How much do pregnant women know about the importance of oral health in pregnancy? Questionnaire-based survey

Frequency and factors associated with the utilization (curative and preventive) of oral health care services among pregnant women in Kinshasa, Democratic Republic of Congo

BACKGROUND

The Democratic Republic of Congo (DRC) has one of the highest maternal and neonatal mortality rates in Africa. There is a growing body of evidence about the relationship between poor oral health and adverse pregnancy outcomes. However, there is a lack of information about oral health status during pregnancy in the DRC. This study aimed to identify the factors related to the utilization of oral health care services among pregnant women.

METHODS

A hospital-based cross-sectional study was conducted in four health facilities representing each administrative district of the city of Kinshasa, between March and May, 2021. The study population comprised pregnant women aged at least 18 or over attending antenatal care (ANC), selected using a simple random sampling technique. Data were collected using a structured questionnaire. Multivariable logistic regression was employed to identify factors associated with the outcome variable using the adjusted odds ratio (AOR) with its 95% confidence interval (95% CI) and p value  <  0.05.

RESULTS

A total of 5% of the 500 pregnant women who participated in the study were identified as users of oral healthcare services. 15% of pregnant women were aware of the necessity of oral health care during pregnancy, while 58% indicated that dental visits for routine and/or treatment purposes were not a priority during pregnancy. Factors associated with its utilization were knowledge of the need for oral health care during pregnancy (AOR:3.62, 95% CI: 1.42-9.26), knowledge of the importance of routine visits or dental treatment for oral diseases during pregnancy (AOR: 4.94, 95% CI: 1.70-16.73), and having experience oral health problem during the current pregnancy (AOR: 3.13, 95% CI: 1.22-8.21).

CONCLUSION

The utilization of oral health care services during pregnancy is very low. Appropriate public health initiatives are urgently needed to facilitate collaboration between health professionals to integrate oral and dental consultations, oral health counseling, and check-ups as an essential component of routine ANC.

Multicenter Cross-Sectional Study of Oral Health and Hygiene Practices Among Pregnant Women

Background: Hormonal, vascular, and behavioral changes during pregnancy can negatively impact a woman's oral health, resulting in conditions such as gingivitis, dental sensitivity, and caries. Although oral health is critical during pregnancy, it remains frequently overlooked. In this study, the oral health status and hygiene practices of pregnant women attending two university hospitals in southern Italy were evaluated. Methods: A cross-sectional cohort study was conducted with 72 pregnant women. Data were collected through an anonymous questionnaire that evaluated oral hygiene habits, dental visits, and oral pathologies, followed by a clinical examination. The examination included the assessment of the Decayed, Missing, Filled Teeth (DMFT) index and the Oral Hygiene Index (OHI) scores. Results: Among the participants, 61% were in their 9th month of pregnancy. The mean DMFT score was 7.9, and the mean OHI score was 3.6. Only 19.4% of participants had visited a dentist in the past 6 months, while 97.2% reported brushing their teeth just once per day. Gingival bleeding was reported by 72.2% of the women, and 38.9% experienced dental sensitivity, with both conditions worsening during pregnancy. Conclusions: The need for greater oral hygiene education and regular dental care during pregnancy is highlighted in this study. Integrating oral health maintenance into prenatal care programs is essential for preventing pregnancy-related oral diseases and promoting maternal and fetal well-being.

Impact of Hormones and Lifestyle on Oral Health During Pregnancy: A Prospective Observational Regression-Based Study

Background and Objectives: This study explores the impact of hormonal fluctuations during pregnancy and lifestyle factors on stomatognathic system (SS) health. The aim is to determine how pregnancy-related hormonal changes and oral hygiene behaviors affect the onset of stomatognathic issues, such as gingival inflammation (GI) and dental erosion (DE). Materials and Methods: A prospective, observational study was conducted with 100 pregnant women, divided into two groups: Group A (60 women with significant stomatognathic alterations) and Group B (40 women without such alterations). Multiple regression analysis was used to evaluate the influence of hormonal levels, oral hygiene habits, and vomiting episodes on stomatognathic health. Results: Age and socioeconomic status showed no significant association with stomatognathic health (p > 0.05). In contrast, elevated levels of estrogen (p = 0.001) and progesterone (p = 0.003) were significantly linked to the severity of stomatognathic changes. Oral hygiene habits also had a statistically significant impact (p = 0.02), while vomiting frequency was not an important factor (p > 0.05). Conclusions: Hormonal changes during pregnancy, particularly increased estrogen and progesterone levels, are key predictors of stomatognathic health. These findings suggest that while oral hygiene is important, hormonal fluctuations play a dominant role in influencing stomatognathic system (SS) health during pregnancy.

Factors Associated with Dental Care Utilization for Oral Disease Prevention Among Adolescents in Multicultural Families in Republic of Korea

OBJECTIVES

This study utilized data from the 2022 Korea Youth Risk Behavior Survey to examine the utilization of preventive dental care among adolescents from multicultural families and analyze the associated factors.

METHODS

The number of adolescents from multicultural families, based on parental nationality, was 1361. The dependent variables were asymptomatic dental visits, sealant experience, and scaling experience. The independent variables included health perception factors (subjective health status, subjective oral health status), health behaviors (fruit consumption frequency, vegetable consumption frequency, sugary drink consumption frequency, drinking experience, smoking experience), and oral health behaviors (daily tooth-brushing frequency, tooth brushing after lunch, use of oral care products, oral symptom experience). Confounding variables included demographic variables (age, grade) and socioeconomic variables (academic performance, economic level, parental education level, mother's nationality). Statistical analyses were conducted using a complex samples cross-tabulation and complex samples logistic regression.

RESULTS

Asymptomatic dental visits were significantly associated with subjective oral health status and sugary drink consumption. Those who perceived their oral health as "Healthy" had an odds ratio (OR) of 3.34 (CI = 1.76-6.32; p < 0.001), and those who perceived themselves "Normal" had an OR of 2.03 (CI = 1.08-3.82; p = 0.029). A sugary drink consumption of less than three times per week was linked with an OR of 1.68 (CI = 1.05-2.70; p = 0.031). Sealant experience was associated with brushing before bedtime (OR = 2.27, CI = 1.18-4.35; p = 0.014) and using more than one oral care product (OR = 1.97, CI = 1.27-3.07; p = 0.003). Scaling experience associated with oral symptoms (OR = 1.94, CI = 1.21-3.11; p = 0.006).

CONCLUSIONS

To enhance access to preventive dental care utilization for adolescents from multicultural families, efforts are needed to raise subjective oral health awareness, improve oral health behaviors, and develop strategies that ensure timely preventive dental care.

Consideration of hormonal changes for orthodontic treatment during pregnancy and lactation - a review

Hormonal changes in pregnant and lactating women significantly affect bone metabolism and overall stress levels, positioning them as a unique group within the orthodontic population. Fluctuations in estrogen, progesterone, prolactin, and other hormones are closely linked to bone remodeling and the periodontal tissue's response to inflammation caused by dental plaque. Hormones such as thyrotropin, leptin, and melatonin also play crucial roles in pregnancy and bone remodeling, with potential implications for orthodontic tooth movement. Additionally, adverse personal behaviors and changes in dietary habits worsen periodontal conditions and complicate periodontal maintenance during orthodontic treatment. Notably, applying orthodontic force during pregnancy and lactation may trigger stress responses in the endocrine system, altering hormone levels. However, these changes do not appear to adversely affect the mother or fetus. This review comprehensively examines the interaction between hormone levels and orthodontic tooth movement in pregnant and lactating women, offering insights to guide clinical practice.

Does YouTube™ Provide Adequate Information on Oral Health During Pregnancy?

Background This study aimed to assess the reliability, quality, and content of the information provided by YouTube™ videos on oral health during pregnancy to reveal the effectiveness of the videos for patients. Methodology This cross-sectional study was conducted by two experienced dental specialists. They initiated the study by searching for YouTube™ videos using the keyword 'pregnancy oral health'. The videos were then assessed based on various parameters, including origin, type, number of days since upload, duration, number of views, number of likes and dislikes, and number of comments. The specialists also calculated the interaction index and viewing rate. The reliability and quality of the videos were evaluated using the global quality scale (GQS) and modified DISCERN (mDISCERN) scales, while the content was assessed with the comprehensiveness tailor-made index. The data were analyzed with the Shapiro-Wilk, the Kruskal-Wallis, the post-hoc Bonferroni, and Fisher's exact tests. The significance level was set at P < 0.05. Results After reviewing initially 224 videos, 129 were included in the study. Health professionals were the publishers of most videos. A statistically significant positive correlation was found between content scores and video duration, number of comments, interaction index, and total DISCERN scores (p<0.05) (r=0.445, r=0.186, r=0.552, r=0.241, r=0.200, r=0.681, respectively). Statistically significant associations were found between GQS scores, video duration, number of comments, and total mDISCERN scores (p<0.05) (r=0.510, r=225, r=0.156, r=0.768, respectively). Statistically significant relationships were identified between the total content score, video source, and GQS (p<0.05). According to the total content score, 57.4% of the videos had a score of 2, 35.7% had a score of 1, and only 7% had a score of 0. Conclusions This study's findings underscore the significant variability in the scientific accuracy, content, and quality of health information on the Internet, particularly on YouTube™. It reveals that, while there are videos that provide rich content and high-quality information, there are also poor-quality and inadequate videos that may mislead patients. Health professionals should be aware of misinformation found on YouTube™ and ensure that patients always have access to accurate and reliable information.

The relationship between pregnancy and temporomandibular disorder (TMD) through diagnostic criteria for temporomandibular disorders (DC/TMD) axis II evaluation: a case-control cross-sectional study

INTRODUCTION

This study focuses on temporomandibular disorders (TMDs), which affect the temporomandibular joint and related muscles and have multiple causes. Recent studies have examined the connection between menstrual cycles, estrogen levels, and TMDs, but results are inconsistent, highlighting the need for more research. The aim is to explore the prevalence of TMDs in pregnant women and consider how hormonal changes during pregnancy might influence these disorders.

METHODS

In this cross-sectional case-control study, we compared 32 pregnant women with 35 non-pregnant women. We evaluated several TMD-related factors such as pain levels, chronic pain classification, scores on the Jaw Functional Limitation Scale-20 and Oral Behaviors Checklist, and psychological health. We used various statistical methods including descriptive statistics, chi-square tests, linear regression, and adjustments for multiple comparisons to analyze the data.

RESULTS

Pregnant women showed different pain perceptions, generally reporting less pain and lower severity. Nonetheless, these differences were not uniform across all TMD-related measures. Linear regression did not find a consistent link between pregnancy and TMD scores, except for chronic pain grade, which was not significant after adjusting for multiple comparisons. There was a significant relationship between depression and TMD severity, emphasizing the need to consider mental health in TMD evaluations.

DISCUSSION

The findings suggest that pregnancy is neither a risk nor a protective factor for TMD. Differences in pain perception, functional status, and psychological health were observed in pregnant women but were not consistent for all TMD-related aspects. The role of estrogen in TMJ health and TMD risk is complex and requires further study. The research highlights the necessity of including mental health, especially depression, in TMD assessments. More comprehensive research with larger sample sizes is essential to better understand the connections between pregnancy, TMD, and hormones, aiming to improve TMD management in pregnant women and others.

Pregnancy related factors and temporomandibular disorders evaluated through the diagnostic criteria for temporomandibular disorders (DC/TMD) axis II: a cross sectional study

INTRODUCTION

Temporomandibular disorder (TMD) is a multifaceted condition impacting the chewing system, with its frequency varying across different age groups and showing a higher incidence in women. The involvement of estrogen in TMD has been examined due to the presence of estrogen receptors in the TMJ area. However, the exact effect of estrogen on TMD is complex. During pregnancy, marked by significant hormonal fluctuations, the impact on TMD has been hypothesized but remains unclear due to inconsistent results from various studies.

METHODS

In this cross-sectional study, we enrolled 32 pregnant women consecutively. We gathered information on demographics, TMD evaluations (using the Graded Chronic Pain Scale, Jaw Functional Limitation Scale-20, and Oral Behaviors Checklist), and mental health assessments (including Patient Health Questionnaire-9, Patient Health Questionnaire-15, and Generalized Anxiety Disorder-7). We employed descriptive statistics to summarize continuous and categorical data and used t-tests and chi-square tests for comparisons. We also conducted multivariate linear regression, adjusted for demographic factors, to investigate correlations.

RESULTS

The study group mainly consisted of women aged 30-35 (40.6%) and 25-30 (18.8%). Most participants had completed high school (50%) and were married (71.9%). A notable association was found between younger women (under 30) and higher levels of somatic symptoms (p = 0.008) and generalized anxiety (p = 0.015). Women in their second trimester showed lower severity of somatic symptoms (p = 0.04). A significant link was also observed between depression severity and somatic symptom severity (p = 0.01). However, we found no significant correlations with other TMD-related health aspects.

DISCUSSION

Our study identified significant associations between psychosomatic and psychological symptoms with variables like age and pregnancy trimester in pregnant women. However, it notably failed to establish a clear relationship between pregnancy-related factors and the severity of temporomandibular disorders (TMD). More comprehensive studies with larger participant pools are necessary to further validate and expand these findings.

Perceptions and determinants of oral health care among Iranian pregnant women: a qualitative study

OBJECTIVES

This study aimed to gain a comprehensive understanding of the determinants that influence oral healthcare behaviours among Iranian pregnant women.

STUDY DESIGN

Qualitative study.

SETTING

Comprehensive health service centres.

PARTICIPANTS

A sample consisting of all people involved in the process of oral care during pregnancy, 18 pregnant women, 7 midwives/healthcare workers, 3 supervisors of prenatal care services and 3 dentists) were purposefully sampled in terms of demographic characteristics.

METHODS

The qualitative content analysis study conducted 31 semistructured individual interviews in 2022, utilising MAXQDA V.10.

RESULTS

The participants identified 3 main categories and 11 subcategories: individual and physiological determinants (care needs, perceived importance, motivation, oral health literacy and inherent pregnancy limitations), organisational determinants (costs, access to equipment and services, review of service delivery process and professional behaviour) and social-cultural determinants (educational services and support from family and friends).

CONCLUSIONS

The results can be used in interventions to improve oral healthcare for pregnant women. This study highlights the importance of addressing individual, organisational and social-cultural determinants to improve oral healthcare during pregnancy.

Exploring the Perception and Awareness of Dental Students and Interns in Managing and Treating Pregnant Patients

Background Undergraduate dental students and interns express reluctance to deal with pregnant women in the dental office due to the fear of medical consequences on the fetus. This study aims to explore the knowledge, attitudes, and practices of dental students and interns regarding the dental considerations of pregnant women in three dental schools in Saudi Arabia. Methodology This cross-sectional study was performed between October and December 2023 and targeted the clinical academic years of dental students and interns at three dental schools in Saudi Arabia, namely, Taibah University, Umm Al-Qura University, and Qassim University. Using the convenience sampling method, 223 students were invited to respond to a questionnaire constructed from previously published studies and reviewed by experts in the field. It consisted of 15 questions divided into four sections. Descriptive analysis and chi-square test were conducted to assess the difference between the different sociodemographic groups and students' educational levels with the significance level set at p-values <0.05. Results Overall, 223 complete responses were received, with a response rate of 97%. Demographics included 99 (44.40%) males and 124 (55.60%) females, with a reasonable distribution across academic years. Knowledge assessment findings revealed that 114 (51%) participants acquired adequate knowledge. Regarding participants' attitudes, 112 (50%) found the curriculum-centered information sufficient. In addition, 173 (77.6%) participants chose lectures/books as their preferred source of information. Almost 138 (61.9%) participants did not feel confident in managing pregnant women. The chi-square test revealed that educational level significantly impacts the knowledge and practice of the participants, regardless of their gender (p < 0.05). Conclusions Both students and dental interns showed adequate-to-good levels of knowledge and attitude. Both need more exposure to clinical situations with pregnant women during their undergraduate dental training programs to boost their confidence level and enhance their readiness to practice dental procedures with such a group of patients after graduation.

Efficacy of Sonic-Powered and Manual Toothbrushes on Plaque-Induced Gingivitis in Pregnant Women: A Randomized Controlled Trial

Hormonal changes and physiological alterations in pregnancy increase the susceptibility of the woman to oral diseases such as plaque-induced gingivitis. In individual oral prophylaxis, effective tooth brushing can reduce gingival inflammation. Therefore, it is necessary to update the scientific evidence to identify which type of toothbrush, manual or sonic-powered, is most effective in reducing the incidence of gingivitis in pregnant women. The aim of this clinical trial is to compare the biofilm control effectiveness of two manual and two sonic toothbrushes in pregnant women. This study is designed as a four-arm, parallel, randomized controlled trial with an allocation ratio of 1:1:1:1. The pregnant woman will be included at 15-18 weeks of amenorrhea and followed for 3 months. The primary outcome will be the change in the incidence of gingival bleeding from a baseline and various follow-up periods of the study. Secondary outcomes measures will be to compare clinical effects of the toothbrushes tested on (i) gingival inflammation, (ii) dental plaque, (iii) gingival attachment and (iv) periodontal pocket; and to assess toothbrush acceptability. Thus, identifying the best device for effective tooth brushing in pregnancy could be helpful in reducing and improving the incidence of gingival inflammation.