Association between Nutrient Intake, Oral Symptoms, and Oral Health Related Quality of Life of Antenatal Mothers in Sri Aman District, Sarawak

Abstract

The physiological and hormonal alternations during pregnancy cause antenatal mothers to experience multiple oral symptoms because of oral diseases, namely dental caries, and periodontal disease [1]. The changes in dietary intake cause them to be more vulnerable to nutritional deficiencies and further oral health problems. The objectives of this study were to assess the nutrient intake, oral symptoms, and oral health related quality of life (OHRQoL) among antenatal mothers in the Sri Aman district of Sarawak. The association between nutrient intake and oral symptoms and the association between oral symptoms and OHRQoL were also determined. A cross-sectional study was conducted among 124 antenatal mothers in the second and third trimesters attending the Maternal and Child Health (MCH) Clinic, Klinik Kesihatan Sri Aman, Sarawak. A validated self-administered questionnaire was used to collect the following variables: the socioeconomic and obstetric profile, perceived oral health status, and OHRQoL. OHRQoL was assessed using short version of the Malaysian Oral Health impact Profile (S-OHIP(M)) instrument with the original author’s permission. A 24-hour diet recall assessment was used for nutrient intake assessment for three non-consecutive days involving 2 weekdays and 1 weekend. The first 24-hour diet assessment was conducted through face-to-face interview, while the second and third 24-hour diet assessments were conducted using phone interviews. Nutrient intake was further analyzed using Nutritionist Pro™. All the data obtained were further analyzed using IBM SPSS for Windows version 26. Results showed that most antenatal mothers (71.0%) were in the second trimester. More than half (75.0%) of them had at least one oral symptom: cavitated tooth (51.6%), bleeding gum (32.3%), bad breath (27.4%), gum pain (13.7%), toothache (12.1%), swollen gum (6.5%). About half of them (52.5%) were satisfied with their oral health status. The intake of energy, vitamin D, calcium, iodine, zinc, fluoride, and iron for most antenatal mothers was below the recommended nutrient intake (RNI) values. The most reported oral impact was feeling discomfort due to food stuck (11.3%), feeling shy (10.5%), bad breath (5.6%), and avoiding smiling (5.6%). The most affected OHRQoL domain was psychological discomfort (mean 1.95, SD 1.89), followed by functional limitation (mean 1.29, SD 1.48) and physical pain (mean 1.19, SD 1.29). The intake of the 13 selected nutrients was found not to be significantly different between antenatal mothers with at least one oral symptom and without oral symptoms. Antenatal mothers with at least one oral symptom had significantly lower OHRQoL compared to those with no oral symptom. The presence of toothache, cavitated tooth, bleeding gum, and halitosis had significantly lower OHRQoL as compared to those without the symptoms.
 In conclusion, most antenatal mothers do not have adequate nutrient intake. Dental caries and periodontal disease were prevalent, and the presence of oral symptoms was associated with poor OHRQoL.