Views of pregnant women in South Western Sydney towards dental care and an oral-health program initiated by midwives
Ajesh George A E , Maree Johnson A , Anthony Blinkhorn B , Shilpi Ajwani C , Sharon Ellis D and Sameer Bhole C
+ Author Affiliations
- Author Affiliations
A Centre for Applied Nursing Research, University of Western Sydney, South Western Sydney Local Health District (SWSLHD) and Ingham Institute Applied Medical Research, Locked Bag 7103, Liverpool BC, NSW 1871, Australia.
B Population Oral Health, Faculty of Dentistry, University of Sydney, 1 Mons Road, Westmead, NSW 2145, Australia.
C Sydney and South Western Sydney LHD and Sydney Dental Hospital, Faculty of Dentistry, University of Sydney, Locked Mail Bag 7279, Liverpool BC, NSW 1871, Australia.
D Camden and Campbelltown Hospitals, SWSLHD, Therry Road, Campbelltown, NSW 2560, Australia.
E Corresponding author. Email: ajesh.george@sswahs.nsw.gov.au
Health Promotion Journal of Australia 24(3) 178-184 https://doi.org/10.1071/HE13040
Submitted: 16 May 2013 Accepted: 20 September 2013 Published: 4 December 2013
Abstract
Issues addressed: Oral health during pregnancy is important, yet is often neglected by women. A program is currently being developed for midwives in Australia to promote maternal oral health. The aim of this study was to record the views of pregnant women in Australia towards dental care and midwives promoting oral health.
Methods: Using convenience sampling, a cross-sectional survey was undertaken of 241 pregnant women attending a metropolitan hospital in South Western Sydney in 2010.
Results: Only 10% of women received oral-health promotional material during pregnancy. More than 50% reported dental problems, yet only 17% had discussed this with their midwives and less than half (44.6%) had sought dental treatment. The main barriers to obtaining dental care were: lack of awareness, safety concerns about dental treatment and dental costs. Pregnant women were more likely (P < 0.05) to see a dentist if they had received information about oral health (odds ratio (OR) 3.25, 95% CI 1.34–7.90) and had private health insurance (OR 2.47, 95% CI 1.26–4.85). Most women (> 90%) were receptive to midwives providing oral-health education, assessments and referrals to affordable dental services.
Conclusion: This study has shown that pregnant women are receiving limited dental advice and are concerned about dental costs. It has also confirmed for the first time in Australia that women are very positive about receiving oral-health advice from midwives during their pregnancy.
So what?: Oral-health promotion programs during pregnancy should consider using midwives to increase dental awareness among women and provide pathways to affordable dental services.
Keywords: antenatal care, Australia, pregnancy.
References
[1] Silk H, Douglass AB, Douglass JM, Silk L (2008) Oral health during pregnancy. Am Fam Physician 77, 1139–44.[2] Xiong X, Buekens P, Fraser WD, Beck J, Offenbacher S (2006) Periodontal disease and adverse pregnancy outcomes: a systematic review. BJOG 113, 135–43.
| Periodontal disease and adverse pregnancy outcomes: a systematic review.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD28%2FisFWntA%3D%3D&md5=5bfe60969dd2d9da831ac03d387fea59CAS | 16411989PubMed |
[3] Shub A, Wong C, Jennings B, Swain JR, Newnham JP (2009) Maternal periodontal disease and perinatal mortality. Aust N Z J Obstet Gynaecol 49, 130–6.
| Maternal periodontal disease and perinatal mortality.Crossref | GoogleScholarGoogle Scholar | 19441161PubMed |
[4] American Academy of Pediatric Dentistry Guideline on perinatal oral health care. 2011. Available from: http://www.aapd.org/media/Policies_Guidelines/G_PerinatalOralHealthCare.pdf [Verified 1 October 2011].
[5] Gussy MG, Waters EG, Walsh O, Kilpatrick NM (2006) Early childhood caries: current evidence for aetiology and prevention. J Paediatr Child Health 42, 37–43.
| Early childhood caries: current evidence for aetiology and prevention.Crossref | GoogleScholarGoogle Scholar | 16487388PubMed |
[6] Yost J, Li Y (2008) Promoting oral health from birth through childhood: prevention of early childhood caries. MCN Am J Matern Child Nurs 33, 17–23.
| Promoting oral health from birth through childhood: prevention of early childhood caries.Crossref | GoogleScholarGoogle Scholar | 18158522PubMed |
[7] California Dental Association Foundation, American College of Obstetricians and Gynecologists, District IX. (2010) Oral health during pregnancy and early childhood: evidence-based guidelines for health professionals. J Calif Dent Assoc 38, 391–440.
[8] Keirse MJNC, Plutzer K (2010) Women’s attitude to and perceptions of oral health and dental care during pregnancy. J Perinat Med 38, 3–8.
| Women’s attitude to and perceptions of oral health and dental care during pregnancy.Crossref | GoogleScholarGoogle Scholar |
[9] Gaffield ML, Colley-Gilbert BJ, Malvitz DM, Romaguera R (2001) Oral health during pregnancy. An analysis of information collected by the Pregnancy Risk Assessment Monitoring System. J Am Dent Assoc 132, 1009–16.
[10] Hullah E, Turok Y, Nauta M, Yoong W (2008) Self-reported oral hygiene habits, dental attendance and attitudes to dentistry during pregnancy in a sample of immigrant women in North London. Arch Gynecol Obstet 277, 405–9.
| Self-reported oral hygiene habits, dental attendance and attitudes to dentistry during pregnancy in a sample of immigrant women in North London.Crossref | GoogleScholarGoogle Scholar | 17940783PubMed |
[11] George A, Johnson M, Blinkhorn A, Ellis S, Bhole S, Ajwani S (2010) Promoting oral health during pregnancy: current evidence and implications for Australian midwives. J Clin Nurs 19, 3324–33.
| Promoting oral health during pregnancy: current evidence and implications for Australian midwives.Crossref | GoogleScholarGoogle Scholar | 20955483PubMed |
[12] National Health Service. What are my rights during pregnancy? 2008. Available from: http://www.nhs.uk/chq/pages/941.aspx [Verified 15 April 2009].
[13] Stevens J, Iida H, Ingersoll G (2007) Implementing an oral health program in a group prenatal practice. J Obstet Gynecol Neonatal Nurs 36, 581–91.
| Implementing an oral health program in a group prenatal practice.Crossref | GoogleScholarGoogle Scholar | 17973702PubMed |
[14] Carl LD, Roux G, Matacale R (2000) Exploring dental hygiene and perinatal outcomes. AWHONN lifelines 4, 22–7.
[15] Meyer K, Geurtsen W, Gunay H (2010) An early oral health care program starting during pregnancy: results of a prospective clinical long-term study. Clin Oral Investig 14, 257–64.
| An early oral health care program starting during pregnancy: results of a prospective clinical long-term study.Crossref | GoogleScholarGoogle Scholar | 19543927PubMed |
[16] New South Wales Parliament. Dental services in NSW: Report by standing committee on social issues. 2006. Available from: http://www.parliament.nsw.gov.au/Prod/parlment/committee.nsf/0/4fa2d0149b588095ca25714200077d20/$FILE/FINAL-%20COMPILED%2030%20MARCH.pdf [Verified 8 September 2008].
[17] Sydney South West Area Health Service. Annual Report 2006/07. 2008. Available from: http://www.slhd.nsw.gov.au/ARarchive/Statutory_Annual_Report_06-07.pdf [Verified 8 September 2008].
[18] George A, Johnson M, Duff M, Ajwani S, Bhole S, Blinkhorn A, et al (2012) Midwives and oral health care during pregnancy: perceptions of pregnant women in South-Western Sydney, Australia. J Clin Nurs 21, 1087–96.
| Midwives and oral health care during pregnancy: perceptions of pregnant women in South-Western Sydney, Australia.Crossref | GoogleScholarGoogle Scholar | 22007929PubMed |
[19] George A, Johnson M, Duff M, Blinkhorn A, Ajwani S, Bhole S, et al (2011) Maintaining oral health during pregnancy: perceptions of midwives in Southwest Sydney. Collegian 18, 71–9.
| Maintaining oral health during pregnancy: perceptions of midwives in Southwest Sydney.Crossref | GoogleScholarGoogle Scholar | 21706994PubMed |
[20] George A, Johnson M, Blinkhorn A, Ajwani S, Bhole S, Yeo AE, et al (2013) The oral health status, practices and knowledge of pregnant women in South-western Sydney. Aust Dent J 58, 26–33.
| The oral health status, practices and knowledge of pregnant women in South-western Sydney.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3svhs1KgsA%3D%3D&md5=43fd5d3a39351a093a62181e7e43d73bCAS | 23441789PubMed |
[21] Carter KD, Stewart JF. National dental telephone interview survey 1999. Adelaide: AIHW Dental Statistics and Research Unit; 2002. AIHW cat. no. DEN 109.
[22] California Department of Public Health. Maternal and Infant Health Assessment (MIHA) survey. 2010. Available from: http://www.cdph.ca.gov/data/surveys/Pages/MaternalandInfantHealthAssessment(MIHA)survey.aspx [Verified 12 October 2011].
[23] Department of Health. The NHS Oral Health Assessment Final report. 2006. Available from: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4134370 [Verified 12 October 2011].
[24] SPSS Inc. PASW Statistics for Windows, Version 18.0.. Chicago: SPSS Inc.; 2009.
[25] Campbelltown City Council. Community Profile. 2011. Available from: http://profile.id.com.au/Default.aspx?id=208&pg=2&gid=10&type=enum [Verified 11 October 2011].
[26] Thomas NJ, Middleton PF, Crowther CA (2008) Oral and health care practice in pregnant women in Australia: a postnatal survey. BMC Pregnancy Childbirth 8, 13–20.
| Oral and health care practice in pregnant women in Australia: a postnatal survey.Crossref | GoogleScholarGoogle Scholar | 18426558PubMed |
[27] Xiong X, Buekens P, Fraser WD, Beck J, Offenbacher S (2006) Periodontal disease and adverse pregnancy outcomes: a systematic review. BJOG 113, 135–43.
| Periodontal disease and adverse pregnancy outcomes: a systematic review.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD28%2FisFWntA%3D%3D&md5=5bfe60969dd2d9da831ac03d387fea59CAS | 16411989PubMed |
[28] Department of Health and Ageing. Dental Health: Final Report of National Advisory Council on Dental Health. 2012. Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/final-report-of-national-advisory-council-on-dental-health.htm [Verified 12 September 2012].
[29] Al-Habashneh R, Guthmiller JM, Levy S, Johnson GK, Squier C, Dawson DV, et al (2005) Factors related to utilization of dental services during pregnancy. J Clin Periodontol 32, 815–21.
| Factors related to utilization of dental services during pregnancy.Crossref | GoogleScholarGoogle Scholar | 15966891PubMed |
[30] Saddki N, Yusoff A, Hwang YL (2010) Factors associated with dental visit and barriers to utilisation of oral health care services in a sample of antenatal mothers in Hospitak University Sains Malaysia. BMC Public Health 10, 75
| Factors associated with dental visit and barriers to utilisation of oral health care services in a sample of antenatal mothers in Hospitak University Sains Malaysia.Crossref | GoogleScholarGoogle Scholar | 20163741PubMed |
[31] National Maternal and Child Oral Health Resource Center. Oral health Care during pregnancy: A summary of practice guidelines. 2008. Available from: http://www.cdph.ca.gov/HealthInfo/healthyliving/childfamily/Documents/MO-OHP-SummaryPracticeGuidelines9-08.pdf [Verified 2 April 2009].
[32] Australian Health Ministers’ Advisory Council. Clinical Practice Guidelines: Antenatal Care – Module 1. Canberra: Australian Government Department of Health and Ageing; 2012. Available from: http://www.health.gov.au/antenatal [Verified 6 April 2013].
[33] Stewart DCL, Ortega AN, Dausey D, Rosenheck R (2002) Oral health and use of dental services among Hispanics. J Public Health Dent 62, 84–91.
| Oral health and use of dental services among Hispanics.Crossref | GoogleScholarGoogle Scholar |
[34] Centre for Applied Nursing Research. MIOH online education program. 2012. Available from: https://www.sswahs.nsw.gov.au/sswahs/canr/training/ [Verified 6 April 2013].
[35] George A, Shamim S, Johnson M, Dahlen H, Ajwani S, Bhole S, et al (2012) Perceptions of dental and prenatal care practitioners towards dental care during pregnancy: current evidence and implications. Birth 39, 238–47.
[36] Zanata RL, Fernandes KB, Navarro PS (2008) Prenatal dental care: evaluation of professional knowledge of obstetricians and dentists in the cities of Londrina/PR and Bauru/SP, Brazil, 2004. J Appl Oral Sci 16, 194–200.
| Prenatal dental care: evaluation of professional knowledge of obstetricians and dentists in the cities of Londrina/PR and Bauru/SP, Brazil, 2004.Crossref | GoogleScholarGoogle Scholar | 19089217PubMed |
[37] Strafford KE, Shellhaas C, Hade EM (2008) Provider and patient perceptions about dental care during pregnancy. J Matern Fetal Neonatal Med 21, 63–71.
| Provider and patient perceptions about dental care during pregnancy.Crossref | GoogleScholarGoogle Scholar | 18175246PubMed |
[38] Al-Habashneh R, Aljundi SH, Alwaeli HA (2008) Survey of medical doctors’ attitudes and knowledge of the association between oral health and pregnancy outcomes. Int J Dent Hyg 6, 214–20.
| Survey of medical doctors’ attitudes and knowledge of the association between oral health and pregnancy outcomes.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1crotVSkug%3D%3D&md5=bde11dc655ae80302833d5b0346dc001CAS | 18768026PubMed |
[39] Morgan MA, Crall J, Goldenberg RL, Schulkin J (2009) Oral health during pregnancy. J Matern Fetal Neonatal Med 22, 733–9.
| Oral health during pregnancy.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1MngsFalsw%3D%3D&md5=912f6de25637e545748f854ca1a0e005CAS | 19488943PubMed |