and Part-Hawaiian women were more likely to experience PTL (OR=1.73, 95% CI=1.22-2.46, P=.002) compared to Caucasian women. These findings document the underutilization of dental services in pregnant women in Hawai'i and reveal an association between poor dental care and PTL. Identification of groups at risk for maternal complications may assist in the development of programs that are sensitive to the diverse cultures and variability of community resources that exist throughout Hawai'i.
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Affiliation(s)
| | - Maureen Shannon
- School of Nursing, University of Hawai'i, Honolulu, HI (DM,MS)
| | - Eunjung Lim
- School of Nursing, University of Hawai'i, Honolulu, HI (DM,MS)
| | - Krupa Gandhi
- School of Nursing, University of Hawai'i, Honolulu, HI (DM,MS)
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18
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Anisimova EN, Axamit LA, Manukhina EI, Letunova NY, Golikova AM, Fedotova TM. [Specific features of emergency dental care in pregnant women]. STOMATOLOGII︠A︡ 2016; 95:18-25. [PMID: 27239992 DOI: 10.17116/stomat201695318-25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of the study was to evaluate the algorithm of safe emergency dental care in pregnant patients. Eighty-five pregnant women aged 20-35 were included in the study. The paper presents elaborated state-of-the-art guidelines for emergency dental care in pregnant patients. Articaine 4% with epinephrine 1:200,000 is recommended as a choice agent for local anesthesia in these patients.
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Affiliation(s)
- E N Anisimova
- A.I. Evdokimiv Moscow State Medical and Dental University, Moscow, Russia
| | - L A Axamit
- A.I. Evdokimiv Moscow State Medical and Dental University, Moscow, Russia
| | - E I Manukhina
- A.I. Evdokimiv Moscow State Medical and Dental University, Moscow, Russia
| | - N Yu Letunova
- A.I. Evdokimiv Moscow State Medical and Dental University, Moscow, Russia
| | - A M Golikova
- A.I. Evdokimiv Moscow State Medical and Dental University, Moscow, Russia
| | - T M Fedotova
- A.I. Evdokimiv Moscow State Medical and Dental University, Moscow, Russia
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19
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Brown B, Young J, Kneebone AB, Brooks AJ, Dominello A, Haines M. Knowledge, attitudes and beliefs towards management of men with locally advanced prostate cancer following radical prostatectomy: an Australian survey of urologists. BJU Int 2016; 117 Suppl 4:35-44. [DOI: 10.1111/bju.13037] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Bernadette Brown
- Sax Institute; Haymarket New South Wales Australia
- School of Public Health; University of Sydney; Camperdown New South Wales Australia
| | - Jane Young
- School of Public Health; University of Sydney; Camperdown New South Wales Australia
| | - Andrew B Kneebone
- Northern Sydney Cancer Centre; Sydney New South Wales Australia
- Northern Clinical School; University of Sydney; Camperdown New South Wales Australia
| | - Andrew J Brooks
- Westmead Private Hospital; Westmead New South Wales Australia
- Westmead Clinical School; University of Sydney; Camperdown New South Wales Australia
- NSW Agency for Clinical Innovation; Sydney New South Wales Australia
| | | | - Mary Haines
- Sax Institute; Haymarket New South Wales Australia
- School of Public Health; University of Sydney; Camperdown New South Wales Australia
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20
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Jeelani S, Khader KA, Rangdhol RV, Dany A, Paulose S. Coalition of attitude and practice behaviors among dental practitioners regarding pregnant patient's oral health and pregnant patient's perception toward oral health in and around Pondicherry. J Pharm Bioallied Sci 2015; 7:S509-12. [PMID: 26538908 PMCID: PMC4606650 DOI: 10.4103/0975-7406.163520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: This study aims to evaluate the knowledge, attitude, practice behaviors among general dental practitioners and assess the perception toward oral health by pregnant patients in and around Puducherry. Methodology: A self-designed and structured questionnaire was used to obtain information from the dental practitioner and the pregnant patients. Results: The majority of the dental practitioners had a lack of knowledge, attitude, practice behaviors regarding pregnant patient's oral health and similarly majority of pregnant patient's perception toward oral health was poor. Conclusions: Drowning and dilemmatic attitude and practice behavior of dentists to be streamlined to render right care to the pregnant women at the right time. Perplexing perception toward oral health care by pregnant women to be overcome to orient them to understand the impact of oral health on their general systemic health.
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Affiliation(s)
- S Jeelani
- Department of Oral Medicine and Radiology, Indira Gandhi Institute of Dental Sciences, SBV, Puducherry, India
| | - K Abdul Khader
- Department of Oral Medicine and Radiology, Indira Gandhi Institute of Dental Sciences, SBV, Puducherry, India
| | - R Vishwanath Rangdhol
- Department of Oral Medicine and Radiology, Indira Gandhi Institute of Dental Sciences, SBV, Puducherry, India
| | - A Dany
- Department of Oral Medicine and Radiology, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Swetha Paulose
- Department of Oral Medicine and Radiology, Indira Gandhi Institute of Dental Sciences, SBV, Puducherry, India
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21
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Riedy CA, Weinstein P, Mancl L, Garson G, Huebner CE, Milgrom P, Grembowski D, Shepherd-Banigan M, Smolen D, Sutherland M. Dental attendance among low-income women and their children following a brief motivational counseling intervention: A community randomized trial. Soc Sci Med 2015; 144:9-18. [PMID: 26372934 DOI: 10.1016/j.socscimed.2015.09.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 08/19/2015] [Accepted: 09/04/2015] [Indexed: 11/29/2022]
Abstract
UNLABELLED This study tested a behavioral intervention to increase dental attendance among rural Oregonian low-income women and their children. It utilized a multi-site, single-blind, randomized trial design. Four hundred women were randomized into one of four conditions to receive prenatal or postpartum motivational interviewing/counseling (MI) or prenatal or postpartum health education (HE). Counselors also functioned as patient navigators. Primary outcomes were dental attendance during pregnancy for the mother and for the child by age 18 months. Attendance was obtained from the Oregon Division of Medical Assistance Programs and participant self-report. Statewide self-reported utilization data were obtained from the Oregon Pregnancy Risk Assessment Monitoring System (PRAMS). Maternal attendance was 92% in the prenatal MI group and 94% in the prenatal HE group (RR = 0.98; 95% CI = 0.93-1.04). Children's attendance was 54% in postpartum MI group and 52% in the postpartum HE group (RR = 1.03; 95% CI = 0.82-1.28). Compared to statewide PRAMS, attendance was higher during pregnancy for study mothers (45% statewide; 95% CI = 40-50%) and for their children by 24 months (36% statewide; 95% CI = 27-44%). MI did not lead to greater attendance when compared to HE alone and cost more to implement. High attendance may be attributable to the counselors' patient navigator function. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT01120041.
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Affiliation(s)
- Christine A Riedy
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Philip Weinstein
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Lloyd Mancl
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Gayle Garson
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Colleen E Huebner
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Peter Milgrom
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - David Grembowski
- University of Washington School of Public Health, Box 357660, 1959 NE Pacific St, Seattle, WA 98195-7660, USA.
| | - Megan Shepherd-Banigan
- University of Washington School of Public Health, Box 357660, 1959 NE Pacific St, Seattle, WA 98195-7660, USA.
| | - Darlene Smolen
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Marilynn Sutherland
- Klamath County Department of Public Health, 305 Main Street, Klamath Falls, OR 97601, USA.
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22
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Cunha-Cruz J, Milgrom P, Shirtcliff RM, Bailit HL, Huebner CE, Conrad D, Ludwig S, Mitchell M, Dysert J, Allen G, Scott J, Mancl L. Population-centered Risk- and Evidence-based Dental Interprofessional Care Team (PREDICT): study protocol for a randomized controlled trial. Trials 2015; 16:278. [PMID: 26091669 PMCID: PMC4475615 DOI: 10.1186/s13063-015-0786-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 05/29/2015] [Indexed: 11/21/2022] Open
Abstract
Background To improve the oral health of low-income children, innovations in dental delivery systems are needed, including community-based care, the use of expanded duty auxiliary dental personnel, capitation payments, and global budgets. This paper describes the protocol for PREDICT (Population-centered Risk- and Evidence-based Dental Interprofessional Care Team), an evaluation project to test the effectiveness of new delivery and payment systems for improving dental care and oral health. Methods/Design This is a parallel-group cluster randomized controlled trial. Fourteen rural Oregon counties with a publicly insured (Medicaid) population of 82,000 children (0 to 21 years old) and pregnant women served by a managed dental care organization are randomized into test and control counties. In the test intervention (PREDICT), allied dental personnel provide screening and preventive services in community settings and case managers serve as patient navigators to arrange referrals of children who need dentist services. The delivery system intervention is paired with a compensation system for high performance (pay-for-performance) with efficient performance monitoring. PREDICT focuses on the following: 1) identifying eligible children and gaining caregiver consent for services in community settings (for example, schools); 2) providing risk-based preventive and caries stabilization services efficiently at these settings; 3) providing curative care in dental clinics; and 4) incentivizing local delivery teams to meet performance benchmarks. In the control intervention, care is delivered in dental offices without performance incentives. The primary outcome is the prevalence of untreated dental caries. Other outcomes are related to process, structure and cost. Data are collected through patient and staff surveys, clinical examinations, and the review of health and administrative records. Discussion If effective, PREDICT is expected to substantially reduce disparities in dental care and oral health. PREDICT can be disseminated to other care organizations as publicly insured clients are increasingly served by large practice organizations. Trial registration ClinicalTrials.gov NCT02312921 6 December 2014. The Robert Wood Johnson Foundation and Advantage Dental Services, LLC, are supporting the evaluation.
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Affiliation(s)
- Joana Cunha-Cruz
- Department of Oral Health Sciences, Northwest Center to Reduce Oral Health Disparities, University of Washington, Box 357475, Seattle, WA, 98195-7475, USA.
| | - Peter Milgrom
- Department of Oral Health Sciences, Northwest Center to Reduce Oral Health Disparities, University of Washington, Box 357475, Seattle, WA, 98195-7475, USA.
| | - R Michael Shirtcliff
- Advantage Dental Services, LLC, 442 SW Umatilla Ave, Suite 200, Redmond, OR, 97756, USA.
| | - Howard L Bailit
- Department of Community Medicine and Health Care, UConn Health, 263 Farmington Avenue, Farmington, CT, 06030-6325, USA.
| | - Colleen E Huebner
- Department of Health Services, University of Washington, Box 357230, Seattle, WA, 98195-7230, USA.
| | - Douglas Conrad
- Department of Health Services, University of Washington, Box 357230, Seattle, WA, 98195-7230, USA.
| | - Sharity Ludwig
- Advantage Dental Services, LLC, 442 SW Umatilla Ave, Suite 200, Redmond, OR, 97756, USA.
| | - Melissa Mitchell
- Advantage Dental Services, LLC, 442 SW Umatilla Ave, Suite 200, Redmond, OR, 97756, USA.
| | - Jeanne Dysert
- Advantage Dental Services, LLC, 442 SW Umatilla Ave, Suite 200, Redmond, OR, 97756, USA.
| | - Gary Allen
- Advantage Dental Services, LLC, 442 SW Umatilla Ave, Suite 200, Redmond, OR, 97756, USA.
| | - JoAnna Scott
- Department of Pediatric Dentistry, University of Washington, Box 354915, Seattle, WA, 98195-4915, USA.
| | - Lloyd Mancl
- Department of Oral Health Sciences, Northwest Center to Reduce Oral Health Disparities, University of Washington, Box 357475, Seattle, WA, 98195-7475, USA.
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23
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Heilbrunn-Lang AY, de Silva AM, Lang G, George A, Ridge A, Johnson M, Bhole S, Gilmour C. Midwives' perspectives of their ability to promote the oral health of pregnant women in Victoria, Australia. BMC Pregnancy Childbirth 2015; 15:110. [PMID: 25943399 PMCID: PMC4490712 DOI: 10.1186/s12884-015-0536-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 04/17/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Midwives have a potential role in promoting the oral health of pregnant women although they have little formal training in this area. The aim of this study was to explore the perspectives of midwives in Victoria towards incorporating oral health promotion into their antenatal practice after undergoing training through the Midwifery Initiated Oral Health (MIOH) online education program. METHODS A purposive sample of thirty-nine midwives from maternity services across Victoria, Australia were invited to participate in an online MIOH education program in October 2012. The program included three self-paced modules covering oral health screening, referral processes, and theoretical and practical skill assessments. A mixed methods design was used to capture midwives perspectives. Evaluation questionnaires, completed pre- and post-training, captured knowledge and confidence (confidence likert scale), and also included five opened-ended questions post-training. Open-ended questions, feedback forms and unsolicited emails formed the data for qualitative analysis. Data were analysed using content and thematic analysis and descriptive statistics. RESULTS Thirty-three midwives completed the MIOH education program and demonstrated a significant increase (51.5%) in their confidence to promote oral health. All participants viewed the program as suitable, acceptable and useful for their practice and were happy to recommend the course to other Victorian midwives. Participants indicated that it would be feasible to incorporate oral health into the first antenatal booking visit and recognised that oral health promotion was within their scope of practice. CONCLUSIONS This study has shown that the MIOH education program is a valued resource that can assist midwives to increase their confidence and skills to incorporate oral health promotion into their practice. A key barrier identified was time constraints during antenatal care booking visits. However, it is evident that with relevant training it would be feasible and acceptable for Victorian midwives to incorporate oral health promotion within their practice. The current engagement with midwives in Victoria and other parts of Australia provides an opportunity to continue to explore and define the role of antenatal health care professionals in oral health promotion at a state and national level.
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Affiliation(s)
- Adina Y Heilbrunn-Lang
- Centre for Applied Oral Health Research, Dental Health Services Victoria, Melbourne, Australia.
| | - Andrea M de Silva
- Centre for Applied Oral Health Research, Dental Health Services Victoria, Melbourne, Australia.
| | - Gillian Lang
- Health Promotion, Dental Health Services Victoria, Melbourne, Australia.
| | - Ajesh George
- Centre for Applied Nursing Research, University of Western Sydney/ South Western Sydney Local Health District, Sydney, Australia. .,Ingham Institute Applied Medical Research, Sydney, Australia. .,Faculty of Dentistry, University of Sydney, Sydney, Australia.
| | - Allison Ridge
- Health Promotion, Dental Health Services Victoria, Melbourne, Australia.
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, Sydney, Australia.
| | - Sameer Bhole
- Faculty of Dentistry, University of Sydney, Sydney, Australia. .,Sydney Local Health District Oral Health Services and Sydney Dental Hospital, Sydney, Australia.
| | - Carole Gilmour
- Australian College of Midwifery Victorian Branch, Melbourne, Australia. .,Monash University, Melbourne, Australia.
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Ramazani N, Aoyub Rigi Ladez M, Zareban I, Bagheri E. Oral Health Care Education Regarding the Gingival Health, Knowledge, Attitude, and Behavior of the Pregnant Women. HEALTH SCOPE 2014. [DOI: 10.17795/jhealthscope-19446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Azofeifa A, Yeung LF, Alverson CJ, Beltrán-Aguilar E. Oral health conditions and dental visits among pregnant and nonpregnant women of childbearing age in the United States, National Health and Nutrition Examination Survey, 1999-2004. Prev Chronic Dis 2014; 11:E163. [PMID: 25232750 PMCID: PMC4170723 DOI: 10.5888/pcd11.140212] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Oral diseases can be prevented or improved with regular dental visits. Our objective was to assess and compare national estimates on self-reported oral health conditions and dental visits among pregnant women and nonpregnant women of childbearing age by using data from the National Health and Nutrition Examination Survey (NHANES). METHODS We analyzed self-reported oral health information on 897 pregnant women and 3,971 nonpregnant women of childbearing age (15-44 years) from NHANES 1999-2004. We used χ(2) and 2-sample t tests to assess statistical differences between groups stratified by age, race/ethnicity, poverty, and education. We applied the Bonferroni adjustment for multiple comparisons. RESULTS Our data show significant differences in self-reported oral health conditions and dental visits among women, regardless of pregnancy status, when stratified by selected sociodemographic characteristics. Significant differences were also found in self-reported oral health conditions and dental visits between pregnant and nonpregnant women, especially among young women, women from minority race/ethnicity groups, and women with less than high school education. CONCLUSION We found disparities in self-reported oral health conditions and use of dental services among women regardless of pregnancy status. Results highlight the need to improve dental service use among US women of childbearing age, especially young pregnant women, those who are non-Hispanic black or Mexican American, and those with low family income or low education level. Prenatal visits could be used as an opportunity to encourage pregnant women to seek preventive dental care during pregnancy.
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Affiliation(s)
- Alejandro Azofeifa
- Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-86 Atlanta, GA 30333. E-mail:
| | | | - C J Alverson
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Chi DL, Milgrom P, Carle AC, Huebner CE, Mancl LA. Multilevel factors associated with dentists' counseling of pregnant women about periodontal health. SPECIAL CARE IN DENTISTRY 2014; 34:2-6. [PMID: 24382365 PMCID: PMC3879956 DOI: 10.1111/scd.12014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify factors associated with dentists' counseling of pregnant patients about periodontal health. METHODS Survey data from Oregon general dentists (N = 771) were linked to county-level data from the U.S. Area Resource Files and analyzed using two-level hierarchical linear models. RESULTS Dentists who believed there is an important relationship between periodontal disease and adverse pregnancy outcomes counseled significantly larger proportions of pregnant patients (p < .0001). Female dentists (p < .05) and those who saw a greater number of pregnant patients (p < .05) were more likely to counsel. County-level health workforce characteristics (e.g., percent female physicians, obstetricians or gynecologists, female dentists) were not significantly associated with dentists' counseling. CONCLUSIONS Dentists who were knowledgeable about periodontal disease were more likely to counsel pregnant patients. Future interventions should improve the oral health knowledge of dentists and other healthcare professionals regarding the importance of comprehensive dental care, including periodontal treatment when needed, for all pregnant patients.
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Affiliation(s)
- Donald L. Chi
- University of Washington, School of Dentistry, Department of Oral Health Sciences
| | - Peter Milgrom
- University of Washington, School of Dentistry, Department of Oral Health Sciences
| | - Adam C. Carle
- University of Cincinnati, School of Medicine, Department of Pediatrics
| | - Colleen E. Huebner
- University of Washington, School of Public Health, Department of Health Services
| | - Lloyd A. Mancl
- University of Washington, School of Dentistry, Department of Oral Health Sciences
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Singhal A, Chattopadhyay A, Garcia AI, Adams AB, Cheng D. Disparities in Unmet Dental Need and Dental Care Received by Pregnant Women in Maryland. Matern Child Health J 2013; 18:1658-66. [DOI: 10.1007/s10995-013-1406-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
BACKGROUND The authors conducted an observational cohort study to determine the levels of and examine the associations of oral health literacy (OHL) and oral health knowledge in low-income patients who were pregnant for the first time. METHODS An analytic sample of 119 low-income patients who were pregnant for the first time completed a structured 30-minute, in-person interview conducted by two trained interviewers in seven counties in North Carolina. The authors measured OHL by means of a dental word recognition test and assessed oral health knowledge by administering a six-item knowledge survey. RESULTS The authors found that OHL scores were distributed normally (mean [standard deviation], 16.4 [5.0]). The percentage of correct responses for each oral health knowledge item ranged from 45 to 98 percent. The results of bivariate analyses showed that there was a positive correlation between OHL and oral health knowledge (P < .01). Higher OHL levels were associated with correct responses to two of the knowledge items (P < .01). CONCLUSIONS OHL was low in the study sample. There was a significant association between OHL and oral health knowledge. CLINICAL IMPLICATIONS Low OHL levels and, thereby, low levels of oral health knowledge, might affect health outcomes for both the mother and child. Tailoring messages to appropriate OHL levels might improve knowledge.
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Milgrom P, Huebner CE, Mancl LA, Chi DL, Garson G, Grembowski D. County-level characteristics as predictors of dentists' ECC counseling in the USA: a survey study. BMC Oral Health 2013; 13:23. [PMID: 23688178 PMCID: PMC3679951 DOI: 10.1186/1472-6831-13-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 05/16/2013] [Indexed: 11/27/2022] Open
Abstract
Background Transmission of Streptococcus mutans from mother-to-child can lead to Early Childhood Caries. A previous study identified characteristics and beliefs of general dentists about counseling pregnant women to reduce risk of infection and Early Childhood Caries. This study extends those findings with an analysis of county level factors. Methods In 2006, we surveyed 732 general dentists in Oregon, USA about dental care for pregnant women. Survey items asked about individual and practice characteristics. In the present study we matched those data to county level factors and used multinomial logistic regression to test the effects of the factors (i.e., dentist to population ratio, percentage of female dentists, percentage of females of childbearing age, and percentage of individuals living in poverty) on counseling behavior. Results County level factors were unrelated to counseling behavior when the models controlled for dentists' individual attitudes, beliefs, and practice level characteristics. The adjusted odds ratios for no counseling of pregnant patients (versus 100 percent counseling) were 1.1 (95% CI .8-1.7), 1.0 (1.0-1.1), 1.2 (.9-1.5), and 1.1 (1.0-1.2) for dentist/population ratio, percent female dentists, percent females of childbearing age, and percent in poverty, respectively Similar results were obtained when dentists who counseled some patients were compared to those counseling 100 percent of patients. Conclusions Community level factors do not appear to impact the individual counseling behavior of general dentists in Oregon, USA regarding the risk of maternal transmission of Early Childhood Caries.
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Affiliation(s)
- Peter Milgrom
- Department of Oral Health Sciences, University of Washington, Box 357475, Seattle, WA 98195-7475, USA.
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Chi DL, Momany ET, Jones MP, Kuthy RA, Askelson NM, Wehby GL, Damiano PC. Relationship between medical well baby visits and first dental examinations for young children in Medicaid. Am J Public Health 2013; 103:347-54. [PMID: 23237163 PMCID: PMC3558774 DOI: 10.2105/ajph.2012.300899] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2012] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the relationship between preventive well baby visits (WBVs) and the timing of first dental examinations for young Medicaid-enrolled children. METHODS The study focused on children born in 2000 and enrolled continuously in the Iowa Medicaid Program from birth to age 41 months (n = 6322). The main predictor variables were number and timing of WBVs. The outcome variable was timing of first dental examination. We used survival analysis to evaluate these relationships. RESULTS Children with more WBVs between ages 1 and 2 years and ages 2 and 3 years were 2.96 and 1.25 times as likely, respectively, to have earlier first dental examinations as children with fewer WBVs. The number of WBVs before age 1 year and the timing of the WBVs were not significantly related to the outcome. CONCLUSIONS The number of WBVs from ages 1 to 3 years was significantly related to earlier first dental examinations, whereas the number of WBVs before age 1 year and the timing of WBVs were not. Future interventions and policies should actively promote first dental examinations by age 12 months at WBVs that take place during the first year of life.
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Affiliation(s)
- Donald L Chi
- Department of Oral Health Sciences, University of Washington, Seattle, WA 98195-7475, USA.
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Alves RT, Ribeiro RA, Costa LR, Leles CR, Freire MDCM, Paiva SM. Oral care during pregnancy: attitudes of Brazilian public health professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012. [PMID: 23202756 PMCID: PMC3509465 DOI: 10.3390/ijerph9103454] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
There is little information about health professionals’ behavior regarding oral health care during pregnancy. We evaluated attitudes of obstetricians/gynecologists, nurses, and dentists working at a public community service towards pregnant women’s oral health. Health professionals responded to a self-applied questionnaire. Cluster analysis identified two clusters of respondents; Chi-square, Student’s t test, and logistic regression were used to compare the two clusters in terms of the independent variables. Respondents were categorized into cluster 1 ‘less favorable’ (n = 159) and cluster 2 ‘more favorable’ (n = 124) attitudes. Professionals that had attended a residency or specialization program (OR = 2.08, 95% CI = 1.15–3.77, p = 0.016) and worked exclusively at the public service (OR = 2.15, 95% CI = 1.10–4.20, p = 0.025) presented more favorable attitudes. Obstetricians/gynecologists (OR = 0.22, 95% CI = 0.09–0.54, p = 0.001) and nurses (OR = 0.50, 95% CI = 0.29–0.86, p = 0.013) showed less favorable attitudes than dentists. Health care providers’ attitudes regarding pregnant women’s oral health were related to their occupation, qualification, and dedication to the public service.
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Affiliation(s)
- Renata Toledo Alves
- Estacio de Sa College, Avenida Presidente Joao Goulart, 600, Cruzeiro do Sul, Juiz de Fora, MG 30130-900, Brazil;
| | - Rosangela Almeida Ribeiro
- Department of Social and Child Dentistry, Faculty of Dentistry, Federal University of Juiz de Fora, Rua José Lourenço Kelmer, Bairro São Pedro, Juiz de Fora, MG 36036-900, Brazil;
| | - Luciane Rezende Costa
- Department of Preventive and Restorative Dentistry, Faculty of Dentistry, Federal University of Goias, Primeira Avenida, Setor Universitario, Goiania, GO 74605-220, Brazil;
- Author to whom correspondence should be addressed; ; Tel.: +55-62-3209-6047; Fax: +55-62-3209-6325
| | - Claudio Rodrigues Leles
- Department of Preventive and Restorative Dentistry, Faculty of Dentistry, Federal University of Goias, Primeira Avenida, Setor Universitario, Goiania, GO 74605-220, Brazil;
| | - Maria do Carmo Matias Freire
- Department of Stomatological Sciences, Faculty of Dentistry, Federal University of Goias, Primeira Avenida, Setor Universitario, Goiania, GO 74605-220, Brazil;
| | - Saul Martins Paiva
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Minas Gerais, Avenida Antonio Carlos, 6627, Pampulha, Belo Horizonte, MG 31270-901, Brazil;
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George A, Shamim S, Johnson M, Dahlen H, Ajwani S, Bhole S, Yeo AE. How do dental and prenatal care practitioners perceive dental care during pregnancy? Current evidence and implications. Birth 2012; 39:238-47. [PMID: 23281906 DOI: 10.1111/j.1523-536x.2012.00553.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Poor maternal oral health may be associated with adverse pregnancy and infant outcomes. However, women seldom seek dental care during pregnancy, and misconceptions by prenatal care practitioners about oral health care during pregnancy may contribute to the problem. The aim of this study was to review current knowledge, attitudes, and behavior of dental and prenatal care practitioners about oral health care during pregnancy. METHODS This review examined all studies published in English that explored the knowledge, attitude, behavior, and barriers faced by dentists, general practitioners, midwives, and obstetricians/gynecologists with respect to oral health care during pregnancy. RESULTS Despite acknowledging the importance of maternal oral health, many dentists are uncertain about the safety of dental procedures and are hesitant in treating pregnant women. General practitioners and midwives are poorly informed about the impact of poor maternal oral health and rarely initiate this topic during prenatal care. Many general practitioners also believe that dental procedures are unsafe during pregnancy. Obstetricians/gynecologists are well informed about perinatal oral health and are supportive of dental procedures, but because of lack of training in this area and competing health demands they seldom focus on oral health care during their prenatal care. CONCLUSION No real consensus exists among dentists and prenatal care practitioners with respect to oral health care during pregnancy. This issue poses a significant deterrent for pregnant women seeking dental care. Practice guidelines in perinatal oral health are needed for health professionals to emphasize this important aspect of prenatal care.
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Affiliation(s)
- Ajesh George
- Centre for Applied Nursing Research (CANR), South Western Sydney Local Health District (SWSLHD)/University of Western Sydney, Sydney, New South Wales, Australia
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Bates SB, Riedy CA. Changing knowledge and beliefs through an oral health pregnancy message. J Public Health Dent 2011; 72:104-11. [PMID: 22316424 DOI: 10.1111/j.1752-7325.2011.00289.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Pregnancy can be a critical and important period in which to intervene to improve oral health in both the mother and her child. This study examined an online approach for promoting awareness of oral health messages targeted at pregnant women, and whether this type of health messaging impacts oral health knowledge and beliefs. METHODS The study was conducted in three parts: production and pilot testing of a brief commercial, Web site/commercial launch and testing, and dissemination and monitoring of the commercial on a video-sharing site. The brief commercial and pre- and postsurveys were produced and pilot tested among a convenience sample of pregnant women (n = 13). The revised commercial and surveys were launched on a newly created Web site and monitored for activity. After 2 months, the commercial was uploaded to a popular video-sharing Web site. RESULTS Fifty-five individuals completed both the pre- and postsurveys after the Web site was launched. No one responded 100 percent correctly on the presurvey; 77.4 percent responded correctly about dental visits during pregnancy, 66.0 percent about cavity prevention, and 50.9 percent about transmission of bacteria by saliva. Most respondents recalled the correct information on the posttest; 100 percent or close to 100 percent accurately responded about visiting the dentist during pregnancy and preventing cavities, while 79.2 percent responded correctly to the transmission question. CONCLUSION Social media can effectively provide dental health messages during pregnancy. This approach can play an important role in increasing awareness and improving oral health of both mother and child.
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Affiliation(s)
- S Brady Bates
- School of Dentistry, University of Washington, Seattle, WA, USA
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Jehu-Appiah C, Aryeetey G, Agyepong I, Spaan E, Baltussen R. Household perceptions and their implications for enrollment in the National Health Insurance Scheme in Ghana. Health Policy Plan 2011; 27:222-33. [PMID: 21504981 DOI: 10.1093/heapol/czr032] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This paper identifies, ranks and compares perceptions of insured and uninsured households in Ghana on health care providers (quality of care, service delivery adequacy, staff attitudes), health insurance schemes (price, benefits and convenience) and community attributes (health 'beliefs and attitudes' and peer pressure). In addition, it explores the association of these perceptions with household decisions to voluntarily enroll and remain in insurance schemes. METHODS First, data from a household survey of 3301 households and 13,865 individuals were analysed using principal component analysis to evaluate respondents' perceptions. Second, percentages of maximum attainable scores were computed for each cluster of perception factors to rank them according to their relative importance. Third, a multinomial logistic regression was run to determine the association of identified perceptions on enrollment. RESULTS Our study demonstrates that scheme factors have the strongest association with voluntary enrollment and retention decisions in the National Health Insurance Scheme (NHIS). Specifically these relate to benefits, convenience and price of NHIS. At the same time, while households had positive perceptions with regards to technical quality of care, benefits of NHIS, convenience of NHIS administration and had appropriate community health beliefs and attitudes, they were negative about the price of NHIS, provider attitudes and peer pressure. The uninsured were more negative than the insured about benefits, convenience and price of NHIS. CONCLUSIONS Perceptions related to providers, schemes and community attributes play an important role, albeit to a varying extent in household decisions to voluntarily enroll and remain enrolled in insurance schemes. Scheme factors are of key importance. Policy makers need to recognize household perceptions as potential barriers or enablers to enrollment and invest in understanding them in their design of interventions to stimulate enrollment.
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Affiliation(s)
- Caroline Jehu-Appiah
- Department of Primary and Community Care, Radboud University Nijmegen Medical Center, PO Box 9101, 6500HB Nijmegen, The Netherlands.
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Carrion IV, Castañeda H, Martinez-Tyson D, Kline N. Barriers impeding access to primary oral health care among farmworker families in Central Florida. SOCIAL WORK IN HEALTH CARE 2011; 50:828-844. [PMID: 22136348 DOI: 10.1080/00981389.2011.594491] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Oral health care is critical for farmworkers' families in Central Florida. There is little research regarding the access to primary oral health care, barriers, and behaviors of Mexican migrant families. Forty semi-structured interviews were conducted with parents who are farmworkers in order to understand the factors that impact dental service utilization. Other factors that were also examined related to parental decisions regarding visits to the dentist with their children. This study highlights the inconsistent and inadequate patterns of dental health care services available for women, men, and children of farmworkers in Central Florida.
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Affiliation(s)
- Iraida V Carrion
- School of Social Work, University of South Florida, Tampa, Florida 33620-6600, USA.
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