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Lee H, Deshpande R, Benn EKT. Race, Ethnicity, and Other Barriers to Access Dental Care During Pregnancy. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02001-4. [PMID: 38671252 DOI: 10.1007/s40615-024-02001-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/30/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Historically, women of color showed poorer oral health and lower dental service utilization in the USA. These barriers to dental care during pregnancy included dental coverage, primary language, dental provider availability, safety concerns, affordability of dental care, and perceived oral health benefits during pregnancy. METHODS The purpose of this study is to examine whether race/ethnicity modified the associations between barriers to accessing dental care and dental service utilization during pregnancy. This cross-sectional study sample included 62,189 women aged 20 and older with a recent birth history in 21 states from the Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2016 to 2019. We introduced a race/ethnicity by barrier interaction term to our multiple logistic regression models. RESULTS After adjusting for other confounders, dental insurance during pregnancy and perceived oral health benefits were associated with 4.0- and 5.6-fold higher odds, respectively, of dental service utilization during pregnancy. Statistically significant effect modification by race/ethnicity was observed in crude and adjusted analyses of the relationship between dental service utilization for all barriers included in the interaction analyses with all adjusted p-values < 0.001. CONCLUSION The interaction analysis found that racial/ethnic disparity in visiting dentists during pregnancy was significant among women who reported these dental barriers. In contrast, such racial/ethnic disparity was substantially attenuated among women who did not report such barriers. PRACTICAL IMPLICATIONS The observed racial/ethnic disparities could be mitigated by such supporting mechanisms: dental coverage, provider availability and willingness to treat pregnant women, oral health education on the safety of dental care during pregnancy, and affordable dental care costs.
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Affiliation(s)
- Hyewon Lee
- Global Maternal and Child Oral Health Center, Seoul National University, Dental Research Institute & School of Dentistry, Seoul, South Korea.
| | - Richa Deshpande
- Center for Scientific Diversity, Center for Biostatistics, and Department of Population Health Science and Policy, Icahn School of Medicine, New York City, USA
| | - Emma K T Benn
- Center for Scientific Diversity, Center for Biostatistics, and Department of Population Health Science and Policy, Icahn School of Medicine, New York City, USA
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Geurs NC, Jeffcoat MK, Tanna N, Geisinger ML, Parry S, Biggio JR, Doyle MJ, Grender JM, Gerlach RW, Reddy MS. A Randomized Controlled Clinical Trial of Prenatal Oral Hygiene Education in Pregnancy-Associated Gingivitis. J Midwifery Womens Health 2023; 68:507-516. [PMID: 37026567 DOI: 10.1111/jmwh.13486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 01/18/2023] [Accepted: 02/02/2023] [Indexed: 04/08/2023]
Abstract
INTRODUCTION Research shows there is a significant increase in gingival inflammation during pregnancy. This study was conducted to determine if an oral health intervention (OHI), including oral hygiene education delivered by nurse-led staff and an advanced over-the-counter (OTC) oral home care regimen, improved gingival inflammation in pregnant women with moderate-to-severe gingivitis compared with a standard oral hygiene control group. METHODS This was a multicenter, randomized, controlled, single-masked, parallel group clinical trial conducted in obstetrics clinics of 2 medical centers. A total of 750 pregnant women between 8 and 24 weeks of pregnancy with at least 20 natural teeth and moderate-to-severe gingivitis (>30 intraoral bleeding sites) were enrolled. Participants were randomized to either the OHI group, which included oral hygiene instructions supplemented with an educational video and advanced OTC antibacterial/mechanical oral hygiene products, or the control group receiving oral hygiene instructions and standard products. Both groups received oral hygiene instructions from nurse-led staff. Experienced, masked examiners measured whole mouth gingival index (GI) and periodontal probing depths (PDs) at baseline and months 1, 2, and 3. RESULTS Participants enrolled in this study presented with moderate-to-severe gingivitis at baseline. Both the OHI and control groups exhibited significant reductions in GI (P < .001) and PD (P < .03) from baseline that persisted throughout the study period. The OHI group exhibited modest, yet statistically greater, reductions in GI (P ≤ .044) compared with the control at all time points. The reduction in PD directionally favored the OHI group, but between-group differences were small (<0.03 mm) and not statistically significant (P > .18). DISCUSSION Significant gingivitis was prevalent among participants in this study and identifies an opportunity to improve gingival health during pregnancy by providing oral health education during the course of prenatal care when coupled with an advanced OTC oral hygiene regimen.
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Affiliation(s)
- Nicolaas C Geurs
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Marjorie K Jeffcoat
- Department of Periodontics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nipul Tanna
- Department of Periodontics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Maria L Geisinger
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Samuel Parry
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph R Biggio
- Department of Obstetrics and Gynecology, Ochsner Baptist, New Orleans, Louisiana
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Matthew J Doyle
- Research & Development, The Procter & Gamble Company, Cincinnati, Ohio
| | - Julie M Grender
- Research & Development, The Procter & Gamble Company, Cincinnati, Ohio
| | - Robert W Gerlach
- Research & Development, The Procter & Gamble Company, Cincinnati, Ohio
| | - Michael S Reddy
- School of Dentistry, University of California San Francisco, San Francisco, California
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Naavaal S, Harless DW. Comprehensive pregnancy dental benefits improved dental coverage and increased dental care utilization among Medicaid-enrolled pregnant women in Virginia. FRONTIERS IN ORAL HEALTH 2022; 3:989659. [PMID: 36204196 PMCID: PMC9530928 DOI: 10.3389/froh.2022.989659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesTo evaluate the changes in dental insurance and utilization among pregnant women before and after the pregnancy Medicaid dental benefit policy implementation in 2015 in Virginia.MethodsWe used pooled cross-sectional data from six cycles of the Virginia Pregnancy Risk Assessment Monitoring System on women aged ≥21 years. Using logistic regression models and a difference-in-difference design, we compared the effects of policy implementation on dental insurance and utilization between pre-policy (2013–2014) and post-policy period (2016–2019) among women enrolled in Medicaid (treatment, N = 1,105) vs. those with private insurance (control, N = 2,575). A p-value of 0.05 was considered significant.ResultsAmong Medicaid-enrolled women, the report of dental insurance (71.6%) and utilization (37.7%) was higher in the post-period compared to their pre-period (44.4% and 30.3%, respectively) estimates but still remained lower than the post-period estimates among women with private insurance (88.0% and 59.9%, respectively). Adjusted analyses found that Medicaid-enrolled women had a significantly greater change in the probability of reporting dental insurance in all post-period years than women with private insurance, while the change in the probability of utilization only became statistically significant in 2019. In 2019, there was a 16 percentage point increase (95% CI = 0.05, 0.28) in the report of dental insurance and a 17 percentage point increase (95% CI = 0.01–0.33) in utilization in treatment group compared to controls.ConclusionsThe 2015 pregnancy Medicaid dental benefit increased dental insurance and dental care utilization among Medicaid-enrolled women and reduced associated disparities between Medicaid and privately insured groups.
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Affiliation(s)
- Shillpa Naavaal
- Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, VA, United States
- OralHealth Core, Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA, United States
- Correspondence: Shillpa Naavaal
| | - David W. Harless
- Department of Economics, School of Business, Virginia Commonwealth University, Richmond, VA, United States
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Yang I, Claussen H, Arthur RA, Hertzberg VS, Geurs N, Corwin EJ, Dunlop AL. Subgingival Microbiome in Pregnancy and a Potential Relationship to Early Term Birth. Front Cell Infect Microbiol 2022; 12:873683. [PMID: 35646730 PMCID: PMC9132049 DOI: 10.3389/fcimb.2022.873683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/13/2022] [Indexed: 12/14/2022] Open
Abstract
Background Periodontal disease in pregnancy is considered a risk factor for adverse birth outcomes. Periodontal disease has a microbial etiology, however, the current state of knowledge about the subgingival microbiome in pregnancy is not well understood. Objective To characterize the structure and diversity of the subgingival microbiome in early and late pregnancy and explore relationships between the subgingival microbiome and preterm birth among pregnant Black women. Methods This longitudinal descriptive study used 16S rRNA sequencing to profile the subgingival microbiome of 59 Black women and describe microbial ecology using alpha and beta diversity metrics. We also compared microbiome features across early (8-14 weeks) and late (24-30 weeks) gestation overall and according to gestational age at birth outcomes (spontaneous preterm, spontaneous early term, full term). Results In this sample of Black pregnant women, the top twenty bacterial taxa represented in the subgingival microbiome included a spectrum representative of various stages of biofilm progression leading to periodontal disease, including known periopathogens Porphyromonas gingivalis and Tannerella forsythia. Other organisms associated with periodontal disease reflected in the subgingival microbiome included several Prevotella spp., and Campylobacter spp. Measures of alpha or beta diversity did not distinguish the subgingival microbiome of women according to early/late gestation or full term/spontaneous preterm birth; however, alpha diversity differences in late pregnancy between women who spontaneously delivered early term and women who delivered full term were identified. Several taxa were also identified as being differentially abundant according to early/late gestation, and full term/spontaneous early term births. Conclusions Although the composition of the subgingival microbiome is shifted toward complexes associated with periodontal disease, the diversity of the microbiome remains stable throughout pregnancy. Several taxa were identified as being associated with spontaneous early term birth. Two, in particular, are promising targets of further investigation. Depletion of the oral commensal Lautropia mirabilis in early pregnancy and elevated levels of Prevotella melaninogenica in late pregnancy were both associated with spontaneous early term birth.
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Affiliation(s)
- Irene Yang
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
- *Correspondence: Irene Yang,
| | - Henry Claussen
- Emory Integrated Computational Core, Emory University, Atlanta, GA, United States
| | - Robert Adam Arthur
- Emory Integrated Computational Core, Emory University, Atlanta, GA, United States
| | | | - Nicolaas Geurs
- Department of Periodontology, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, United States
| | | | - Anne L. Dunlop
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, GA, United States
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ZAÇE DRIEDA, ORFINO ALESSIA, MARIAVITERITTI ANNA, VERSACE VALERIA, RICCIARDI WALTER, DI PIETRO MARIALUISA. A comprehensive assessment of preconception health needs and interventions regarding women of childbearing age: a systematic review. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E174-E199. [PMID: 35647378 PMCID: PMC9121675 DOI: 10.15167/2421-4248/jpmh2022.63.1.2391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/15/2022] [Indexed: 11/24/2022]
Abstract
Background This systematic review summarizes the preconception health needs of women in childbearing age, necessary to be addressed to have an eventual safe and healthy pregnancy. Methods Web of Science, PubMed and Scopus were searched. We excluded studies involving women with reproductive system pathologies and referring to interconceptive or pregnancy period and non-empirical or only abstract studies. Two researchers independently performed the blind screening based on titles/abstracts and full-text and the quality assessment. Results Four major domains resulted from the thematic analysis: knowledge, behaviors and attitudes, health status and access to healthcare services. The most examined topics were knowledge and awareness on preconception health, folic acid assumption, tobacco and alcohol consumption, physical activity and healthy diet. Conclusions This review could assist healthcare professionals (physicians, nurses, midwives) in guiding tailored counselling to women to provide the adequate level of preconception care and act as a reference to policymakers.
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Affiliation(s)
- DRIEDA ZAÇE
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - ALESSIA ORFINO
- ASL Roma 2, Rome, Italy
- Correspondence: Alessia Orfino, ASL Roma 2, Rome, Italy - E-mail:
| | | | - VALERIA VERSACE
- Dipartimento di Salute della Donna e del Bambino e Sanità Pubblica - Area Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - WALTER RICCIARDI
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Salute della Donna e del Bambino e Sanità Pubblica - Area Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - MARIA LUISA DI PIETRO
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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Wilson A, Hoang H, Bridgman H, Crocombe L, Bettiol S. Clinical practice guidelines and consensus statements for antenatal oral healthcare: An assessment of their methodological quality and content of recommendations. PLoS One 2022; 17:e0263444. [PMID: 35113944 PMCID: PMC8812839 DOI: 10.1371/journal.pone.0263444] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 01/19/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To review the content of recommendations within antenatal oral healthcare guidance documents and appraise the quality of their methodology to inform areas of development, clinical practice, and research focus. METHOD A systematic search of five electronic databases, Google search engine, and databases from relevant professional and guideline development groups published in English, developed countries, and between 2010 and 2020 was undertaken to identify guidance documents related to antenatal oral healthcare. Quality of documents was appraised using the Appraisal of Guidelines Research and Evaluation II tool, and a 3-step quality cut-off value was used. Inductive thematic analysis was employed to categories discreet recommendations into themes. RESULTS Six guidelines and one consensus statement were analysed. Two documents developed within Australia scored ≥60% across five of the six domains of the quality appraisal tool and were recommended for use. Four documents (developed in the United States and Canada) were recommended for use with modifications, whilst one document (developed in Europe) was not recommended. A total of 98 discreet recommendations were identified and demonstrated considerable unanimity but differed in scope and level of information. The main content and number of recommendations were inductively categorised within the following clinical practice points: risk factor assessments (n = 2), screening and assessment (n = 10), pre-pregnancy care (referral, n = 1), antenatal care (health education and advice, n = 14; management of nausea and vomiting, n = 7; referral, n = 2), postnatal care (health education and advice, n = 1; anticipatory guidance, n = 6), documentation (n = 4), coordinated care (n = 4), capacity building (n = 6), and community engagement (n = 1). CONCLUSION The methodological rigour of included guidance documents revealed areas of strengths and limitations and posit areas for improvement. Further research could centre on adapting antenatal oral healthcare guidelines and consensus statements to local contexts. More high-quality studies examining interventions within antenatal oral healthcare are needed to support the development of recommendations.
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Affiliation(s)
- Annika Wilson
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Ha Hoang
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Heather Bridgman
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Leonard Crocombe
- Dentistry & Oral Health, Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Silvana Bettiol
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Lee H, Marsteller JA, Wenzel J. Dental care utilization during pregnancy by Medicaid dental coverage in 26 states: Pregnancy risk assessment monitoring system 2014-2015. J Public Health Dent 2022; 82:61-71. [PMID: 34904236 DOI: 10.1111/jphd.12483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To examine the association between Medicaid dental coverage for adult pregnant women with dental care utilization during pregnancy. METHODS Pregnancy risk assessment monitoring system (PRAMS) data (2014-2015) and the Medicaid-SCHIP state dental association (MSDA) national profiles (2014-2015) were used in this study. The study sample included 16,612 Medicaid-enrolled women, for a weighted number of 965,046 women from 26 states and New York City. State Medicaid dental coverage was categorized into (1) no coverage for the dental cleaning, (2) coverage for dental cleaning and fillings, (3) extended dental coverage. The adjusted prevalence ratios (aPR) for dental visits for cleaning during pregnancy were examined by Medicaid dental coverage level. RESULTS Medicaid-enrolled women in states with no dental coverage were less likely to visit dentists for cleaning during pregnancy (26.7%) compared with women in states with either limited dental coverage (36.6%) or extended dental coverage (44.9%). Compared with women in state without dental coverage, Medicaid-enrolled women in states with extended dental coverage (aPR = 1.20, 95% CI [1.16-1.23]) and women in states with limited coverage (aPR = 1.10, 95% CI [1.06-1.14]) were more likely to visit dentists for cleaning during pregnancy when adjusted for other sociodemographic variables and adequacy of prenatal care. A similar pattern of association was observed for a dental visit to address dental problems during pregnancy. CONCLUSIONS This study highlights the importance of Medicaid dental coverage for adult pregnant women related to dental service utilization during pregnancy.
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Affiliation(s)
- Hyewon Lee
- Mount Sinai Hospital, Department of Dentistry, New York, New York, USA
| | - Jill A Marsteller
- Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
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Swathi K, Koothati RK, Motor RR, Priyadarshini, RajaShekar CH, Vallakonda S. Knowledge and Experience of Women about Dental Services Utilization during Pregnancy: A Cross-Sectional Questionnaire Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2021; 13:S1042-S1046. [PMID: 35017926 PMCID: PMC8686874 DOI: 10.4103/jpbs.jpbs_281_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/16/2021] [Accepted: 04/23/2021] [Indexed: 11/12/2022] Open
Abstract
AIM OF THE STUDY The present study was aimed to assess the knowledge and experience of women about dental services utilization during pregnancy. METHODOLOGY A hospital-based, cross-sectional questionnaire-based study was conducted among 300 women of age between 18 and 45 years who attended Malla Reddy Dental Hospital during 3 months period from October 2019 to December 2019. A questionnaire was distributed to all the participants who had given consent to participate in the study. RESULTS Only 30.7% of the participants attended for dental checkup during their pregnancy. Among them, most of the people (52%) had visited dentist for toothache, followed by gum care (29.34%) and regular checkup (18.47%). Most of the subjects (69.3%) did not use dental services as they were unaware of dental checkup during pregnancy. A significant difference was found between the urban and rural participants regarding the visit to the dentist during pregnancy (P = 0.000, Chi-square value = 19.157). CONCLUSION Most of the women unaware of dental checkup during pregnancy. They were also not sure aware of dental treatments which can be done during pregnancy and consequences of poor oral hygiene on pregnancy outcome.
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Affiliation(s)
- Kapu Swathi
- Department of Public Health Dentistry, Malla Reddy Institute of Dental Sciences, Hyderabad, Telangana, India
| | - Ramesh Kumar Koothati
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
| | - Rashmitha Roy Motor
- Department of Intern, Malla Reddy Institute of Dental Sciences, Hyderabad, Telangana, India
| | - Priyadarshini
- Department of Dental, New Janapriya Hospital, Bengaluru, Karnataka, India
| | - C. H. RajaShekar
- Department of Conservative Dentistry and Endodontics, Meghna Institute of Dental Sciences, Nizambad, Telangana, India
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Robison V, Bauman B, D'Angelo DV, Espinoza L, Thornton-Evans G, Lin M. The Impact of Dental Insurance and Medical Insurance on Dental Care Utilization During Pregnancy. Matern Child Health J 2021; 25:832-840. [PMID: 33389456 PMCID: PMC10921926 DOI: 10.1007/s10995-020-03094-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To measure the association between dental and medical insurance with the receipt of dental cleaning during pregnancy. METHODS We analyzed Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2012 to 2015 on 145,051 women with a recent live birth from 36 states. We used adjusted prevalence ratios [aPR] from multivariable regression to examine the association of dental and medical insurance with receipt of dental cleaning during pregnancy, controlling for selected covariates that influence dental care utilization. RESULTS Seventy-seven percent (77%) of all women reported having dental insurance during pregnancy. Receipt of dental cleaning before pregnancy was strongly associated with dental cleaning during pregnancy. Among women without pre-pregnancy dental cleaning who had dental insurance, those with Medicaid medical insurance had a significantly higher prevalence of dental cleaning during pregnancy [aPR = 1.42, 95% CI (1.32 - 1.52)], compared to those private medical insurance. Among women without pre-pregnancy dental cleaning, those without dental insurance but with Medicaid medical insurance were about 70% less likely to have dental cleaning during pregnancy compared to those with dental and private medical insurance. CONCLUSIONS FOR PRACTICE With or without dental insurance, pre-pregnancy dental cleaning was strongly associated with dental cleaning during pregnancy. Dental insurance was an important determinant of dental utilization. Medical insurance had an independent and positive effect. This effect varied by private versus Medicaid medical insurance. Programs which provide women with dental insurance both before and during pregnancy could improve the oral health of maternal and infant populations.
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Affiliation(s)
- Valerie Robison
- Division of Oral Health, National Center for Chronic Disease Preventions and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy. NE, MS F-74, Atlanta, GA, USA.
| | - Brenda Bauman
- Division of Reproductive Health, National Center for Chronic Disease Preventions and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Denise V D'Angelo
- Division of Reproductive Health, National Center for Chronic Disease Preventions and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lorena Espinoza
- Division of Oral Health, National Center for Chronic Disease Preventions and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy. NE, MS F-74, Atlanta, GA, USA
| | - Gina Thornton-Evans
- Division of Oral Health, National Center for Chronic Disease Preventions and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy. NE, MS F-74, Atlanta, GA, USA
| | - Mei Lin
- Division of Oral Health, National Center for Chronic Disease Preventions and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy. NE, MS F-74, Atlanta, GA, USA
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Wang L, Ren J, Fiscella KA, Bullock S, Sanders MR, Loomis EL, Eliav E, Mendoza M, Cacciato R, Thomas M, Kopycka-Kedzierawski DT, Billings RJ, Xiao J. Interprofessional collaboration and smartphone use as promising strategies to improve prenatal oral health care utilization among US underserved women: results from a qualitative study. BMC Oral Health 2020; 20:333. [PMID: 33228617 PMCID: PMC7685586 DOI: 10.1186/s12903-020-01327-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/12/2020] [Indexed: 12/12/2022] Open
Abstract
Background Data on barriers and facilitators to prenatal oral health care among low-income US women are lacking. The objective of this study was to understand barriers/facilitators and patient-centered mitigation strategies related to the use of prenatal oral health care among underserved US women.
Methods We used community-based participatory research to conduct two focus groups with eight pregnant/parenting women; ten individual in-depth interviews with medical providers, dental providers and community/social workers; and one community engagement studio with five representative community stakeholders in 2018–2019. Using an interpretive description research design, we conducted semi-structured interviews and focus groups which were audio-recorded, transcribed, and analyzed for thematic content. Results We identified individual and systemic barriers/facilitators to the utilization of prenatal oral health care by underserved US women. Strategies reported to improve utilization included healthcare system-wide changes to promote inter-professional collaborations, innovative educational programs to improve dissemination and implementation of prenatal oral health care guidelines, and specialized dental facilities providing prenatal oral health care to underserved women. Moreover, smartphones have the potential to be an innovative entry point to promote utilization of prenatal oral care at the individual level. Conclusions Low-income women face multiple, addressable barriers to obtaining oral health care during pregnancy. Inter-professional collaboration holds strong promise for improving prenatal oral health care utilization.
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Affiliation(s)
- Lin Wang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.,Peking University School of Stomatology, Beijing, China
| | - Johana Ren
- University of Rochester River Campus, Rochester, NY, USA
| | - Kevin A Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Mechelle R Sanders
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Elizabeth L Loomis
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Eli Eliav
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael Mendoza
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA.,Monroe County Department of Public Health, Rochester, NY, USA
| | - Rita Cacciato
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Marie Thomas
- University of Rochester River Campus, Rochester, NY, USA
| | | | - Ronald J Billings
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
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11
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Stephens R, Quinonez R, Boggess K, Weintraub JA. Perinatal Oral Health Among Underserved Women: A Call to Action for North Carolina Patients, Providers and Policymakers. Matern Child Health J 2020; 24:351-359. [PMID: 31897932 DOI: 10.1007/s10995-019-02868-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Knowledge gaps exist among providers and pregnant women about the importance and safety of oral health care around pregnancy. This article describes the current state of perinatal oral health and healthcare among underserved women in North Carolina (NC) and provides policy recommendations to improve their access to and utilization of dental services. METHODS A descriptive analysis is provided using (a) 2016 oral health surveillance data of a convenience sample of 459 pregnant women across NC, (b) 2014-2016 Medicaid dental provider and dental services utilization data for the Medicaid for Pregnant Women (MPW) program, and (c) 2017 Medicaid dental benefits policy. Surveillance data was not linked to Medicaid dental services utilization data. RESULTS Less than 20% of pregnant women surveyed reported having a dental visit during pregnancy and oral screenings revealed 33% had untreated caries. Medicaid data showed a steady decline since 2014 in percentage of MPW beneficiaries utilizing any dental service-less than 10% as of 2016. MPW dental benefits lapse at delivery because dental care is not considered pregnancy-related in NC policy. Only 20% of practicing NC dentists provided care to MPW beneficiaries in 2015. DISCUSSION Inadequacies in oral health knowledge, beliefs and practices exist among pregnant women, health care professionals and policymakers. Statewide efforts are needed to promote a standard of perinatal care that emphasizes collaborative practice and addresses existing barriers at the patient, provider and policy levels.
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Affiliation(s)
- Rhonda Stephens
- Regional Public Health Dentist, Oral Health Section, Division of Public Health, North Carolina Department of Health and Human Services, 1910 Mail Service, Raleigh, NC, 27699-1910, USA.
| | - Rocio Quinonez
- Pediatric Dentistry and Pediatrics, Schools of Dentistry and Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kim Boggess
- Division of Maternal-Fetal Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jane A Weintraub
- Department of Dental Ecology, University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, NC, USA
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12
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Xiao J, Fogarty C, Wu TT, Alkhers N, Zeng Y, Thomas M, Youssef M, Wang L, Cowen L, Abdelsalam H, Nikitkova A. Oral health and Candida carriage in socioeconomically disadvantaged US pregnant women. BMC Pregnancy Childbirth 2019; 19:480. [PMID: 31805881 PMCID: PMC6896277 DOI: 10.1186/s12884-019-2618-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 11/21/2019] [Indexed: 12/13/2022] Open
Abstract
Background Despite the well-documented associations between poor maternal oral health and increased risk for adverse birth outcomes and dental caries in children after birth, prenatal oral health care is under-utilized, especially among the underserved population. In addition, oral Candida has recently been suggested as a potential culprit for children’s dental caries, with evident maternal contributions. Therefore, this study aimed to obtain epidemiological data on the oral health and oral Candida carriage in a cohort of underserved US pregnant women, and reveal factors associated with their oral Candida carriage. Methods Demographic-medical-oral hygiene practice data were collected. Comprehensive oral examination was conducted. Caries status and plaque index were recorded. Oral samples (saliva, plaque and swab) were processed to identify Candida species and Streptococcus mutans by culturing-dependent and -independent methods. Multiple logistic regression analyses were used to identify factors associated with oral Candida carriage and caries severity. Results Eighty-two socioeconomically disadvantaged women (48 pregnant and 34 non-pregnant) were enrolled. More pregnant women (79.1%) had > = 1 untreated decayed tooth when compared to their non-pregnant counterparts (47.1%) (p = 0.01). The average number of decayed teeth in pregnant and non-pregnant women was 3.9 and 3.1 (p > 0.05). Caries severity was positively associated with race (African American vs. white), plaque index and salivary Candida albicans level. C. albicans was the most predominant/abundant Candida strain, with cheek and tonsil as the most common colonized sites. The detection of C. albicans was 56%/56% in saliva and 40%/47% in plaque of the pregnant and non-pregnant groups, respectively. Study women’s oral Candida carriage is positively associated with hypertension [p = 0.03, odds ratio = 14.47(1.28, 163.51)], decayed teeth number [p = 0.04, odds ratio = 1.31 (1.01,1.69)] and salivary S. mutans level [p = 0.03, odds ratio = 4.80 (1.18–19.43)]. Conclusions Socioeconomically disadvantaged US women are in need of improved prenatal oral health, a large proportion of them have untreated decayed teeth and high carriage of oral Candida. Due to the observed significant association between the decayed teeth number and oral Candida carriage, providing oral health care during pregnancy (including limiting decayed teeth) will not only improve women’s oral health, but also present as a promising approach to reduce oral Candida carriage in women.
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Affiliation(s)
- Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA.
| | - Colleen Fogarty
- Department of Family Medicine, University of Rochester Medical Center, Rochester, USA
| | - Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, USA
| | - Naemah Alkhers
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA
| | - Yan Zeng
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA.,Department of Forensic Medicine, North Sichuan Medical College, Nanchong, China
| | - Marie Thomas
- Department of Family Medicine, University of Rochester Medical Center, Rochester, USA
| | - Moustafa Youssef
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA
| | - Lin Wang
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA.,College of Stomatology, Peking University, Beijing, China
| | - Lauren Cowen
- Department of Family Medicine, University of Rochester Medical Center, Rochester, USA
| | - Hossam Abdelsalam
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA
| | - Anna Nikitkova
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA
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13
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Muralidharan C, Merrill RM. Dental care during pregnancy based on the pregnancy risk assessment monitoring system in Utah. BMC Oral Health 2019; 19:237. [PMID: 31694634 PMCID: PMC6836497 DOI: 10.1186/s12903-019-0921-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 09/27/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Although receiving dental care is recommended for women during pregnancy, getting such care remains low. This study will identify the level of dental care received during pregnancy and factors associated with care for a group of pregnant women in Utah. METHODS Analyses were based on 2793 pregnant women completing the 2014-2015 Utah PRAMS survey. Descriptive and bivariate techniques were used. RESULTS Approximately 91.2% knew it was important to care for their teeth and gums during pregnancy, yet only 58.8% had their teeth cleaned during pregnancy. Those who knew such care was important were 1.4 (95% CI 1.1-2.0) times more likely to have their teeth cleaned during pregnancy. Although 18.8% needed to see a dentist for a problem, only 74.5% of them received treatment for the problem during pregnancy. Approximately 76.0% had dental insurance during pregnancy. Those with dental insurance were 1.9 (95% CI 1.5-2.4) times more likely to have their teeth cleaned and 1.6 (95% CI 1.2-2.2) times more likely to go to a dentist for needed treatment during pregnancy. Approximately 51.4% had a dental/health care worker talk with them about how to care for their teeth and gums. These women were more likely to know it was important to care for their teeth and gums during pregnancy (97.4% vs 87.6%, p < 0.0001). For women who received care for a problem during pregnancy, 70.0% had a dental/health care worker talk with them about how to care for their teeth and gums. These women were more likely to know it was important to care for their teeth and gums during pregnancy (95.2% vs 82.8%, p < 0.0001). Women who had their teeth cleaned the year prior to pregnancy were more likely to have their teeth cleaned during pregnancy (78.5% vs 21.5%, p < 0.0001). CONCLUSIONS A large proportion of women knowing of the importance of dental care during pregnancy did not receive care. Knowledge of its importance during pregnancy, having a dental/health care worker talk with them about how to care for their teeth and gums, and having dental insurance during pregnancy are positively associated with dental care during pregnancy.
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Affiliation(s)
- Chandni Muralidharan
- Department of Public Health, College of Life Sciences, Brigham Young University, 2063 Life Sciences Building, Provo, UT, 84602, USA
| | - Ray M Merrill
- Department of Public Health, College of Life Sciences, Brigham Young University, 2063 Life Sciences Building, Provo, UT, 84602, USA.
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14
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Gupta A, Feldman S, Perkins RB, Stokes A, Sankar V, Villa A. Predictors of dental care use, unmet dental care need, and barriers to unmet need among women: results from NHANES, 2011 to 2016. J Public Health Dent 2019; 79:324-333. [PMID: 31407356 DOI: 10.1111/jphd.12334] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 06/11/2019] [Accepted: 07/09/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To examine socio-demographic and economic predictors of dental care access among women in the United States. METHODS A total of 52,493,940 women at the US national level aged 20-44 years were identified from the National Health and Nutrition Examination Survey, 2011 to 2016. Weighted multivariate logistic regression models were computed to identify predictors of dental care use, unmet dental-care need, and reported reasons for unmet need. RESULTS Young, Mexican-American, other minority race-ethnicities, less educated, and uninsured women were independently more likely to have never visited a dental clinic (P < 0.025). Mexican-Americanwomen with a poverty income ratio (PIR) <2.00 and less than excellent health status and those uninsured were independently more likely to have unmet dental need (P < 0.025). Women with PIR <1.00 and those uninsured were independently more likely to have an unmet need because of unaffordable cost (P < 0.0008) or lack of procedure coverage by insurance (P < 0.0008). Younger women were more likely to think that the dental problem would go away (P < 0.0001). CONCLUSIONS While young, less educated, and women from minority race-ethnicities were less likely to report ever use of dental care, only low income, poor health, and uninsured women were more likely to report unmet dental care need. Racial-ethnic minority, less educated, and young women may benefit from improved education about the value of dental care. Expanding insurance coverage for dental care and improving access for women with poor health may address racial-ethnic and education-level disparities in unmet dental care need.
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Affiliation(s)
- Avni Gupta
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
| | - Sarah Feldman
- Division of Gynecological Oncology, Brigham and Women's Hospital, Boston, MA, USA
| | - Rebecca B Perkins
- Department of Obstetrics and Gynecology, Boston University School of Medicine/Boston Medical Center, Boston, MA, USA
| | - Andrew Stokes
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Vidya Sankar
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.,Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.,Division of Oral Medicine and Oncology, Dana Farber Cancer Institute, Boston, MA, USA
| | - Alessandro Villa
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.,Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.,Division of Oral Medicine and Oncology, Dana Farber Cancer Institute, Boston, MA, USA
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15
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Neumann A, Obadan-Udoh E, Bangar S, Kumar SV, Tokede O, Kim A, Yansane A, Mertz E, Panwar S, Gharpure A, Kookal KK, Mullins J, Even JB, Simmons K, White JM, Walji MF, Kalenderian E. Number of Pregnant Women at Four Dental Clinics and the Care They Received: A Dental Quality eMeasure Evaluation. J Dent Educ 2019; 83:1158-1165. [PMID: 31235503 DOI: 10.21815/jde.019.123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 05/07/2019] [Indexed: 12/15/2022]
Abstract
Process-of-care quality measure research can be used to identify gaps in the delivery of dental services to pregnant patients. The aim of this study was to evaluate the types of dental services that pregnant patients received in four dental clinics over five years as documented in the electronic health record (EHR). To accomplish this objective, the authors modified and validated a previously published claims-based dental quality measure for EHR use. After the electronic dental quality measure specifications were defined, the number of pregnant patients was calculated at three academic dental institutions and one large accountable care organization, and the types of dental care services they received over a five-year period (2013-17) were determined. Calibrated reviewers at each institution independently reviewed a sub-sample of patient charts to validate the information obtained from EHR queries, and the concordance between manual chart reviews and EHR query reports was analyzed. Of the 335,078 women aged 15-44 years who received care at the four clinics for the five reporting years, 3.9% (n=13,026) were pregnant. Among these pregnant patients, 48.9% (n=6,366) received a periodic dental examination; 30.0% (n=3,909) received a comprehensive dental exam; and 21.5% (n=2,799) received additional dental services, irrespective of comprehensive or periodic oral evaluations. Overall, the mean proportion of pregnant patients seeking care in these academic dental and group practice clinics was low, but 78.9% of them received either a periodic or comprehensive oral evaluation. Given the importance of oral health care during pregnancy, these findings suggest a need for curriculum development to incorporate prenatal oral health education in the training of dental students.
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Affiliation(s)
- Ana Neumann
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Enihomo Obadan-Udoh
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Suhasini Bangar
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Shwetha V Kumar
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Oluwabunmi Tokede
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Aram Kim
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Alfa Yansane
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Elizabeth Mertz
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Sapna Panwar
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Arti Gharpure
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Krisha Kumar Kookal
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Joanna Mullins
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Joshua B Even
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Kristen Simmons
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Joel M White
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Muhammad F Walji
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco
| | - Elsbeth Kalenderian
- Ana Neumann and Enihomo Obadan-Udoh contributed equally to this article. Ana Neumann is Associate Professor, The University of Texas School of Dentistry at Houston; Enihomo Obadan-Udoh is Assistant Professor, School of Dentistry, University of California, San Francisco; Suhasini Bangar is Research Associate, The University of Texas School of Dentistry at Houston; Shwetha V. Kumar is Graduate Research Assistant, The University of Texas School of Dentistry at Houston; Oluwabunmi Tokede is Assistant Professor, Harvard School of Dental Medicine; Aram Kim is Instructor, Harvard School of Dental Medicine; Alfa Yansane is Assistant Professor, School of Dentistry, University of California, San Francisco; Elizabeth Mertz is Professor, School of Dentistry, University of California, San Francisco; Sapna Panwar is Research Assistant, School of Dentistry, University of California, San Francisco; Arti Gharpure is Research Assistant, School of Dentistry, University of California, San Francisco; Krisha Kumar Kookal is Clinical Informatics Research Data Warehouse Lead Systems Analyst, The University of Texas School of Dentistry at Houston; Joanna Mullins is Manager of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Joshua B. Even is Director of Clinical Strategy and Support, Skourtes Institute, Hillsboro, OR; Kristen Simmons is Chief Operating Officer, Skourtes Institute, Hillsboro, OR; Joel M. White is Professor, School of Dentistry, University of California, San Francisco; Muhammad F. Walji is Associate Dean and Professor, The University of Texas School of Dentistry at Houston; and Elsbeth Kalenderian is Professor and Department Chair, School of Dentistry, University of California, San Francisco.
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Naavaal S, Brickhouse TH, Hafidh S, Smith K. Factors Associated with Preventive Dental Visits Before and During Pregnancy. J Womens Health (Larchmt) 2019; 28:1670-1678. [PMID: 31084459 DOI: 10.1089/jwh.2018.7509] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Poor prenatal oral health has implications for maternal, fetal, and infant health. Studies have shown an association between periodontal disease and adverse pregnancy outcomes, such as preterm delivery, low birth weight, and pre-eclampsia. The objective of this study was to identify the factors associated with preventive dental visits before and during pregnancy and examine the relationship of dental insurance with those visits among Virginia women. Methods: The Virginia Pregnancy Risk Assessment Monitoring System (2012-2014) cross-sectional data were used to explore the use of dental cleaning visit among women. The bivariate and multivariate analyses included sociodemographic variables, health risk factors, chronic conditions, oral health knowledge, and oral health promotion variables. All estimates were weighted; p < 0.05 was considered statistically significant. Results: A total of 1,344 weighted respondents represented ∼293,608 women in Virginia. Overall, 56% of women reported a before pregnancy dental cleaning visit, and 47% of women reported a during pregnancy dental cleaning visit. Nearly 60% of women were non-Hispanic white, 78% were between 20 and 34 years of age, and 67% reported having dental insurance. Dental insurance (odds ratio [OR] = 3.5; 95% confidence interval [95% CI] = 2.17-5.67) and oral health knowledge (OR = 2.8; 95% CI = 1.42-5.48) were associated with before pregnancy dental visit. During pregnancy dental visit was strongly associated with dental insurance (OR = 5.8; 95% CI = 2.80-11.97), before pregnancy dental visit (OR = 20.72, 95% CI = 11.14-38.54), and oral health promotion by health provider (OR = 12.37, 95% CI = 7.31-20.93). Conclusions: Overall, the use of a preventive dental visit before and during pregnancy was low among Virginia women. Improving the use of routine dental visits before pregnancy, increasing access to dental insurance, and engaging health care providers to promote oral health can impact the use of dental care during pregnancy.
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Affiliation(s)
- Shillpa Naavaal
- Department of Oral Health Promotion and Community Outreach, School of Dentistry, Oral Health in Childhood and Adolescence Core, Institute for Inclusion, Inquiry and Innovation, Virginia Commonwealth University, Richmond, Virginia
| | - Tegwyn H Brickhouse
- Department of Oral Health Promotion and Community Outreach, School of Dentistry, Oral Health in Childhood and Adolescence Core, Institute for Inclusion, Inquiry and Innovation, Virginia Commonwealth University, Richmond, Virginia
| | - Shahid Hafidh
- Division of Population Health Data, Office of Family Health Services, Virginia Department of Health, Richmond, Virginia
| | - Kenesha Smith
- Division of Population Health Data, Office of Family Health Services, Virginia Department of Health, Richmond, Virginia
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Khadija B, Abbasi A, Khan S, Nadeem M, Badshah L, Faryal R. Isolation of pathogenic Candida species from oral cavity of postpartum females, and its association with obstetric and dental problems. Microb Pathog 2019; 131:40-46. [PMID: 30905714 DOI: 10.1016/j.micpath.2019.03.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 01/31/2019] [Accepted: 03/18/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of the current study was to investigate pathogenic Candida spp. Colonization in oral cavity of postpartum females and its association with adverse pregnancy outcomes (APOs) and dental issues. METHODS Saliva samples and clinico-demographic data were collected from 267 postpartum females along with 54 non-pregnant females (Jan 2016-March 2018). Isolation of Candida was carried out by using standard microbiological methods and different virulence factors (Esterase activity, phospholipase activity and biofilm formation) were evaluated. RESULTS Candidacolonization was high in postpartum females (p<0.001, OR = 4.28). This colonization was not significant among females with APOs, however, one to three folds risk was seen with different obstetric and dental factors. High esterase activity was seen among Candida isolates from postpartum females in comparison to control group (p = 0.01). Phospholipase activity of C.albicans isolates from this group was also high (p = 0.001). Majority of the Candida isolates (66.87%) from postpartum females were biofilm formers. Increase in antifungal activity was seen among isolates from postpartum females, with 85% isolates resistant to Fluconazole and Voriconazole (p<0.001) and Amphotericin B resistance was present in 64.38% isolates (p<0.001). CONCLUSION Postpartum females are more susceptible to oral Candida colonization, which exhibit enhanced virulence characteristics and its carriage are associated with increased risk for development of APOs and dental problems.
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Affiliation(s)
- Bibi Khadija
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Aqsa Abbasi
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Sadia Khan
- Holy Family Hospital, Rawalpindi Medical College, Rawalpindi, Pakistan
| | - Meera Nadeem
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Lal Badshah
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Rani Faryal
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan.
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Xiao J, Alkhers N, Kopycka-Kedzierawski DT, Billings RJ, Wu TT, Castillo DA, Rasubala L, Malmstrom H, Ren Y, Eliav E. Prenatal Oral Health Care and Early Childhood Caries Prevention: A Systematic Review and Meta-Analysis. Caries Res 2019; 53:411-421. [PMID: 30630167 PMCID: PMC6554051 DOI: 10.1159/000495187] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 10/31/2018] [Indexed: 11/19/2022] Open
Abstract
Despite the advancement of early childhood caries (ECC) prediction and treatment, ECC remains a significant public health burden in need of more effective preventive strategies. Pregnancy is an ideal period to promote ECC prevention given the profound influence of maternal oral health and behaviors on children's oral health. However, studies have shown debatable results with respect to the effectiveness of ECC prevention by means of prenatal intervention. Therefore, this study systematically reviewed the scientific evidence relating to the association between prenatal oral health care, ECC incidence, and Streptococcus mutans carriage in children. Five studies (3 randomized control trials, 1 prospective cohort study, and 1 nested case-control study) were included for qualitative assessment. Tested prenatal oral health care included providing fluoride supplements, oral examinations/cleanings, oral health education, dental treatment referrals, and xylitol gum chewing. Four studies that assessed ECC incidence reduction were included in meta-analysis using an unconditional generalized linear mixed effects model with random study effects and age as a covariate. The estimated odds ratio and 95% confidence intervals suggested a protective effect of prenatal oral health care against ECC onset before 4 years of age: 0.12 (0.02, 0.77) at 1 year of age, 0.18 (0.05, 0.63) at 2 years of age, 0.25 (0.09, 0.64) at 3 years of age, and 0.35 (0.12, 1.00) at 4 years of age. Children's S. mutans carriage was also significantly reduced in the intervention group. Future studies should consider testing strategies that restore an expectant mother's oral health to a disease-free state during pregnancy.
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Affiliation(s)
- Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA,
| | - Naemah Alkhers
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | | | - Ronald J Billings
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, USA
| | - Daniel A Castillo
- Miner Library, University of Rochester Medical Center, Rochester, New York, USA
| | - Linda Rasubala
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Hans Malmstrom
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Yanfang Ren
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Eli Eliav
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
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Abstract
Oral health care is a necessary and critical component of health care for pregnant women, but its importance is often overlooked by clinicians. Pregnant women who are low-income also find it particularly difficult to access care. This analytic essay summarizes oral health coverage for pregnant women under various types of health insurance coverage, including Medicaid, the Children's Health Insurance Program, and coverage options available under the Affordable Care Act. We hope this information will help clinicians better understand the importance of oral health care during pregnancy and the range of coverage options that may be available to their patients.
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Lasisi T, Abdus-Salam R. Pattern of Oral Health Among a Population of Pregnant Women in Southwestern Nigeria. ARCHIVES OF BASIC AND APPLIED MEDICINE 2018; 6:99-103. [PMID: 30035209 PMCID: PMC6052798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Oral health in pregnancy is important to the health of the pregnant woman; and good oral health plays a role in the outcome of pregnancy. However, many pregnant women and healthcare providers are either unaware of this or accord this less attention. The study was designed to describe pattern of oral health among a cohort of pregnant women. Seventy-seven pregnant women attending antenatal care at a secondary healthcare facility were evaluated in third trimester following written informed consent. Each participant had a structured data collection form administered and clinical examination conducted. Information on socio-demographic characteristics, dental and obstetric history and examination were obtained. Dental assessment involved the use of the oral hygiene, gingival, periodontal and caries indices. The data collected was entered and analysed using IBM SPSS Statistics version 20. The mean age of the participants was 29.90 (± 4.38) years and all women were in the third trimester of pregnancy. Only 6.5% of the participants had dental complaints, 26% indicated brushing twice a day and 96.1% never had dental health check in the past. A good oral hygiene score was found in 40% of participants; 6.5% and 10.4% had a healthy periodontal and gingival status respectively and only 8 (10.4%) had caries. Less than half of the pregnant women had good oral health status. The antenatal care period may be an opportunity to identify oral diseases; counsel and introduce positive oral health behaviours and enhance improved personal oral hygiene.
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Affiliation(s)
- T.J. Lasisi
- Department of Physiology, College of Medicine, University of Ibadan
- Department of Oral Pathology, University College Hospital. P.M.B. 5017, Ibadan, Nigeria
| | - R.A. Abdus-Salam
- Department of Obstetrics and Gynaecology, Adeoyo Maternity Teaching Hospital, Ibadan, Nigeria
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Rocha JS, Arima LY, Werneck RI, Moysés SJ, Baldani MH. Determinants of Dental Care Attendance during Pregnancy: A Systematic Review. Caries Res 2018; 52:139-152. [DOI: 10.1159/000481407] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 09/08/2017] [Indexed: 12/14/2022] Open
Abstract
Despite the fact that dental care attendance during pregnancy has been recommended by guidelines and institutions, the demand for dental services is still low among pregnant women. The aim of this study was to identify and analyze the determinants of dental care attendance during pregnancy. We performed a systematic literature search in the electronic databases PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature, Brazilian Library in Dentistry, Cumulative Index to Nursing and Allied Health Literature, and Medline using relevant keywords. Studies were filtered by publication year (2000-2016) and language (English, Portuguese, Spanish, and French). The included studies were assessed for quality. Their characteristics and statistically significant factors were reported. Fourteen papers were included in the review. The prevalence of dental service usage during pregnancy ranged from 16 to 83%. Demographic factors included women's age, marital status, parity, and nationality. The socioeconomic factors were income, educational level, and type of health insurance. Many psychological and behavioral factors played a role, including oral health practices, oral health and pregnancy beliefs, and health care maintenance. Referred symptoms of gingivitis, dental pain, or dental problems were perceived need. Demographic, socioeconomic, psychological, behavioral factors and perceived need were associated with the utilization of dental services during pregnancy. More well-designed studies with reliable outcomes are required to confirm the framework described in this review.
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Górniaczyk A, Czech-Szczapa B, Sobkowski M, Chmaj-Wierzchowska K. Maternal health-related behaviours during pregnancy: a critical public health issue. EUR J CONTRACEP REPR 2017. [PMID: 28650726 DOI: 10.1080/13625187.2017.1332304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM The aim of the study was to investigate the health-related behaviours of pregnant women. Maternal health-related habits, use of psychoactive medicines, diet, prevention of neural tube defects, oral cavity hygiene, chronic diseases and physical activity were analysed in a group of pregnant women attending antenatal classes. METHODS Hundred pregnant women recruited from various antenatal classes in Poznań, Poland, were investigated using a questionnaire based on the Pregnancy Risk Assessment Monitoring System. RESULTS The results showed that 29% of pregnancies were unplanned. In women with higher education, 62% reported that they were taking folic acid supplements during pregnancy, in contrast with 35% women with a lower level of education (p = .012). The study showed that 24% of women were exposed to second-hand smoke during pregnancy, and this was more common among younger study participants (p = .038). Nine percentage of women admitted drinking alcohol during pregnancy. Pre-pregnancy alcohol consumption was more frequent among women with higher education (p = .011). Only 46.7% of women informed their dentist about their pregnancy, and these were more often older participants (p = .023). CONCLUSION The study found low maternal awareness regarding health-related behaviours, which presents a serious challenge to public health care in Poland. Pregnant women and those who wish to conceive need to be educated effectively about preventive measures in order to maintain optimal maternal and reproductive health, as well as normal fetal development.
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Affiliation(s)
- Aleksandra Górniaczyk
- a Department of Preventive Medicine, Epidemiology Unit , Poznań University of Medical Sciences , Poznań , Poland
| | - Barbara Czech-Szczapa
- a Department of Preventive Medicine, Epidemiology Unit , Poznań University of Medical Sciences , Poznań , Poland
| | - Maciej Sobkowski
- b Department of Mother and Child Health , Poznań University of Medical Sciences , Poznań , Poland
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Rosenberg N, Daviglus ML, DeVon HA, Park CG, Eldeirawi K. The Association between Parity and Inflammation among Mexican-American Women of Reproductive Age Varies by Acculturation Level: Results of the National Health and Nutrition Examination Survey (1999-2006). Womens Health Issues 2017; 27:485-492. [PMID: 28410971 DOI: 10.1016/j.whi.2017.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 03/01/2017] [Accepted: 03/06/2017] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Parity and acculturation are linked with cardiometabolic risk. Their joint association with cardiometabolic health among Mexican-American women is less established, even though immigrant Mexican-American women have the highest fertility rate in the United States. We examined the modifying role of acculturation on the association of parity with a cardiometabolic risk biomarker, C-reactive protein (CRP). METHODS Participants (n = 1,002) were women of Mexican background, ages 16 to 39 years, in the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2006. The association between parity and elevated CRP was examined using logistic regression adjusted for age, household food security, access to health care, hemoglobin A1c, total cholesterol, high-density lipoprotein cholesterol, waist circumference, physical activity, acculturation, and a product term of parity and acculturation. Acculturation was measured on a 6-point score based on nativity status and duration of residence in the United States (0, Mexico born, U.S. resident <10 years; 1, Mexico born, U.S. resident 10-19 years; 2-Mexico born, U.S. resident ≥20 years; and 3, U.S. born), and language used at home (0, Spanish; 1, bilingual; 2, English). Scores of 0 or 1, 2 or 3, and 4 or 5 represented low, moderate, and high acculturation, respectively. RESULTS The association of parity with elevated CRP varied by acculturation level (pinteraction = 0.10). Parity was associated with elevated CRP among women with low (adjusted odds ratio [OR], 2.26; 95% CI, 1.07-4.80) and moderate acculturation (adjusted OR, 2.79; 95% CI, 1.16-6.73), compared with nulliparous women. CONCLUSIONS Higher odds of elevated CRP associated with parity in immigrant Mexican-American women of reproductive age indicate the need for greater use of maternal/women's health care services for cardiometabolic risk screening and interventions.
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Affiliation(s)
- Natalya Rosenberg
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, Illinois.
| | - Martha L Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Holli A DeVon
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Chang Gi Park
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Kamal Eldeirawi
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
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Azofeifa A, Yeung LF, Alverson CJ, Beltrán-Aguilar E. Dental caries and periodontal disease among U.S. pregnant women and nonpregnant women of reproductive age, National Health and Nutrition Examination Survey, 1999-2004. J Public Health Dent 2016; 76:320-329. [PMID: 27154283 PMCID: PMC5097890 DOI: 10.1111/jphd.12159] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 02/29/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study assessed and compared the prevalence and severity of dental caries and the prevalence of periodontal disease among pregnant and nonpregnant women of reproductive age (15-44 years) using data from the National Health and Nutrition Examination Survey, NHANES (1999-2004). METHODS Estimates were derived from a sample of 897 pregnant women and 3,971 nonpregnant women. Chi-square and two-sample t-tests were used to assess differences between groups stratified by age, race/ethnicity, education, and poverty. Bonferroni method was applied to adjust for multiple comparisons. RESULTS In general, there were no statistically significant differences in the prevalence estimates of dental caries and periodontal disease between pregnant women and nonpregnant women. However, results showed significant differences when stratified by sociodemographic characteristics. For example, the prevalence of untreated dental caries among women aged 15-24 years was significantly higher in pregnant women than in nonpregnant women (41 percent versus 24 percent, P = 0.001). Regardless of their pregnancy status, racial/ethnic minorities or women with less education or lower family income had higher prevalence of untreated dental caries, severity of dental caries, and periodontal disease compared to the respective reference groups of non-Hispanic whites or women with more education or higher family income. CONCLUSION Results of this study show few clinical differences in dental caries and periodontal disease between pregnant and nonpregnant women but persistent disparities by sociodemographic characteristics. In order to reduce oral health disparities in the United States, it is important to improve access to oral health care particularly among vulnerable groups. Integrating oral health into the overall health care could benefit and improve women's oral health outcomes.
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Affiliation(s)
- Alejandro Azofeifa
- Division of Evaluation, Analysis and Quality, Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lorraine F. Yeung
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - C. J. Alverson
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
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Hartnett E, Haber J, Krainovich-Miller B, Bella A, Vasilyeva A, Lange Kessler J. Oral Health in Pregnancy. J Obstet Gynecol Neonatal Nurs 2016; 45:565-73. [DOI: 10.1016/j.jogn.2016.04.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 12/22/2022] Open
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Hayes DK, Turnure M, Mattheus DJ, Shannon MT. Predictors of Dental Cleaning Over a Two-year Time Period Around Pregnancy Among Asian and Native Hawaiian or Other Pacific Islander Race Subgroups in Hawai'i, 2009-2011. HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2015; 74:328-333. [PMID: 26535162 PMCID: PMC4610258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Oral health disease is linked to several chronic diseases including adverse health outcomes around pregnancy. Optimizing a woman's oral health before, during, and after pregnancy can impact her health and the health of her children. Preventive, diagnostic, and restorative dental services can be done safely and effectively including during pregnancy. We examined data from the 2009-2011 Hawai'i Pregnancy Risk Assessment Monitoring System (PRAMS) to assess the prevalence of dental cleanings over an approximately 2 year (Median: 2.0 years, Range:1.6-2.5 years) time period (12 months before pregnancy, during pregnancy, and in the first few months postpartum) among 4,735 mothers who recently had a live birth. Adjusted prevalence ratios (APR) of dental cleanings were calculated for both race and Medicaid/QUEST insurance status adjusting for maternal age and education. During a two-year span before, during, and after pregnancy an estimated 60.8% of women had dental cleanings. Native Hawaiian (APR=0.87; 95% CI=0.80-0.93), Other Pacific Islander (0.70; 0.58-0.83), Filipino (0.90; 0.82-0.97), and Chinese (0.76; 0.63-0.93) mothers were less likely to have had dental cleanings compared to white mothers. Additionally, mothers with Medicaid/QUEST health insurance (0.73; 0.68-0.79) were less likely to have had cleanings. More than one-third of recently pregnant mothers did not have dental cleanings in the approximately two-year time period. Native Hawaiian, Other Pacific Islander, Filipino, and Chinese mothers and those on Medicaid/QUEST health insurance were less likely to receive regular dental care. Identification of the reasons why these populations do not seek regular dental care can inform programmatic efforts to improve oral health outcomes for women and families.
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