Qualitative exploration of barriers and facilitators of dental service utilization of pregnant women: A triangulation approach

Hoda Bahramian,Rocio Beatriz Quinonez,Simin Z Mohebbi,Mohammad Reza Khami

doi:10.1186/s12884-018-1773-6

Hoda Bahramian, Rocio Beatriz Quinonez + Show 2 more

Open Access

https://doi.org/10.1186/s12884-018-1773-6

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Abstract

BackgroundPregnant women are vulnerable to a wide range of oral health conditions that could be harmful to their own health and future child. Despite the usefulness of regular dental service utilization in prevention and early detection of oral diseases, it is notably low among pregnant women. In this qualitative study, we aimed to explore barriers and facilitators influencing pregnant women’s dental service utilization.MethodsUsing a triangulation approach, we included pregnant women (n = 22) from two public health centers, midwives (n = 8) and dentists (n = 12) from 12 other public centers in Tehran (Iran). Data was gathered through face-to-face semi-structured interviewing and focus group discussion methods. The analysis of qualitative data was performed using conventional content analysis with MAXQDA10 software.ResultsReported barriers of dental service utilization among pregnant women were categorized under emerging themes: Lack of knowledge and misbelief, cost of dental care, physiological changes, fear and other psychological conditions, time constraint, dentists’ unwillingness to accept pregnant women treatment, cultural taboos and lack of interprofessional collaboration. Solutions proposed by dentists, midwives and pregnant women to improve dental care utilization during pregnancy were categorized under three themes: Provision of knowledge, financial support and establishing supportive policies.ConclusionsUnderstanding perceived barriers of dental service utilization during pregnancy can serve as baseline information for planning and formulating appropriate oral health education, financial support, and legislations tailored for lower income pregnant women, midwives and dentists in countries with developing oral health care system.

Highlights

Pregnant women are vulnerable to a wide range of oral health conditions that could be harmful to their own health and future child
Data was collected on 22 pregnant women, 12 dentists and 8 midwives regarding their perspective views on barriers of dental service utilization for pregnant women
Dentists and pregnant women participating in our study suggested that payment for dental services in installments, establishment of dental care loans, or better insurance coverage should be provided

Summary

Introduction

Pregnant women are vulnerable to a wide range of oral health conditions that could be harmful to their own health and future child. Despite the usefulness of regular dental service utilization in prevention and early detection of oral diseases, it is notably low among pregnant women. Pregnant women are vulnerable to a wide range of oral health problems including dental caries, periodontal diseases and erosion. These changes can be associated with physiological increase in estrogenic hormones levels, poor oral hygiene practices, microbial changes in oral flora, daily diet alterations, frequent snacking, and vomiting [1,2,3,4]. An Iranian study by Hajikazemi et al showed that 70% of pregnant women had negative attitudes about dental care during pregnancy [7]; and in a study by Shamsi et al [14], only 37% of Iranian women had dental visit during this period.

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