Comparative Evaluation of Oral Health Knowledge, Practices and Attitude of Pregnant and Non-Pregnant Women, and Their Awareness Regarding Adverse Pregnancy Outcomes

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Oral health knowledge, attitude, and practice of pregnant women in Deccan, South India: a cross-sectional prenatal survey

Pregnancy is a unique condition for women, associated with physiological and emotional changes in the body. Various research showed an association between periodontal disease and adverse pregnancy outcomes. Importance to hygiene maintenance should be given during pregnancy and improve the wellbeing of the mother and child. This study assessed oral health knowledge, attitude, and practices among pregnant women in Hyderabad. The study design was cross-sectional and included 445 women who responded and completed the survey. Subjects were selected using a random sampling technique in gynecology clinics. The questionnaire form consisted of four sections: demographic data, knowledge, attitude, and oral hygiene practice. Out of the 482 pregnant females invited to participate in the study, 445 women completed the survey, giving a response rate of 92%. The majority of women showed good knowledge and attitude regarding oral hygiene and its relation to pregnancy. However, the participants showed poor compliance with the recommended protocol. There are certain myths and barriers to dental treatment that need to be considered in the prenatal education of women. If explained by the gynecologist, the importance of oral health and its correlation with systemic health will play a crucial role in improving oral hygiene practice and regular dental visits.

Validation of an instrument to determine oral health knowledge, attitudes, and practices during pregnancy

BACKGROUND

Oral health of the mother-infant dyad is important to preserve general health. However, there are few instruments in Spanish for the evaluation of knowledge, attitudes and practices that determine this construct. Therefore, this research aimed to develop and evaluate the psychometric properties of the Maternal Oral Health Knowledge, Attitudes and Practices Questionnaire (CAPSOM in Spanish).

METHODS

In this instrument development study that carried out in 2018-2019, involving pregnant women between the ages of 18 and 45 in the city of Leon, Guanajuato, Mexico. The sample size was calculated based on 10 women per questionnaire item (n = 10 k). The study used Cronbach's alpha, the modified Lawshe test of validity criteria, factor analysis, and the level of difficulty and discrimination of the items.

RESULTS

207 women took part with their signed, informed consent (25 ± 6 years). The internal consistency of the instrument, both total and by dimension was α = 0.70, α = 0.66 knowledge, α = 0.74 attitudes, and α = 0.66 practices. Values of Content Validity Ratio' ≥ 0.60 were obtained for the final 10 items and Content Validity Index' = 0.90. The average difficulty index of items was 0.40, and there were significant differences (Kruskall-Wallis, p < 0.001) in the discrimination test. Factor analysis demonstrated three main components.

CONCLUSIONS

A valid and reliable 10-item Spanish questionnaire was designed to measure pregnant women's oral health knowledge, attitudes, and practices.

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

Background

The objectives of the study were to assess the knowledge, attitude, and practice of dentists towards providing oral health care to pregnant women and to identify barriers and predictors of periodontal and caries related perinatal oral healthcare practices.

Methods

A cross-sectional analytical survey was conducted on dentists by using a random sampling technique, and a pre-validated questionnaire was delivered to 350 dentists from May 2018 to October 2018. Data were analyzed by utilizing SPSS software. Frequencies and percentages were recorded for descriptive variables. Binary logistic regression was used to analyze the probability of predicting group membership to the dependent variable using different independent variables determined from contingency tables.

Results

Overall response rate was 41%. The mean knowledge score of respondents was 15.86 ± 3.34. The lowest correct responses were noted in the questions related to periodontal health. It was found that the advice to delay dental visits until after pregnancy was eight times more likely to be observed among dentists who lacked the knowledge of importance of oral health during pregnancy (P = 0.04, OR = 8.75). Dentists were more likely to consult obstetricians regarding dental procedures when they fear a risk of labor in the dental practice (P < 0.05, OR = 3.72). Dentists who had the knowledge of periodontal disease association with preterm delivery were about four times more likely to treat periodontal disease during pregnancy (P = 0.01, OR = 3.95). Dentists knowing the association between maternal oral health and childhood decay were more likely to counsel pregnant patients regarding caries prevention (P > 0.05, OR = 3.75).

Conclusions

Collectively the results indicated few gaps in knowledge among some dentists and a need to improve existing attitudes towards perinatal oral health. Dentists failing to recognize the importance of perinatal oral health are more likely to be hesitant in treating pregnant patients. Failing to recognize the link between periodontal disease and obstetric complications increases the possibility of hesitance to counsel pregnant patients regarding the same. The appreciation of the evidence for poor perinatal oral health and risk of early childhood caries increases the likelihood of counseling by dentists on caries prevention.

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

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

Awareness, Attitude and Knowledge Regarding Oral Health among Pregnant Women: A Comparative Study

Background:

Pregnancy in a woman's life is associated with many physiological changes in the body due to alterations in the hormone levels. These altered hormonal levels are associated with many systemic diseases. The incidence of oral diseases in general and periodontal diseases in particular are higher in pregnant women, with gingivitis and periodontitis being the most common. Furthermore, it has been evidenced in literature that periodontal diseases are associated with adverse pregnancy outcomes such as preterm low birth weight and preeclampsia.

Aims and Objectives:

The aim of this study was to evaluate the oral health knowledge among pregnant women visiting and not visiting a dental professional.

Materials and Methods:

The study was a survey-based one with a sample size of 260. The study population was divided into two groups based on their visits to a dentist. A questionnaire comprising 20 questions has been used to assess their awareness and attitude towards oral health.

Results:

The awareness regarding oral health and association with adverse pregnancy outcomes among the study population was very low, irrespective of their dental visit. Furthermore, majority of the study population in neither of the groups were aware that dental treatment was safe during pregnancy.

Conclusion:

The results of the study clearly reflected that the awareness levels among the pregnant women regarding this association were low. Hence, more collective efforts are required from dental and medical professionals to improve the oral and periodontal health outcomes during pregnancy.

Evaluation of Impact of Pregnancy on Oral Health Status and Oral Health Related Quality of Life among Women of Kashmir Valley

INTRODUCTION

Oral health is a key component of overall health and wellbeing of women throughout life; and particularly important prior to conception and during pregnancy. Pregnancy affects both general health as well as the oral health related quality of life.

AIM

To assess the difference in oral health status and related quality of life among pregnant, postpartum and non pregnant women of Kashmir valley.

MATERIALS AND METHODS

The present cross-sectional study was conducted among a convenient sample of 900 women (22-37 years) attending Sheri-Kashmir Institute of Medical Sciences (SKIMS) Maternity Hospital, Srinagar, Jammu and Kashmir, India. Sample included 300 pregnant, 280 postpartum women and 320 non pregnant women of matched age group. Pretested and validated proforma for Oral Health Related Quality of Life (OHRQoL) Questionnaire designed in local language was used. Oral health was assessed using Oral Hygiene Index Simplified Index (OHIS), Gingival Index (GI) and Decayed Missing Filled Teeth/Surface Index (DMFT/DMFS). Mean differences were carried out using Kruskal-Wallis one-way ANOVA. Correlation analysis was performed to analyse their relationship with Oral Health Impact Profile (OHIP-14) score. Post-hoc Tukey test was employed for comparing the means within the three trimesters of the pregnant group.

RESULTS

Pregnant women presented with significantly higher periodontal disease (p≤0.05). Decayed Missing and Filled Teeth index (DMFT) showed no difference within the groups. Comparison for the mean OHIP-14 presented significantly poorer scores among the pregnant women.

CONCLUSION

Pregnancy had an influence only on the gingiva and not on periodontal attachment levels. However, oral health status and perceived OHRQoL were poorer among pregnant women. The present study draws attention toward the need for highlighting the importance of conserving oral health during pregnancy.