Oral Health Knowledge and Related Factors among Pregnant Women Attending to a Primary Care Center in Spain

Oral health knowledge, literacy and behavior of pregnant women: a qualitative study in a northeastern province of Thailand

BACKGROUND

Pregnancy is a unique period of women's lives, and oral health is an important public health indicator during this period. Pregnant women have increased vulnerability to oral health problems. The study aimed to describe oral health knowledge, literacy and behavior of pregnant women in a northeastern province of Thailand.

METHODS

A descriptive study was used. Twenty pregnant women who attended antenatal care clinics of eight public hospitals in the province were recruited by use of purposive sampling. They participated voluntarily in individual interview. The Health Belief Model was used as conception framework. All data were transcribed and subjected to content analysis.

RESULTS

Five categories emerged: Misbelief and lack of knowledge, Oral health problems and dental care seeking, Oral health information from different persons, Self-care management of oral health, and Fear of and anxiety towards dental treatment. The findings showed that low knowledge of need for treatment, little importance to oral health and low priority of dental needs affect the demand for dental care. Fear of and anxiety towards dental treatment were the results of negative past experiences of neglecting dental care. Some women perceived health benefits of practicing self-care of oral health during pregnancy.

CONCLUSION

The findings help to better understand the oral health issues of pregnant women and provide baseline information for oral health promotion. Such promotion and culturally appropriate care should be integrated in maternal health education classes.

Unfavourable beliefs about oral health and safety of dental care during pregnancy: a systematic review

BACKGROUND

Oral conditions such as gingivitis and periodontitis are correlated with adverse pregnancy outcomes such as preeclampsia, preterm birth and low birth weight. Oral health-related unfavourable beliefs can have negative influences on oral health behaviours including hesitation in accessing preventative dental treatments and dental service utilization. The objective of this systematic review was to examine unfavourable beliefs that expectant or new mothers frequently hold about oral health and the safety of dental care during pregnancy.

METHODS

An electronic database search on PubMed, Scopus, CINAHL, and MEDLINE (Ovid) followed by forward and backward citation tracing of the included studies was conducted. All English primary studies regardless of the year of publication were independently screened by two reviewers to identify studies addressing unfavourable beliefs about oral health and dental care during pregnancy. The CLARITY tool was applied to assess the risk of bias in the included studies.

RESULTS

Out of a total of 5766 records, 39 quantitative and six qualitative studies met the inclusion criteria. The commonly held unfavourable beliefs were regarding the safety of dental services utilization and dental treatment procedures, the adverse impacts of pregnancy on oral health, and oral hygiene necessity during pregnancy. The most discussed unfavourable beliefs included "pregnant women lose their teeth because of pregnancy" (n = 18), "dental treatments are not safe and harm the fetus" (n = 17), and "the developing baby absorbs calcium from the mother's teeth" (n = 14).

CONCLUSIONS

Unfavourable beliefs about oral health and dental care utilization are common among pregnant women and new mothers. The literature suggests that a low level of oral health knowledge and seeking information from social networks can contribute to such beliefs. This has implications for health promotion.

Social and Preventive Factors That Explain Oral Health among Pregnant Women in the Canton of Cuenca, Ecuador

(1) Background: pregnant women in underprivileged areas may face challenges that affect their oral health. The analysis of these issues such as toothaches or cavities, among others could be crucial for them. However, no studies have been conducted in Cuenca, Ecuador. Thus, this study aimed to create a model explaining how social factors and healthy habits impact oral health in Cuenca, Ecuador. (2) Methods: An observational study was performed using a questionnaire developed from scratch. Principal component factor analysis was performed to calculate the oral disease index based on the oral health issues reported by women during pregnancy. (3) Results: 1971 women participated in the research. In total, 88% reported at least one oral health problem, with cavities (34%) and bleeding gums (33%) as the most prevalent. The rate of preventive visits and frequent brushing were the two variables that most impacted the oral disease index. The consumption of sweets, age, and the belief that visiting the dentist harms their unborn child were also important factors. However, income, education, and ethnic background showed little to no effect. (4) Conclusions: The most beneficial determinants of oral health factors in pregnant women in Cuenca, Ecuador, are preventive dentist visits, frequent brushing, and a contained consumption of sweets. The main harmful factors are age and the misconception that dental visits can harm their unborn child. Surprisingly, income, education, and ethnic background have little effect. This study can be replicated in other countries and cultures.

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

BACKGROUND

Although pregnancy is a physiological process it causes hormonal changes that can also affect the oral cavity. Pregnancy increases the risk of gum disease inflammation and tooth caries which could affect the health of the developing baby. Proper oral health is crucial both for mother and her babies and is related with mothers' awareness of this connection. The aim of this study was the self-assessment of women's both oral health and oral health literacy as well as mothers' awareness of the connection of oral health and pregnancy.

MATERIAL AND METHODS

In the study anonymous questionnaire was prepared and provided to be filled in by 200 mothers at the age from 19 to 44 y.o. who gave birth in the gynecological clinic. The questionnaire included demographic, and concerning the areas of oral health before and during pregnancy and after the childbirth questions.

RESULTS

Only 20% of the investigated women underwent the oral examination before the pregnancy and the next 38.5% underwent it intentionally when the pregnancy had been confirmed. As much as 24% of women pointed out lack of awareness of the importance of proper oral hygiene during pregnancy. 41.5% of investigated women declared complaints during the pregnancy concerning teeth or gums and 30.5% underwent dental treatment; 68%, brushed their teeth properly-twice a day; 32% of women observed deterioration of oral health state during the pregnancy. The knowledge of the importance of oral health during pregnancy presented by the majority of mothers was relatively proper, which was strongly connected with higher education status and living in big cities. A significant correlation between higher birth weight and more frequent daily tooth brushing was observed. Both higher frequency of problems concerning the oral cavity and dental treatment during pregnancy were significantly related to the younger age of mothers.

CONCLUSIONS

The knowledge of women concerning of oral health on the management of pregnancy and development of fetus is still insufficient. Gynecologists should inquire pregnant women if they have done dental examination, and provide wider education about importance of oral health in pregnancy.

Attitude of Midwives towards Fluoride Recommendations and Oral Prevention in Infants and Young Children

Early childhood caries is a challenge. Early dental screening flanked by multidisciplinary preventions by pediatricians, dentists, and midwives (MWs) may be helpful. New recommendations for dental screening in children (FUs) and fluoride have been introduced in Germany. The aim of this study was to investigate whether midwives consider FUs useful and implement early childhood caries prevention, as well as fluoride recommendations. The survey was conducted using an online questionnaire. Demographic data, including 11 items on early childhood dental prophylaxis and fluoride, were requested. Agreement was recorded using Likert scales. The data were analyzed descriptively. Two hundred and seventeen female MWs participated (age: 44.1 (11.04) years). One hundred and four (47.9%) participants knew about the FUs. Of the MWs, 30.7% found a referral from the first tooth to be very important (important/neutral/unimportant: 27%/27.9%/14.4%), compared with 84.8% for the entire primary dentition (11.8%/2.8%/0.5%). Of the MWs, 41.7% always recommended fluoride toothpaste from the first tooth (often/occasionally/rarely/never: 22.7%/12.4%/7.9%/15.3%) and 48.1% completely rejected fluoride-free toothpaste (always/often/occasionally/rarely: 9.8%/8.9%/17.3%/15.9%). In addition, 54.8% never recommended the use of fluoride tablets (always/often/occasionally/rarely: 9.2%/7.4%/10.2%/18.4%). The FUs are not yet well-known among MWs, and only less than one-third recommended dental check-ups, starting with the first tooth. This contrasts with the high uptake of fluoridated toothpaste. More educational work should be carried out to convince more MWs of the benefits of the FUs.

Association between ethnicity and health knowledge among the floating population in China

Background

Health equity remains a priority concerns by central government in China. This study aimed to explore ethnic gaps in access to health knowledge categories and sources based on the survey data from a publicly available dataset.

Methods

Data were from 2015 China Migrants Dynamic Survey issued by The National Health Commission in China. Descriptive analyses were performed to reflect geodemographic differences in the floating population of ethnic minority (EMFP) and Han majority (HMFP) with Chi-square test. Ethnic gaps in access to health knowledge categories and sources were explored with Poisson regressions, logistic regressions, and bivariate ordered probit regressions.

Results

In the sample, most of participants had inadequate health information literacy. There were significant differences regarding geodemographic factors between EMFP and HMFP. Illiterate EMFP had likelihood to obtain less health knowledge categories (IRR = 0.80, 95% CI 0.77–0.84) and sources (IRR = 0.83, 95% CI 0.80–0.86) as compared to illiterate HMFP. Most of correlations between health knowledge categories and sources were weak in the samples of EMFP and HMFP.

Conclusion

Ethnic disparities in access to health knowledge categories and sources among the floating population in China were confirmed. Further effective efforts should be provided to reduce ethnic disparities in access to health knowledge under the ethnicity-orientated support of public health resource.

Impact of a Dental Storybook on Parents' Knowledge of Children's Oral Health: A Randomized Controlled Trial

PURPOSE

To evaluate the effectiveness of a dental storybook on parents' knowledge about oral health of their children and to assess their perception of its effect in reducing dental anxiety levels among their children, as well as improving their oral health knowledge.

PATIENTS AND METHODS

This was a two-arm parallel, single-blind, randomized controlled trial (RCT) which was performed at the pediatric dental clinics in the Dental University Hospital, King Saud University, Riyadh, Saudi Arabia. Parents of 88 children (6-8 years old) were included in the present study. Parents and their children were randomly divided into two groups as follows: the intervention group (received the storybook and verbal oral hygiene instructions) and the control group (only received verbal oral hygiene instructions; same information included in the book). Three dental visits, including screening, examination/cleaning and treatment, were provided for each child. In the screening visit, baseline parental oral health knowledge was evaluated for all parents. Afterward, parental oral health knowledge was re-evaluated in the examination visit. In the treatment visit, a parental perception questionnaire was administered to parents following treatment to evaluate their satisfaction regarding the use of the storybook in reducing anxiety levels among their children.

RESULTS

There was a significant improvement in the total knowledge score at the follow-up visit in the intervention group compared to the control group (P<0.0001). Overall, the majority of parents perceived the storybook as a useful source of information, and they found it to be effective in reducing dental anxiety levels among their children.

CONCLUSION

The dental storybook is an effective educational tool that can help parents become more knowledgeable about their children's oral health. Moreover, parents perceived the storybook as an effective tool for enhancing their oral health knowledge and lowering their children's dental anxiety.

Systematic Review of the Literature on Dental Caries and Periodontal Disease in Socio-Economically Disadvantaged Individuals

Dental caries and periodontal disease represent a health problem and a social cost for the entire population, and in particular for socio-economically disadvantaged individuals who are less resistant to disease. The aim of this review is to estimate the prevalence and severity of the two dental pathologies, caries and periodontal disease, in the different classes of socio-economically disadvantaged subjects and to understand which of them are most affected. A systematic search of the literature was performed in MEDLINE (via PubMed), EMBASE and Web of Science after establishing a suitable search strategy for each database, using keywords related to socio-economically vulnerable classes and health outcomes. Socio-economically disadvantaged individuals are more susceptible to tooth decay and periodontal disease (with relative tooth loss) than non-vulnerable people. Additionally, when multiple vulnerabilities are combined in the same subject, these oral diseases worsen. There is no type of vulnerability more affected by caries and periodontitis than others, since overall they all have severe disease indices. The data from this systematic literature review might be useful for health policy makers looking to allocate more resources and services to socially disadvantaged individuals, resulting in making them more resilient to oral disease due to their social marginalization.

Knowledge, Attitudes, and Practices of Spanish Midwives and Midwifery Students toward Oral Healthcare during Pregnancy

Pregnancy can affect the mother's oral health, increasing their susceptibility to oral diseases that have been associated with harmful effects on the newborn. Despite the severity of oral diseases during pregnancy, the demand for dental care during the gestational period is low, which may improve with the participation of midwives in promoting oral health activities. The objectives of this study were: (i) to determine the knowledge, attitudes, and practices of Spanish midwives and midwifery students regarding oral health in pregnant women; and (ii) to identify the barriers faced by these healthcare professionals in addressing oral health promotion during pregnancy. An observational cross-sectional descriptive study was conducted. A total of 128 midwives and/or midwifery students ≥ 18 years old and of both sexes were invited to self-complete a questionnaire between January and April 2020. A total of 85 people participated in the study. Participants had a regular level of knowledge about oral health during pregnancy (overall knowledge score: 6.53), and although they were interested in activities that promote oral healthcare, their oral healthcare practices during pregnancy were limited. As midwives play an important role in promoting health, their training in oral healthcare could help to improve pregnant women's oral health.