Nutrition and oral health guidelines for pregnant women, infants, and children

Maternal and infant oral health benefits from mothers receiving prenatal total oral rehabilitation: a pilot prospective birth cohort study

Aim

This study aimed to evaluate the maternal and infant oral health benefits from mothers receiving prenatal total oral rehabilitation (PTOR) before childbirth.

Methods

Building upon our previous investigation, in which 15 expectant mothers received PTOR before their third trimester, achieving a state of oral health free from disease prior to delivery, we conducted a follow-up study to monitor these mothers and their newborns until they reached 2 years of age. We assessed the impact of PTOR on maternal and infant oral health, the utilization of dental care during the postpartum/early-life period, and the carriage of oral cariogenic microorganisms among mothers and their infants. Control groups consisting of 11 children and 17 mothers who did not undergo PTOR were included for comparative analysis.

Results

PTOR demonstrated a sustained improvement in maternal oral health outcomes by the end of 2 years postpartum, evidenced by a reduction in the Plaque Index and decayed surfaces compared with the control group (p < 0.05). PTOR was also associated with increased perinatal oral health literacy compared with the baseline of the mothers themselves (p < 0.05). In addition, PTOR led to a notable increase in maternal dental care utilization, rising from 26.7% before PTOR to 80% at 1 year postpartum and 70% at 2 years postpartum. Intriguingly, 40% of infants in the PTOR group had their first dental visit before reaching 1 year of age, in contrast to national data from the USA indicating a rate of less than 1%. Furthermore, a decrease in plaque Streptococcus mutans was observed in PTOR mothers 2 years postpartum, compared with both their baseline carriage and that of the control group (p < 0.05). Infants in the PTOR group also had a lower incidence of early childhood caries, with 18% in the PTOR group vs. 27% in the control group, although this difference was not statistically significant due to the small sample size.

Conclusions

PTOR is associated with sustained oral health benefits and improves dental care utilization by mothers and their infants. Large-scale clinical trials are warranted to validate these study findings.

Impact of perinatal environmental health education intervention on exposure to endocrine disruptors during pregnancy-PREVED study: study protocol for a randomized controlled trial

BACKGROUND

The suspected or actual effects on health of endocrine-disrupting chemicals (EDC) and their ubiquitous presence in everyday life justify the implementation of health promotion interventions. These interventions should ideally be applied during critical windows like pregnancy. Perinatal environmental health education interventions may help to reduce EDC exposure during pregnancy.

METHODS/DESIGN

PREVED (Pregnancy, PreVention, Endocrine Disruptors) is an open-label randomized controlled trial assessing the impact of environmental health education intervention on EDC exposure during pregnancy. Inclusion, consent, and randomization take place during the first trimester. The participants are randomly allocated into three groups: (i) control group (information leaflet on EDCs), (ii) intervention group in neutral location (information leaflet and workshops in a meeting room), and (iii) intervention group in contextualized location (information leaflet and workshops in a real apartment). Workshops are organized between the second and third trimesters of pregnancy. Main outcome is the percentage of participants who reported consuming manufactured/industrial food. Secondary outcomes are as follows: (i) psycho-social dimensions, (ii) EDC concentrations in urine, (iii) EDC concentration in colostrum, and (iv) percentage of participants who reported consuming paraben-free personal care products.

DISCUSSION

PREVED is a ground-breaking intervention research project dedicated to perinatal environmental health education that aims to identify pollutant sources in daily life and to offer accessible and realistic alternative solutions, by promoting the sharing of know-how and experience in a positive and non-alarmist approach.

TRIAL REGISTRATION

ClinicalTrials.gov : NCT03233984 (current status: ongoing). Retrospectively registered on 31 July 2017 ( https://clinicaltrials.gov/ct2/show/NCT03233984 ) because when the first participant was enrolled in this non-drug intervention, ClinicalTrials.gov was centered in therapeutic trials. The World Health Organization Trial Registration Data Set is in Additional file 1.

Oral health awareness and practices in pregnant females: A hospital-based observational study

Background:

The aim of this study was to assess the oral health awareness, methods adopted to maintain hygiene, prevalent myths regarding oral health in pregnancy, and importance of oral health during pregnancy, to help formulate oral health program for pregnant females in partaking hospital.

Materials and Methods:

A total of 225 pregnant females participated in the study. After complete demographic assessment of participants, a questionnaire was provided to them. Questionnaire included simple multiple choice questions on how they maintained oral hygiene, their oral health status, visit to the dentist, and barriers in seeking treatment. This was followed by a questionnaire regarding common myths and understanding of the importance of oral health during pregnancy which had three choices: true, false, and do not know. The results were expressed in percentages, and one sample t-test for percentages was applied where ever required.

Results:

Majority of participants self-reported some form of oral health problems with bleeding gums as a chief complaint leading the survey. Around half of the participants had never visited a dentist, and an abundant number of pregnant females reported safety concerns for developing the child as a reason for not taking any treatment during pregnancy. A highly significant number of participants were unaware of the importance of oral health during pregnancy and believed in age-old myths.

Conclusion:

The oral health care still remains on the backseat in care provided to pregnant female. A complete overhaul of understanding through individual, family, and community counseling is required to spread awareness.

Oral health and oral diseases in pregnancy: a multicentre survey of Italian postpartum women

BACKGROUND

The aim of this study was to explore the oral hygiene practices and oral health status of Italian postpartum women.

METHODS

A self-administered questionnaire assessed socio-demographic information, oral hygiene habits and frequency of dental visits. All women received a thorough oral examination within five days after delivery. Logistic regression models were used to estimate odds ratios and 95% confidence intervals for exposures of interest and the presence of 'severe' periodontitis.

RESULTS

Seven hundred and fifty women participated in the study; 99.1% brushed their teeth everyday and 59.9% visited the dentist annually. The mean frequency of sites with bleeding on probing was 16.1% and the median clinical attachment level was 2.1 mm. The mean caries experience score (DMFT) was 8. Severe periodontal disease was present in 21.9% of individuals. Patients who reported visiting a dentist only when in pain and women with three dental caries or more were significantly more likely to have periodontitis (OR: 1.6; 95% CI: 1.1-2.2; p < 0.05 and OR: 2.3; 95% CI: 1.5-3.5; p < 0.01, respectively).

CONCLUSIONS

Given the possible association between maternal and infant oral health, and between periodontal infection and general health, antenatal care providers should collaborate with dentists to encourage all pregnant women to comply with the oral health professionals' recommendations regarding appropriate dental brushing techniques and the importance of dental visits.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Interrelationships of added sugars intake, socioeconomic status, and race/ethnicity in adults in the United States: National Health Interview Survey, 2005

BACKGROUND

The consumption of added sugars (eg, white sugar, brown sugar, and high-fructose corn syrup) displaces nutrient-dense foods in the diet. The intake of added sugars in the United States is excessive. Little is known about the predictors of added sugar intake.

OBJECTIVE

To examine the independent relationships of socioeconomic status and race/ethnicity with added sugar intake, and to evaluate the consistency of relationships using a short instrument to those from a different survey using more precise dietary assessment.

DESIGN

Cross-sectional, nationally representative, interviewer-administered survey.

SUBJECTS/SETTING

Adults (aged > or = 18 years) participating in the 2005 US National Health Interview Survey Cancer Control Supplement responding to four added sugars questions (n=28,948).

STATISTICAL ANALYSES PERFORMED

The intake of added sugars was estimated using validated scoring algorithms. Multivariate analysis incorporating sample weights and design effects was conducted. Least squares means and confidence intervals, and significance tests using Wald F statistics are presented. Analyses were stratified by sex and controlled for potential confounders.

RESULTS

The intake of added sugars was higher among men than women and inversely related to age, educational status, and family income. Asian Americans had the lowest intake and Hispanics the next lowest intake. Among men, African Americans had the highest intake, although whites and American Indians/Alaskan Natives also had high intakes. Among women, African Americans and American Indians/Alaskan Natives had the highest intakes. Intake of added sugars was inversely related to educational attainment in whites, African Americans, Hispanic men, and American Indians/Alaskan Native men, but was unrelated in Asian Americans. These findings were generally consistent with relationships in National Health and Nutrition Examination Survey 2003-2004 (using one or two 24-hour dietary recalls).

CONCLUSIONS

Race/ethnicity, family income, and educational status are independently associated with intake of added sugars. Groups with low income and education are particularly vulnerable to diets with high added sugars. Differences among race/ethnicity groups suggest that interventions to reduce intake of added sugars should be tailored. The National Health Interview Survey added sugars questions with accompanying scoring algorithms appear to provide an affordable and useful means of assessing relationships between various factors and added sugars intake.

A pilot study describing infant formula preparation and feeding practices

Foodborne illnesses pose a problem to all individuals but are especially significant for infants. This observational study collected pilot data on formula preparation practices of 15 mothers of infants under the age of 7 months. A site survey tool was developed, based upon existing instruments. A trained observer traveled to the participants' homes to observe formula preparation and feeding. Some 73% of women did not wash their hands before preparing formula, 60% did not keep the prepared bottle cool during transport away from home, 53% checked the formula expiration date, 20% of infants slept with their bottle, 47% added cereal to formula, and 36% obtained information about formula preparation from a health professional. Hand washing is one of the most important home hygiene practices; however, hand washing practices by participants in our study prior to baby bottle preparation was poor.

Oral health in women during preconception and pregnancy: implications for birth outcomes and infant oral health

The mouth is an obvious portal of entry to the body, and oral health reflects and influences general health and well being. Maternal oral health has significant implications for birth outcomes and infant oral health. Maternal periodontal disease, that is, a chronic infection of the gingiva and supporting tooth structures, has been associated with preterm birth, development of preeclampsia, and delivery of a small-for-gestational age infant. Maternal oral flora is transmitted to the newborn infant, and increased cariogenic flora in the mother predisposes the infant to the development of caries. It is intriguing to consider preconception, pregnancy, or intrapartum treatment of oral health conditions as a mechanism to improve women's oral and general health, pregnancy outcomes, and their children's dental health. However, given the relationship between oral health and general health, oral health care should be a goal in its own right for all individuals. Regardless of the potential for improved oral health to improve pregnancy outcomes, public policies that support comprehensive dental services for vulnerable women of childbearing age should be expanded so that their own oral and general health is safeguarded and their children's risk of caries is reduced. Oral health promotion should include education of women and their health care providers ways to prevent oral disease from occurring, and referral for dental services when disease is present.

Oral health during pregnancy

The purpose of this article is to explore how poor oral health affects pregnancy and to review current recommendations for dental care during pregnancy. While nurses are concerned with numerous aspects of the health of pregnant women, the health of maternal and fetal dentition may be overlooked. However, due to recent findings that periodontal disease may be a risk factor for preterm low birthweight, nurses and other maternal healthcare providers are becoming more aware of oral health during pregnancy. It is important to understand that establishing a healthy oral environment is the most important objective in planning the dental care for the pregnant patient. This objective is achieved by adequate plaque control (brushing and flossing) and professional prophylaxis including coronal scaling, root planing, and polishing. Nurses, nurse practitioners, and nurse-midwives should include assessment of maternal dentition and referral for dental problems as part of their prenatal practice. Patients should be encouraged to schedule elective dental treatment during the second trimester but seek prompt care for acute dental problems. Teaching related to oral health during pregnancy should include the importance of proper nutrition to ensure maternal and fetal oral health, including taking prenatal vitamins and eating foods high in protein, calcium, phosphorus, and vitamins A, C, and D. Potential teratogens that may be encountered during dental care should also be discussed. Nurses can be vital in improving perinatal outcomes and maternal/fetal dental health through screening, referral, and education of their pregnant clients.

[Oral health in pregnancy]

INTRODUCTION

Good oral health care during pregnancy is essential but often overlooked factor of dental growth as well as of other structures of oral cavity. Pregnancy is the time when conscious approach to preventive oral care should increase.

PREVENTIVE MEASURES DURING PREGNANCY

Preventive measures during pregnancy mean usage of fluorides, special dietary measures and increased oral hygiene habits. Preventive measures in pregnant women have one goal: providing conditions for development of fetal teeth as well as preventing tooth decay in pregnant women. The optimal period for introducing preventive measures is the first trimester of pregnancy.

ALTERATIONS OF ORAL HEALTH DURING PREGNANCY

Because of hormonal alterations there is an increased incidence of dental diseases: gingivitis and low salivary pH (inflammation and bleeding gums).

IMPACT OF NUTRITION DURING PREGNANCY ON ORAL HEALTH

Eating habits of pregnant women may lead to frequent snacking on candy or other decay-promoting foods, thereby increasing the risk of caries. However, very poor oral health, possible dental complications and their consequences to the health as well as emotional status represent very strong reasons for activation of dental health care in this period.

Choose beverages and foods to moderate your intake of sugars: the 2000 dietary guidelines for Americans--what's all the fuss about?

As part of the 2000 Dietary Guidelines for Americans, the public is advised to choose beverages and foods to moderate their intake of sugars. The term sugars is conventionally used to describe the mono- and disaccharides. However, the Dietary Guidelines for Americans distinguish between added sugars and other sources of carbohydrates. The concept of added sugars provides consumers with useful information, especially if they are trying to limit excessive use of caloric sweeteners. Added sugars are defined as sugars that are eaten separately at the table or used as ingredients in processed or prepared foods. Consumption of added sugars has increased steadily as documented by both food supply data and nationwide food consumption survey data. The largest source of added sugars in the U.S. diet is nondiet soft drinks, accounting for one third of total intake. Diets high in sugars have been associated with various health problems, including dental caries, dyslipidemias, obesity, bone loss and fractures, and poor diet quality. Research gaps are identified.

Is fruit juice a "no-no" in children's diets?

In addition to milk and other beverages, juices in reasonable quantities (12 fl oz/day or less) provide nutrients infants need while keeping sugar and food energy intakes adequate.