Oral care in pregnancy

Oral Health Status and Dental Services Utilisation Among a Vulnerable Sample of Pregnant Women

INTRODUCTION AND AIMS

Oral health conditions during pregnancy can negatively impact both mother and fetus, highlighting the importance of maintaining dental care. In Canada, significant disparities exist between general and dental healthcare access, with limited evidence on oral health status and dental care utilisation among pregnant women. This study aimed to provide initial insights into self-perceived oral health status and dental utilisation patterns among a vulnerable sample of pregnant women in southwestern Ontario.

METHODS

This cross-sectional study recruited a convenient sample of pregnant women referred to the Family Medicine and Obstetrics Clinic, serving those without a family physician. Data were collected using a self-administered questionnaire adapted from the Canadian Health Measure Survey, the Canadian Community Health Survey, and the Survey of Maternal Health. Andersen and Newman's framework for health service utilisation was used as the theoretical framework. Descriptive and univariable analyses were conducted, followed by a forward stepwise selection of variables with p-values < 0.1 from the univariable analyses.

RESULTS

One-hundred-fifty patients were approached and 130 (86.7%) completed the questionnaire. Of these, 96 (73.9%) reported their oral health as good/excellent while 34 (26.2%) reported having poor/fair oral health. Education level and quality of life were the strongest predictors of oral health status. While 101 (77.7%) visited a dentist within the last 2 years, only 35 (26.9%) had a dental visit during pregnancy. Toothbrushing frequency was the main predictor of time since last dental visit, with no other predictive factors once toothbrushing was considered.

CONCLUSION

The study sample showed relatively positive self-perceived oral health and dental visit patterns. However, the low rate of dental visits during pregnancy highlights the need for better integration of dental care into prenatal care. To ensure maternal and child health, pregnant women should be a high priority in policies aimed at improving access to dental care.

A Survey of Lithuanian Pregnant Women's Knowledge about Periodontal Disease, Its Prevalence and Possible Influence on Pregnancy Outcomes

Background: This study aimed to subjectively assess the changes in the oral health status of pregnant women, to find out their attitudes and knowledge about possible changes in the oral cavity that occurred during pregnancy, and their influence on the outcomes of pregnancy. Methods: 112 pregnant women who visited the Republican Siauliai Hospital during their pregnancy participated in the study. An anonymous self-administered questionnaire was used to conduct the research, surveying their demographic characteristics, oral health changes and habits during pregnancy, and awareness of possible negative pregnancy outcomes. Results: The study involved 112 pregnant women, with 35 in the first trimester, 28 in the second, and 48 in the third trimester. The findings revealed that pregnant women do not take sufficient care of their oral health: more than half of the respondents did not visit an oral care specialist during pregnancy; 22.3% of women reported brushing their teeth only once a day or less; and 35.7% did not clean interdental surfaces at all. Statistically, significantly more urban women believed there is a relationship between maternal oral health and adverse pregnancy outcomes than women living in rural areas (p = 0.013). While significant oral health changes were not observed in the first trimester, more women in the second and third trimesters reported issues such as bleeding gums, swelling, plaque accumulation, tartar, and caries (p < 0.001). Conclusions: The attitude of women towards oral health during pregnancy and their understanding of the possible risks for unfavorable pregnancy outcomes are insufficient. Notably, oral health issues become more prominent in the second and third trimesters, necessitating appropriate oral care to reduce the incidence of oral and dental diseases during pregnancy. This underscores the importance of educational and preventive public health policies focused on oral care for pregnant women, aimed at increasing awareness and promoting practices that safeguard both maternal and fetal health.

Effectiveness of Motivational Interviewing and cross platform messaging application in improving oral health knowledge, attitude and behaviours among pregnant women- A Randomized Controlled Trial

Background

Body goes through significant hormonal and physiological changes during pregnancy, which could be linked to changes in oral health. Many women are unaware of the negative consequences of poor dental health during and after pregnancy, both for themselves and their children. Therefore, this study aimed to assess the effectiveness of Motivational Interviewing (MI) and cross platform messaging application (WhatsApp messenger) for oral health education on the oral health knowledge, attitude and behaviours among pregnant women attending ante natal care.

Methods

A randomized controlled trial was conducted among 84 pregnant women. Simple random sampling was employed to select participants after oral examination. Participants were randomly allocated to two groups (Group 1: Cross-platform messaging application [WhatsApp]; Group 2: MI) using a lottery method. Pregnant women aged 18 years and older, gestational age between 8 and 30 weeks were included. A face-to-face interview and oral examination were conducted to assess baseline knowledge and oral hygiene status. A follow-up examination was conducted after one month of intervention. Inferential statistics, including the chi-square test and independent t-test, were used to compare variables between the two groups.

Results

The mean knowledge score at baseline was comparable between Group 1 (WhatsApp) and Group 2 (MI). However, post-intervention, Group 2 showed a significantly higher mean knowledge score compared to Group 1. Post-intervention, Group 2 exhibited a significantly better oral hygiene status compared to Group 1. Significant improvements in oral health behaviours were observed in Group 2 compared to Group 1 (p < 0.001).

Conclusions

The findings suggested that while both interventions were effective, MI showed superior results in improving knowledge, oral hygiene status, and oral health behaviours. The personalized and client-centred approach of MI enables participants to explore and resolve ambivalence, promoting a deeper understanding of the importance of oral health during pregnancy. Registration: CTRI ( CTRI/2021/09/036407, 10/09/2021).

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.

Evaluation of oral health status in pregnant women and its correlation with calcium and phosphate levels

AIM

This study aimed to analyze the oral health conditions of pregnant women. The analysis involves evaluating two key indices: the decayed, missing, and filled teeth (DMFT) index and the basic erosive wear examination (BEWE) index. Furthermore, this study investigated potential correlations between calcium (Ca) and phosphate (P) levels within specific time intervals and the aforementioned oral health indices.

Status of Research on Dental Caries during Pregnancy: A Biometric Exploration

AIM

To describe the bibliometric characteristics of the state of scientific production on dental caries during pregnancy.

MATERIALS AND METHODS

A bibliometric study with a sample of 408 publications indexed in the Scopus database, which were selected based on a search strategy that included logical operators and the term MESH. The Scival tool was used to analyze the metadata.

RESULTS

Jamieson Lisa Marie is positioned as the author with the most publications, and Schroth Robert as the one with the best-weighted impact (FWCI: 37.7). High-impact journals such as BMC Oral Health, Journal of Dental Research, and BMC Public Health stand out for their productivity and an average number of citations. The United States has a large number of publications and evidence of networks of scientific activity with Australia, Canada, and Brazil. The University of Adelaide leads the production and the work of two Latin American institutions (Universidade de São Paulo and Universidade Federal do Maranhão) stands out. International collaboration has improved during the study period.

CONCLUSION

Scientific production on dental caries during pregnancy is increasingly published in high-impact journals, with growing international collaboration. The United States leads in publications, while Australian institutions are the most productive in this field.

CLINICAL SIGNIFICANCE

Caries during pregnancy is a problem that has an important impact on maternal and perinatal health; thus, its timely management and prevention are important areas of research in the field of oral health. How to cite this article: Muñoz-Hidalgo M, Verastegui-Cabanillas Y, Barja-Ore J. Status of Research on Dental Caries during Pregnancy: A Biometric Exploration. J Contemp Dent Pract 2024;25(4):386-391.

Barriers for why pregnant women do not visit a dentist on a regular basis: using group concept mapping methodology

OBJECTIVES

Periodontitis in pregnancy represents a significant, but often overlooked challenge due to its association to adverse pregnancy (preeclampsia and gestational diabetes) and birth related outcomes (preterm birth and low birth weight). The overall study aim was to identify, organize, and prioritize barriers influencing dental visits among Danish pregnant women not seeing a dentist on a regularly basis.

MATERIALS AND METHODS

Participants were pregnant women screened at weeks 11-13 of gestation, and were recruited if they were not seeing a dentist regularly. The study was conducted at Holbæk and Nykøbing Falster Hospital in Region Zealand, Denmark. The Group Concept Mapping (GCM) approach was applied. The pregnant women participated in brainstorming (n = 18), sorting (n = 20), and rating (n = 17) the seating question 'Thinking as broadly as you can, please list all barriers of importance to you for not seeing a dentist on a regular basis'.

RESULTS

A total of 38 unique barriers were identified, organized, and prioritized online. The multidimensional scaling analysis involved 10 iterations and revealed a low stress value of 0.21. A cluster solution with five clusters including 'economic reasons', 'lack of priority', 'lack of time and energy', 'no problems with teeth', and 'dental fear', was discussed and interpreted at a validation meeting.

CONCLUSIONS

Five overall clusters explaining barriers for not seeing a dentist regularly were revealed. Of the five clusters, 'economic reasons' and 'lack of priority' were rated as the most important clusters. Accordingly, such barriers should be considered in the planning of future strategies of dental care during pregnancy.

Pregnancy-related dental problems: A review

Introduction

The goal of this review is to highlight the significance of dental health during pregnancy, carefully investigate how it affects the health of both the mother and the fetus, and provide practical prevention strategies and therapeutic choices. The main goal is to increase awareness of potential dental problems during pregnancy, understand their effects on the expectant mothers and the fetus's health, and outline practical prevention and management techniques.

Data sources

Conduct a rapid literature search using databases focusing on papers published in English within the last ten years, such as PubMed, Google Scholar, and other relevant platforms from 1st September to 1st October 2023. Use appropriate keywords and search terms related to dental problems, pregnancy, dental care in Bangladesh, and related topics. Include articles published in peer-reviewed journals, books, reports, and official documents.

Study selection

Studies selected on common pregnancy-related dental issues include gingivitis, periodontitis, tooth erosion, xerostomia, tooth decay, and pregnancy tumours. The prevention measures are conditions include regular dental check-ups, maintaining good oral hygiene, and professional cleanings. Treatment options range from scaling and root surface instrumentation to dental restorations and surgical removal, if necessary.

Conclusion

The different dental problems that may develop during pregnancy along with their possible effects on oral health and general wellbeing. Underscores the importance of prioritizing dental care during pregnancy to ensure the well-being of both the mother and the developing baby.

Clinical significance

Dental issues that arise during pregnancy affect both the mother and the fetus, and if left untreated, can result in pain, swelling, and even tooth loss. Recent studies suggest a connection between periodontal disease and unfavourable pregnancy outcomes, emphasizing the importance of precise dental care throughout pregnancy. To minimize hazards and advance general well-being, it is essential to give oral health priority throughout pregnancy. For effective management, routine exams, preventative measures, and oral hygiene practices are crucial. Dental professionals are crucial in helping expecting mothers maintain their best oral health for the sake of both the mother and the unborn child.

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.

Influence of maternal cholesterol-enriched diet on chemical composition of teeth enamel in offspring of mice

OBJECTIVE

Aim: To determine the chemical composition of the tooth enamel of two-day-old mice from hypercholesterolemic mothers by energy dispersive X-ray spectroscopy.

PATIENTS AND METHODS

Materials and Methods: Forty mature female mice were randomly assigned (n = 20/group) to either a standard chow vivarium diet (control group) or a cholesterol-enriched chow diet (experimental group). After fertilization, pregnancy and birth, on postnatal day 2, the incisor segments of 6 pups form each group were used for energy dispersive X-ray spectroscopy.

RESULTS

Results: Influence of maternal hypercholesterolemic diet on tooth development and mineralization was examined, which revealed changes in enamel chemical composition. First, the results indicate the presence of seven elements (Na, Cl, Ca, P, Mg, S, Fe) in the enamel of both the hypercholesterolemic and normal offspring, but the content of element Ca2+ decreased, the content of elements P5+, Na+, Cl- tended to increase in pups from hypercholesterolemic mice. Second, the initial level of mineralization according to the atomic (%) Ca / P in hypercholesterolemic pups ratio was 1.26, comparing with normal pups where level of mineralization was 1.34. Taking into account that irreversible changes in the structure of the enamel were observed when the Ca / P ratio was below 1.33, we can suggest that the eruption of teeth with an imperfect structure could be because of maternal hypercholesterolemic diet.

CONCLUSION

Conclusions: Results of this study suggest that hypercholesterolemic diet during gestation and lactation leads to altered enamel mineralization in mice because of changes in chemical composition and may link to the early childhood caries.

Factors associated with oral health care behaviors of pregnant women in a northeastern province in Thailand: A hospital-based cross-sectional study

BACKGROUND

Oral healthcare behavior leads to oral health status. Factors associated with oral healthcare behavior might affect oral hygiene in pregnant women, who are at high risk for gingivitis and dental caries. This study aimed to explore factors associated with oral healthcare behaviors during pregnancy among pregnant women in a northeastern province of Thailand.

METHOD

A total of 405 pregnant women who attended antenatal care clinics at one of the government hospitals in the province were invited to participate in this cross-sectional study. Dentists in the hospitals measured pregnant women's gingivitis and dental calculus status using mouth mirrors and explorers. A structured questionnaire was used to obtain variables of interest. Linear regression analysis, Beta and 95% confidence interval (CI) were applied.

RESULTS

The majority were 20-24 years old (33.6%). Most of the participants had received upper secondary education (37.6%). Majority had gingivitis (88.1%) and dental calculus (88.6%). The findings revealed that age (Beta = -0.129, 95%CI = -0.269, -0.016), educational level (Beta = 0.118, 95% CI = 0.110, 0.183), and oral health literacy (Beta = 0.283, 95% CI = 0.156, 0.319) were statistically significant factors associated with oral healthcare behaviors.

CONCLUSION

Younger pregnant women had better oral healthcare behaviors than older pregnant women and pregnant women had better oral healthcare behaviors due to higher educational levels and oral health literacy. Oral health promotion should be improved through oral health literacy, and interventions should be added to improve oral care skills particularly in older pregnant women as they are at a greater risk for poor oral healthcare behaviors.

Knowledge, attitudes, and practices of healthcare professionals on oral care of pregnant women in Brunei Darussalam

OBJECTIVE

To examine nationwide the knowledge, attitudes, and practices of healthcare professionals on oral/dental care of pregnant women in Brunei Darussalam.

MATERIALS AND METHODS

A descriptive cross-sectional study conducted using an online survey of eligible healthcare professionals in all Government Maternal and Child Health Care Clinics, Dental Clinics and Obstetrics and Gynecological Clinics in four hospitals covering the whole of Brunei Darussalam. Participants were given seven days to complete the survey. Sub-group analysis using Chi-square test for independence and one-way Analysis of Variance (ANOVA) was used to determine the significant association between domains of oral care practices and demographic factors. P values less than 0.05 was considered statistically significant.

RESULTS

A total of 346 healthcare professionals participated in this online study. Most participants (94.3%) responded that they perceived oral health to be of high importance. However, less than two thirds of the participants (59.0%) included oral health questions during antenatal health assessments. Moreover, only 16.2% of participants frequently discussed the importance of oral care with their antenatal patients.

CONCLUSIONS

In this survey, most healthcare professionals viewed oral health to be of high importance for prenatal/antenatal patients. However, not all put those views into practice with regard to oral care in pregnant women.

Pregnant Women's Oral Health-Related Quality of Life and Lifestyle Factors

Introduction

Pregnancy is often associated with a number of oral manifestations. There is a change in lifestyle factors and dental care during pregnancy.

Aim

We conducted this cross-sectional study to determine how lifestyle factors affect oral health-related quality of life (OHRQOL) in pregnant women residing in Bero block, Jharkhand.

Methods

The study included a total of 400 pregnant women aged 18-45. The assessment of lifestyle factors and OHRQOL was done using Health Practice Index (HPI) Index and Oral Health Impact Profile-14 (OHIP-14), respectively. Data was collected through face-to-face interviews.

Results

Forty percent of the pregnant women showed low OHRQOL. The majority of them were not using mouthwash and were brushing their teeth using faulty techniques. The results of logistic regression analysis showed that women with poor lifestyle scores (Odds Ratio [OR] =3.8, P-value <0.0001*), and systemic diseases (OR = 2.6, P-value < 0.001*) were more likely to have poor OHRQOL.

Conclusion

Pregnancy is associated with poor OHRQOL and poor lifestyle scores. Effective policies for oral health need to be drafted for this group.

Periodontitis in Pregnant Women: A Possible Link to Adverse Pregnancy Outcomes

BACKGROUND

Periodontitis develops in 11% of pregnant women, and it is independently linked to severe complications during pregnancy such as preterm birth, low birth weight, and gestational diabetes.

METHODS

A literature search (Pubmed/MEDLINE, and Scopus) from 2003 to 2023 was conducted to analyze studies focused on periodontitis and adverse pregnancy outcomes.

RESULTS

16 articles have been included. Most of the studies showed adverse outcomes, like preterm birth and the low weight of the unborn child, are among the most frequent consequences (respectively 62.5% and 68.7% of articles); pre-eclampsia is also linked to this condition (12.5% of articles); and perinatal mortality (12.5% of articles).

CONCLUSIONS

Periodontal disease appears to be associated with adverse events in pregnancy due to the transport of biofilm bacteria into the bloodstream and into placental tissue; what would cause adverse events is the body's immune response to infection.

The role of oral and prenatal healthcare providers in the promotion of oral health for pregnant women

BACKGROUND

Hormonal alterations and lowered immunity during pregnancy aggravated by poor oral hygiene increase the risk of pregnant women of developing oral diseases. We conducted this cross-sectional study to examine the role of oral and prenatal health providers in promoting dental care for pregnant women attending primary healthcare centers (PHCs) in Saudi Arabia.

METHODS

An online questionnaire was sent to a random sample of women who attended PHCs in Jeddah, during 2018-2019. From a total of 1350 women who responded to our questionnaire, 515 women reported having a dental visit before pregnancy. These women comprised our study sample. Bivariate analyses and multiple logistic regression models were conducted to examine associations between oral practices of dental and prenatal health providers (exposures) and women's utilization of dental care during pregnancy (outcome). Covariates included age, education (< 12 years of education, 12 years of education, and > 12 years of education), family income (≤ 5,000, 5,001-7,000, 7,001-10,000, and > 10,000 Saudi Riyals), health insurance (yes/no), nationality (Saudi Arabian/non-Saudi Arabian), and presence of dental problems, such as toothache, dental caries, gingival inflammation, and the need for dental extractions.

RESULTS

Only 30.0% of women were informed by a dentist during their dental visit before pregnancy about the importance of visiting a dentist during pregnancy. About 37.0% of women were asked about oral health, 34.4% were informed about the importance of dental care during pregnancy, and 33.2% had their mouths inspected by prenatal health providers. Women informed by dentists about the importance of dental visits during pregnancy were twice as likely (Odds ratio [OR]: 2.42, 95% confidence interval [CI]: 1.63-3.60) to visit a dentist during pregnancy. Women who were referred to dentists, had their mouth inspected, or were advised to visit a dentist during pregnancy by prenatal providers were 4.29 (95% CI: 2.67-6.88), 3.79 (95% CI: 2.47-5.82), and 3.37 (95% CI: 2.16-5.27) times as likely to visit a dentist during pregnancy.

CONCLUSION

The partaking of oral and prenatal healthcare providers in evidence-based oral health promotion practices, antenatal-dental collaboration, and closing the referral loop increase pregnant women's access to and utilization of preventive and treatment dental services.

Oral Health Status and Literacy/Knowledge Amongst Pregnant Women in Shanghai

BACKGROUND

The changes in hormones, diet, and hygiene associated with pregnancy are associated with oral diseases. There is insufficient awareness of the importance of oral health during pregnancy. This study investigated the oral health status and knowledge amongst pregnant women in Shanghai.

METHODS

This cross-sectional study enrolled pregnant women at the Shanghai Red House Obstetrics & Gynecology Hospital in December 2020. The Fourth National Oral Health Questionnaire was used to evaluate the oral health status. Decayed/missing/filled teeth (DMFT) were the sum of the number of decayed, missing due to caries, and filled teeth. The chi-square test and Kruskal-Wallis test were used to compare the groups.

RESULTS

A total of 224 pregnant women were enrolled. The rates of dental caries were 69.8%, periodontal health was 1.8%, calculus detection was 95.6%, shallow periodontal pocket was 51.1%, deep periodontal pocket was 4.9%, regular oral examination was 22.8%, correct brushing was 49.6%, and prepregnancy oral examination was 20.1%. DMFT was 2.27, and the caries filling ratio was 45.4%. The number of missing teeth increased with age (P < .001). Only 26.3% used dental floss more than once a day, 47.3% rinsed the mouth more than twice a day, and 46.9% cleaned their tongue coating every week. In addition, 99% of the pregnant women agreed that "oral health was vital to their lives" and 97.7% agreed that "regular oral examination was necessary."

CONCLUSIONS

The oral health status amongst pregnant women in Shanghai was poor, but oral health awareness and attitudes were relatively high.

Maternal Periodontal Status as a Factor Influencing Obstetrical Outcomes

Background and Objectives: Preterm birth as a complex phenomenon is influenced by numerous endogenic and exogenic factors, although its exact cause often remains obscure. According to epidemiological studies, maternal periodontal diseases, in addition to affecting general health, can also cause adverse pregnancy outcomes. Nonetheless, the existing results in the literature regarding this topic remain controversial. Consequently, our study aimed to determine the connection between poor maternal periodontal status and neonatal birth weight. Materials and Methods: A total of 111 primigravida-primiparous pregnant, healthy women underwent a periodontal examination in the second trimester of their pregnancies. Probing depth (PD) and bleeding on probing (BOP) were determined, and based on these diagnostic measurements, the patients were divided into three subgroups according to their dental status: healthy (H, n = 17), gingivitis (G, n = 67), and periodontitis (P, n = 27). Results: Considering that poor maternal oral status is an influencing factor for obstetrical outcomes, the presence of PD and BOP (characterized by the sulcus bleeding index, SBI) was evaluated. In the case of P, defined as PD ≥ 4 mm in at least one site and BOP ≥ 50% of the teeth, a significant correlation between BOP and a low neonatal birth weight at delivery (p = 0.001) was found. An analysis of the relationship between SBI and gestational age (GA) at the time of the periodontal examination in the different dental status groups showed a significant correlation between these parameters in the G group (p = 0.04). Conclusions: Our results suggest that a worse periodontal status during pregnancy may negatively affect obstetrical outcomes, especially the prematurity rate and newborn weight. Therefore, the importance of periodontal screening to prevent these complications is undeniable.

Iranian Women and Health Care Providers' Perception of Oral Health in Pregnancy: A Qualitative Research

Background

Periodontal diseases during pregnancy are associated with adverse outcomes. This study aimed to explain the perception of healthcare providers and pregnant women about oral health during pregnancy.

Materials and Methods

This qualitative study was conducted with the approach of conventional content analysis in health centers of Hamadan, Iran, in 2020. To collect the data, semi-structured in-depth interviews with sixteen pregnant women and eight healthcare providers (gynecologist, midwife, and dentist) were used. Pregnant women with a singleton fetus, lack of chronic diseases and complications of pregnancy, willingness to participate in the study, and the ability to communicate properly were included in the study. Sampling was done purposefully with maximum variety. Data analysis accomplished according to the proposed steps by Graneheim and Lundman using MAXQDA 10 software.

Results

"Belief in the importance of oral health in pregnancy," "Lack of a coherent structure for oral care," "Accepting the negative effect of pregnancy on oral health," and "The dilemma of treatment and non-treatment in pregnancy" were four categories extracted from the data. The theme of "Ignoring the mother for the fetus" was obtained as the main theme of the present study.

Conclusions

The findings suggest that although mothers and healthcare providers have recognized the importance of oral health in pregnancy, underlying factors in society have led them to understand the mother's oral health should be neglected because of the fetus. This perception can have a negative impact on their behavior, performance, and the oral health of mothers.

Knowledge, attitudes, and practices of prenatal care practitioners regarding oral health in pregnancy-A systematic review

BACKGROUND

Hormonal and behavioral changes during pregnancy may impact the oral health of women, which can influence the pregnancy course. Prenatal care practitioners (PCP) must be aware of this bidirectional relation in order to include an oral assessment in routine prenatal care.

OBJECTIVES

To characterize the knowledge and attitudes of PCP regarding oral health in pregnant women.

SEARCH STRATEGY

The search was carried out in PubMed, Web of Science, Lilacs, Scopus, and Embase on May 2022.

SELECTION CRITERIA

Peer-reviewed cross-sectional studies published in English within the last 5 years that assessed the knowledge, attitudes, and practices of PCP towards oral health in pregnancy were selected.

DATA COLLECTION AND ANALYSIS

Data were standardly extracted by the three reviewers from the selected articles and their bias was assessed.

MAIN RESULTS

From a total of 996 articles, 24 were selected. Overall, most PCP have an adequate level of knowledge regarding the importance of oral health during pregnancy. Although several professionals reported referring their patients to a dentist, the attitudes and practices of the majority of PCP were still inadequate.

CONCLUSIONS

PCP are aware of the importance of oral health during pregnancy but still lack translating this knowledge into clinical practice.

Inflammatory Response in Oral Biofilm during Pregnancy: A Systematic Review

Understanding the inflammatory response in oral biofilm during pregnancy and its association with oral and maternal health is essential for identifying biomarker patterns that may serve as markers of pregnancy-related complications. We aimed to conduct a systematic review of the available literature to assess: (1) inflammatory responses in oral biofilm during pregnancy, (2) the association between inflammatory responses in oral biofilm during pregnancy and maternal, oral or systemic conditions, (3) changes in the response of inflammatory biomarkers found in the oral biofilm during different pregnancy stages, and (4) the value of other risk factors such as nutrition and lifestyle. PubMed, Web of Science and Cochrane Library were systematically searched from inception until April 2022. From 5441 records, 39 studies were included for qualitative assessment. The oral biofilm in pregnant women was associated with increased inflammatory biomarkers when compared to non-pregnant women. Levels of inflammatory biomarkers in the oral biofilm were found to be highest in pregnant women with systemic conditions. Increased inflammatory biomarkers in the oral biofilm were also associated with worse oral health outcomes. Given the importance of nutrition and lifestyle for pregnancy and oral health outcomes and the fact that these factors were largely excluded in the included studies, future research should consider a holistic view of the mother during pregnancy to capture physiological, hormonal, immunologic, and metabolic changes in the context of inflammatory responses.

Correlation of the Oral Health Scoring-based Pregnant Oral Self-Care – package (POSC-p) Model with the Motivation to Seek Oral Health Treatment in Pregnant Women

Background:

Uncomprehensive oral health evaluation instruments and measurement and the low motivation for seeking dental and oral treatment for pregnant women; all require comprehensive measurement instruments that will increase the motivation for seeking oral health treatment for pregnant women. POSC-p model was developed for the Oral Health Scoring (OHS) to assess pregnant women's perceived needs, clinical examination, and salivary state.

Objectives:

The research objective was to analyse the correlation between the POSC-p model with the motivation for seeking oral health care in pregnant women.

Methods:

Cross-sectional research was conducted by a non-probability sampling technique using the consecutive sampling method. The sample size was determined based on the correlation analysis sample size calculation formula. The study variables were POSC-p model built with three dimensions; POSC-p score section 1 was felt needs, POSC-p score section 2 was normative needs, and POSC-p score section 3 was saliva condition. In addition, motivation to seek treatment with intrinsic and extrinsic motivation dimensions. All data were analysed using the Spearman rank correlation test.

Results:

A significant correlation was found between the POSC-p model with intrinsic and a combination of treatment-seeking motivation (p=0.026); a combined score of the POSC-p model with intrinsic (p=0.008) and a combination of treatment-seeking motivation (p=0.032).

Conclusion:

There is a correlation between the POSC-p with motivation for seeking oral health treatment in pregnant women.

Predictors of periodontal and caries related perinatal oral healthcare, investigation of dentists' practices: a cross-sectional study

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.

Periodontal Pathogens and Preterm Birth: Current Knowledge and Further Interventions

Preterm labor is defined as a birth before 37 weeks of gestation and occurs in 5–20% of pregnancies. Preterm labor, as multifactorial entity associated with a high risk of neonatal morbidity and mortality, is influenced by maternal, fetal and environmental factors. Microbiological studies suggest that infectious pathogens may account for 25–40% of preterm birth. Infections of different sites, like genital, urinary tract infections, and pneumonia, are linked to the preterm labor. The most recent epidemiological studies consistently report that maternal periodontal disease is associated with preterm delivery, as well as the association between the presence of pathogenic oral bacteria in the placenta and adverse pregnancy outcomes. On the other hand, some previously published papers found periodontal bacteria in placentas of term pregnancies. In spite of a huge research done on the topic, both experimental and clinical, there are many controversial opinions about the role of periodontal infections in preterm birth. Thus, this comprehensive review addresses this very important topic and evaluates novel strategies of preventive and therapeutic approaches.