Oral Health Of Pregnant Women Research Articles

Experience of Supervised Internships, Focusing Attention on the Health of Pregnant Women

This study aimed to relate the experience of structuring a supervised curricular internship program, focusing attention on the protocol used to promote oral health of pregnant women, at a Brazilian university. The internship was structured in 3 phases. The first consisted of conceptual construction, in which the students came in contact with the contextualization and theoretical grounding by means of debates, discussions about treatment protocols and interdisciplinary classes. The second phase followed, characterized by experience from the field. This phase was developed through practical action, using the protocols designed in the dental clinics of the university. Finally, there was a reflective phase in which the results of the practical experience were discussed. The proposal of this internship was able to attain the 3 pillars of university instruction: practice, teaching, and research.

Self-reported oral health and hygiene habits, dental decay, and periodontal condition among pregnant European women

Objective To investigate the relationship among self-reported oral hygiene habits, dental decay, and periodontal condition among pregnant women. Method In a cross-sectional study, a structured questionnaire and dental examination were used to assess pregnant women's knowledge of oral health and attitudes to oral hygiene, in addition to their dental and periodontal condition. Data were collected from 337 pregnant women living in Murcia in southeast Spain. Results The questionnaire was completed by 337 women, 282 of whom also had an oral examination. More than 57% were in their first pregnancy, their mean age was 30 years, and most (80.1%) were Spanish with a medium-high educational level. Most of the pregnant woman (84%) brushed their teeth 2 or 3 times a day, and a third (30.9%) used a mouthwash daily. The pregnant women who self-reported having good or very good dental health had a lower level of active decay ( P < 0.001) and a lower periodontal index ( P < 0.001). Conclusion In the present study, there was a significant correlation between a high level of self-reported oral health in pregnant women and low levels of dental decay and low periodontal indexes.

Relation of salivary antioxidant status and cytokine levels to clinical parameters of oral health in pregnant women with diabetes

ObjectiveBoth pregnancy and diabetes are thought to predispose to the impairment of oral health. As saliva contributes to oral homeostasis, we have characterised its properties and flow rate in pregnant women with or without diabetes. DesignUnstimulated whole mixed saliva was collected from 63 women in the first trimester of pregnancy and analysed for the concentration of selected antioxidants, cytokines, and growth factors. ResultsPregnant women with diabetes were found to have markedly increased indexes of caries activity, plaque formation, gingival and periodontal status, as well as increased salivary antioxidant capacity and pro-inflammatory cytokine levels. These changes were more pronounced in patients with long-term disease and systemic diabetic complications, but only partly correlated with the level of blood glycated haemoglobin. Of the cytokines examined, salivary VEGF and HGF concentrations in diabetic pregnant women correlated in a positive and negative manner, respectively, with the prevalence of caries. Moreover, VEGF levels in this group correlated inversely with the probing depth and clinical attachment levels. All such associations did not occur in healthy individuals. In contrast, the salivary pH and flow rate correlated inversely with several parameters of caries and plaque formation irrespectively of whether the pregnant women were diabetic or not. ConclusionsDiabetes in pregnant women significantly changes saliva properties, which may contribute to accelerated deterioration of the oral status in this population.

Promoting oral health during pregnancy: current evidence and implications for Australian midwives

The aim of this paper is to examine current evidence supporting the promotion of oral health during pregnancy and proffer aspects of a potential role for Australian midwives. Research continues to show that poor oral health during pregnancy can have an impact on the health outcomes of the mother and baby. Poor maternal oral health increases the chances of infants developing early caries and is strongly associated with adverse pregnancy outcomes such as preterm and low birth-weight babies. Unfortunately in Australia, no preventive strategies exist to maintain the oral health of pregnant women. Systematic review. This review examines all literature on oral health during pregnancy published to date in the English language and focuses on whether preventive oral health strategies during the prenatal period are warranted in Australia and if so, how they could be provided. Maintaining oral health is important during pregnancy and many developed countries have implemented preventive strategies to address this issue using non-dental professionals such as prenatal care providers. However, despite the positive international evidence, limited importance is being given to the oral health of pregnant women in Australia. It is also evident that the unique potential of prenatal care providers such as midwives to assess and improve maternal oral heath is not being thoroughly utilised. Compounding the issue in Australia, especially for pregnant women from socioeconomically disadvantaged backgrounds, is the limited access to public dental services and the high cost of private dental treatment. Promoting and maintaining oral health during pregnancy is crucial, and preventive prenatal oral health services are needed in Australia to achieve this. Midwives have an excellent opportunity to offer preventive oral health services by providing oral health assessments, education and referrals for pregnant women attending antenatal clinics.

Pregnancy and oral health: Forgotten territory revisited !

Pregnancy and early childhood are particularly important times to access oral health care because the consequences of poor oral health can have a lifelong impact (1). Improving the oral health of pregnant women prevents complications of dental diseases during pregnancy, has the potential to decrease early childhood caries and may reduce preterm and low birth weight deliveries. Evidence suggests that most young children acquire caries-causing bacteria from mothers. Cariogenic or decay-causing bacteria are typically transmitted frommother or caregiver to child by behaviours that directly pass saliva, such as sharing a spoon when tasting baby food.

18개월간 자일리톨 껌 저작에 따른 Streptococcus mutans의 집락 형성 억제효과

본 연구는 임신 및 수유기간 동안 구강위생상태가 불량해질 수 있는 임산부에 있어서 장기간의 자일리톨 섭취가 Streptococcus mutans(S. mutans) 집락수에 어떠한 영향을 미치는 지에 대해 알아보고자 하였다. 임산부구강건강 예방프로그램에 대상자를 자발적으로 모집하여 두 군(실험군과 대조군)으로 나눈 후 18개월간 추적 조사하였다. 자극성 타액은 오후시간(1:00-3:00 p.m.)에 초기, 6개월, 12개월 및 18개월에 채취하였다. 구강보건행태(잇솔질 횟수와 정기구강검진)에 관한 정보는 설문지를 통해서 얻어졌다. 타액 내 자일리톨군의 연구기간에 따른 S. mutans 평균집락수의 차이는 통계적으로 유의하였으며, 특히 연구초기에 비해 출산 후 6개월, 12개월 및 18개월 모두에서 유의한 감소를 나타내었다. 반면 대조군에서는 연구초기에 비해 출산 후 18개월에서만 유의한 감소를 나타내었다. 이상의 결과를 종합해 보면, 자일리톨의 장기적인 섭취는 구강 내 S. mutans 집락수를 감소시킴으로써 임산부들에 있어서도 치아우식증 예방효과가 나타날 수 있을 것으로 사료된다. The purpose of this study was to evaluate suppression of Streptococcus mutans(S. mutans) colonization by long-term xylitol consumption among pregnant women who can easily get bad oral hygiene status during pregnancy and breast feeding. Participants were voluntarily recruited for a pregnant women's oral health prevention program, classified into two groups(a control and a xylitol group), and then followed for 18 months. Stimulated whole saliva was collected in the afternoon(1:00-3:00 p.m.) at baseline, 6 months, 12months, and 18 months. Information regarding oral health behavior(tooth brushing frequency and regular dental visits) was obtained via a questionnaire. S. mutans counts of the xylitol group decreased considerably between baseline and the re-examinations at 6, 12, and 18 months. Although the S. mutans counts decreased for all time points compared to baseline in the control group, these differences did not reach significance except 18 months. Regular chewing of xylitol gum over a long period may lead to decrease the colony counts of S. mutans.

IMPLEMENTACIÓN DE UN PROGRAMA EDUCATIVO, DIRIGIDO AL PERSONAL DE SALUD RESPONSABLE DEL CONTROL PRENATAL ORIENTADO A PROMOVER LA SALUD ORAL DE LAS GESTANTES

Objective: Implementation of an educative material oriented to promote the oral health in pregnant women managed by the personnel of health responsible for the prenatal control.Methods: A not controlled clinical test was done. There were chosen 26 professionals of prenatal control programs and 40 pregnant women that fulfilled the established criteria of inclusion. Each one of groups was divided in two, experimental and control. The four groups were evaluated by knowledge questionnaires about prevention and oral health in pregnant women before and after receiving an educative material. In the pregnant women also a clinical examination, DMFT, CIPTN, ICP and a Quantified index of Plaque exams were done before and after the intervention. There were analyzed the variables evaluated in the groups of professionals and pregnant women in the experimental and control groups.Results: In relation with the knowledge on prevention in health’s professionals, there were observed statistically significant differences (p=0,030) between the groups because the average of 53,8% of positives answers before of intervention, increased, after the intervention (84,6%) (p=0,013) between the groups. On the other hand, pregnant women showed statistically significant differences in the variables: DMFT (p=0,0342), CPITN (p=0,000), and the quantified index of plaque (p=0,00l6).Conclusion: The implementation of an educative program directed to professionals of health in charge of the prenatal control can improve the conditions of the oral health in the pregnant women.

Periodontal status, tooth loss and self-reported periodontal problems effects on oral impacts on daily performances, OIDP, in pregnant women in Uganda: a cross-sectional study

BackgroundAn important aim of antenatal care is to improve maternal health- and well being of which oral health is an important part. This study aimed to estimate the prevalence of oral impacts on daily performances (OIDP) during pregnancy, using a locally adapted OIDP inventory, and to document how periodontal status, tooth-loss and reported periodontal problems are related to oral impacts.MethodsPregnant women at about 7 months gestational age who were members of a community based multi-center cluster randomized community trial: PROMISE EBF: Safety and Efficacy of Exclusive Breast feeding in the Era of HIV in Sub-Saharan Africa, were recruited in the district of Mbale, Eastern Uganda between January 2006 and June 2008. A total of 877 women (participation rate 877/886, 98%, mean age 25.6, sd 6.4) completed an interview and 713 (participation rate 713/886, 80.6%, mean age 25.5 sd 6.6) were examined clinically with respect to tooth-loss and according to the Community Periodontal Index, CPI.ResultsSeven of the original 8 OIDP items were translated into the local language. Cronbach's alpha was 0.85 and 0.80 in urban and rural areas, respectively. The prevalence of oral impacts was 25% in the urban and 30% in the rural area. Corresponding estimates for CPI>0 were 63% and 68%. Adjusted ORs for having any oral impact were 1.1 (95% CI 0.7-1.7), 1.9 (95% CI 1.2-3.1), 1.7 (1.1-2.7) and 2.0 (0.9-4.4) if having respectively, CPI>0, at least one tooth lost, tooth loss in molars and tooth loss in molar-and anterior regions. The Adjusted ORs for any oral impact if reporting periodontal problems ranged from 2.7(95% CI 1.8-4.2) (bad breath) through 8.6(95% CI 5.6-12.9) (chewing problem) to 22.3 (95% CI 13.3-35.9) (toothache).ConclusionA substantial proportion of pregnant women experienced oral impacts. The OIDP impacts were most and least substantial regarding functional- and social concerns, respectively. The OIDP varied systematically with tooth loss in the molar region, reported chewing-and periodontal problems. Pregnant women's oral health should be addressed through antenatal care programs in societies with limited access to regular dental care facilities.

Socio-demographic factors related to periodontal status and tooth loss of pregnant women in Mbale district, Uganda

BackgroundInformation on the socio-behavioral distribution of periodontal status and tooth loss in pregnancy emanating from sub Saharan Africa is sparse. This study examined periodontal status and tooth loss in pregnant Ugandan women and assessed the relationship with socio-demographics factors, parity, dental care and oral hygiene.MethodsMothers were participants of a multicentre cluster-randomized behavioral intervention study (PROMISE-EBF Safety and Efficacy of Exclusive Breast feeding Promotion in the Era of HIV in Sub-Saharan Africa). In Uganda, these were pregnant women resident in Mbale district, recruited into the PROMISE EBF study between January 2006 and June 2008. A total of 886 women were eligible to participate of whom information became available for 877 (participation rate 98.9%, mean age 25.6) women who participated in the recruitment interview and 713 (mean age 25.5) women who got a clinical oral examination. Periodontal status was assessed using the Community Periodontal Index of Treatment Needs (CPITN).ResultsThe prevalence of tooth loss was 35.7%, 0.6% presented with pockets shallow pockets (4–5 mm), whereas 3.3% and 63.4% displayed bleeding and calculus, respectively. A total of 32.7% were without any sign of periodontal disease. Binary logistic regression analyses revealed that older women, women from larger households and those presenting with microbial plaque were respectively, 3.4, 1.4 and 2.5 times more likely to have CPI score >0. Rural (OR = 0.9), nulliparous (OR = 0.4) and women who never visited a dentist (OR = 0.04) were less likely, whereas women from larger households (OR = 1.5) were more likely to have lost at least one tooth.ConclusionThe results revealed moderate prevalence of bleeding and tooth loss, high prevalence of calculus, low frequency of pockets 4–5 mm. Disparity in pregnant women's oral health related to parity suggests that education of maternity care providers concerning oral health in pregnancy is warranted.Trial registrationClinicalTrials.gov Identifier NCT00397150

Pregnancy and Oral Health

This article presents a review of the research relevant to oral health during pregnancy and includes nursing practice recommendations for referral of women to a dentist for safe and effective dental care during pregnancy. In recent years, research linking periodontitis to the risk for adverse birth outcomes has resulted in increased interest in the topic of oral health during pregnancy. The achievement of optimal oral health in pregnant women as its own benefit, however, has in the past been hampered by myths surrounding the safety of dental care during pregnancy. Many women also lack access to dental care and dental insurance, which interferes with their ability to receive adequate oral care during pregnancy. Intraoral changes that occur with pregnancy because of hormonal changes, combined with lack of routine exams and delays in treatment for oral disease, place pregnant women at higher risk for dental infections.

Maternal Periodontal Disease, Pregnancy, and Neonatal Outcomes

The purpose of this article is to review the current literature on the association between maternal periodontal disease and poor pregnancy and neonatal outcomes and outline the role nurses can play in improving the oral health of pregnant women. Maternal periodontal disease is linked to preterm birth, low birthweight, and preterm low birthweight, but treatment of periodontal disease during pregnancy has been shown to be safe and effective. Nurses, nurse practitioners, and nurse-midwives are in a position to educate pregnant women on the benefits of good oral health and identify and refer women who are in need of dental care for treatment.

Relato de gestantes quanto à ocorrência de alterações bucais e mudanças nos hábitos de dieta e higiene bucal

This study had the objective to assess the knowledge and occurrence of oral alterations, reported by pregnant women, and to investigate the changes in their diets and oral hygiene habits during the gestational period. Eighty pregnant women were interviewed in Maringa–PR, using a questionnaire with 64 questions. The results obtained demonstrated that 45% of pregnant women reported oral alterations, being the periodontal alteration the one mostly cited. Only 50% of the sample said having any knowledge about gingivitis and 80% did not know how to prevent it. In relation to dental caries, 48.75% thought it was normal to acquire the condition during the gestation. Brushing frequency decreased in 27.5% while feeding frequency increased (77.5%), especially sugars, increasing the risk of caries. The occurrence of regurgitation was 62.5%, taking place especially in the first quarter. It was concluded that educational and preventive measures are needed to better see to the pregnant women oral health needs.

The oral conditions and pregnancy study: periodontal status of a cohort of pregnant women.

Our objective was to describe the oral health of pregnant women, to determine oral health changes during pregnancy, and to determine factors associated with maternal periodontal health or disease. Between December 1997 and July 2001, 1,224 pregnant women at < 26 weeks' gestation were enrolled in the study and oral health examinations were performed at enrollment and within 48 hours of delivery. Demographic, medical, and health behavior data were determined by chart abstraction and questionnaire. Comparisons between oral health at enrollment and delivery were made by student t test or Fisher's exact test. Ordinal logistic regression analysis was used to identify risk factors for maternal periodontal disease. Among 903 women, there was a significant increase in those with health/periodontal disease absence between enrollment and delivery (P < 0.001). However, we also observed a significant increase in women with four or more sites with attachment loss > or = 2 mm or > or = 3 mm (P < 0.05, 0.001). Race, smoking, and insurance status were significantly associated with maternal periodontal disease. Black women were more likely than white women to have periodontal disease at enrollment (adj. odds ratio 2.9, 95% confidence interval 2.2 to 3.9) and delivery (adj. odds ratio 3.1, 95% confidence interval 2.2 to 4.2), and experience incident disease (adj. odds ratio 2.3, 95% confidence interval 1.6 to 3.4). Oral health examinations were well accepted by pregnant women. An increase in attachment loss may represent active periodontal infection accelerated by pregnancy. Further study on racial disparity in oral health among pregnant women is needed. Continued efforts to evaluate and establish appropriate definitions of oral disease in pregnancy are warranted.