Palestinian women's oral health status, knowledge, practices, and access to dental care during pregnancy: a cross-sectional study

Abstract

BackgroundNo data exist about the oral health status, beliefs, and practices of women living in the occupied Palestinian territory generally and in pregnant women in particular. The aim of this study was to investigate pregnant women's oral health status, beliefs, and practices and the barriers to access to dental care. MethodsPregnant women visiting prenatal programmes at Ministry of Health centres in Jerusalem governorates were screened using the Decayed, Missed and Filled Teeth (DMFT) index to quantify their dental caries experience. A structured interview was also done to assess oral health beliefs and practices, demographic characteristics, and mothers' stress level and social support. Ethical approval was obtained from Al-Quds University Ethics Committee. Findings119 pregnant women agreed to participate in this study. 103 (87%) women were housewives with mean age 26 years (SD 5). 30 (25%) women had a household monthly income less than US$380, and 54 (45%) women did not finish their high school education. The sample had a mean DMFT index score of 14 (SD 5). 42 (35%) women had not visited a dentist in the past 3 years, and 61 (51%) women were advised by family and friends not to visit the dentist while pregnant. 96 (81%) women had no dental insurance, and 33 (28%) women considered cost to be a barrier to accessing dental care. 42 (35%) women brushed their teeth sometimes, and 106 (89%) women never flossed their teeth. 29 (24%) women perceived their oral health to be poor, and 65 (55%) women believed that a woman can lose a tooth just because she is pregnant. 60 (50%) women did not know the connection between poor oral health and adverse birth outcomes, and 25 (21%) women believed that cavities in baby teeth do not matter. InterpretationWomen in this study had a high prevalence of dental caries and reported substantial barriers to obtaining dental care. Findings from this study suggest the need for preventive and educational interventions to be incorporated in prenatal health-care programmes to improve maternal and child oral health in Palestine. FundingPartially funded by a L'Oréal/UNESCO “For Women in Science” 2014 Fellowship.