Oral Hygiene Practices and Dental Service Utilization Among Pregnant Women

BackgroundDaily oral hygiene and regular dental visits are important components of oral health care. The authors&apos; objective in this study was to examine women&apos;s oral hygiene practices and use of dental services during pregnancy.MethodsThe authors developed a written oral health questionnaire and administered it to 599 pregnant women. They collected demographic information, as well as data on oral hygiene practices and use of dental services during pregnancy. They used χ² and multivariable logistic regression models to assess associations between oral hygiene practice and dental service use during pregnancy and to identify maternal predictor variables.ResultsOf the 599 participants, 83 percent (n = 497) reported brushing once or twice per day. Twenty-four percent (n = 141) reported flossing at least once daily; Hispanic women were more likely to floss than were white or African American women (28 percent [52 of 183] versus 22 percent [54 of 248] versus 19 percent [23 of 121], respectively, P < .001). Seventy-four percent (n = 442) of the participants reported having received no routine dental care during pregnancy. Hispanic women were significantly less likely than were black or white women to receive routine dental care during pregnancy (13 percent versus 21 percent versus 36 percent, respectively, P < .001). The authors found that being older than 36 years, being of Hispanic race or ethnicity, having an annual income of less than $30,000, flossing infrequently and receiving no dental care when not pregnant were significantly associated with lack of routine dental care during pregnancy (adjusted odds ratios, 95 percent confidence intervals: 2.56 [1.33–4.92]; 2.19 [1.11–4.29]; 2.02 [1.12–3.65]; 1.86 [1.13–3.07]; and 4.35 [2.5–7.69], respectively). A woman&apos;s lack of receiving routine dental care when not pregnant was the most significant predictor of lack of receiving dental care during pregnancy.ConclusionRacial, ethnic and economic disparities related to oral hygiene practices and dental service utilization during pregnancy exist.Clinical ImplicationsMedical and dental care providers who treat women of reproductive age and pregnant women need to develop policy strategies to address this population&apos;s access barriers to, and use of, dental care services.     

Dental Anxiety Amongst Pregnant Women: Relationship With Dental Attendance and Sociodemographic Factors

Introduction: Access to oral care during pregnancy is important for the maintenance of optimal oral health.Objective: The aim of this study was to estimate dental anxiety (DA) and its association with previous dental visits and sociodemographic factors amongst pregnant women.Methods: A cross-sectional study was conducted (June through August 2019) amongst pregnant women (N = 825) attending hospitals and health centres in Dhahran, Khobar, and Dammam cities in the Eastern province of Saudi Arabia. The Modified Dental Anxiety Scale (MDAS) was used to assess DA and the World Health Organization Oral Health Survey for Adults was administered to evaluate patterns of dental attendance.Results: DA was found in 90.9% of the pregnant women. The mean DA score of the sample was 12.53 ± 5.33 (range, 5 to 25) and it was significantly higher amongst non-Saudi (13.21 ± 5.24) vs Saudi women (12.15 ± 5.34) (P = .006), those who had negative dental experience (13.99 ± 5.62) vs those without such experience (12.2 ± 5.21) (P < .001), and those with dental pain or discomfort (13.18 ± 5.46) vs without pain or discomfort (11.94 ± 5.14) (P = .001). The study found a significant relationship between DA and reasons for dental attendance before pregnancy (P = .002) and time since the last dental visit (P = .009). Multiple logistic regression analysis showed significantly increased odds (OR, 1.69; 95% CI, 1.25 to 2.27) of experiencing moderate to extreme DA amongst pregnant women who visited the dentist after a year/never visited compared to those who visited in less than a year. Similarly, participants with negative dental experience were significantly more likely to have moderate to extreme DA (OR, 1.49; 95% CI, 1.02 to 2.20) than those without negative experience after adjusting for sociodemographic factors.Conclusions: DA was highly prevalent amongst pregnant women, which was significantly associated with negative dental experience, dental pain or discomfort, and reasons for and time since the last dental visit.     

1720名孕妇牙体牙周健康状况的调查分析

目的：调查分析武汉市孕妇牙体牙周健康状况,为孕前孕期妇女口腔疾病防治提供依据。方法：按照世界卫生组织制定的口腔健康调查基本方法,对5160名孕妇通过随机抽样,采用口腔健康数据库管理系统记录1720名孕妇牙体牙周健康状况。结果：孕妇总患龋率为58．6％,龋均为1．54,龋面均为2．43。牙龈炎患病率72．1％,结石检出率为53．6％。随着孕周的增加龋患率没有明显差异,牙龈炎的发生明显加重,有统计学意义。结论：孕期妇女牙体牙周健康状况较差,提示应加强孕妇口腔卫生宣传指导,采取措施积极治疗口腔疾病。     

The Missouri Elks Mobile Dental Program–Dental Care for Developmentally Disabled Persons

This article describes the origins, funding, organization, operation, utilization, and outreach program of a statewide mobile dental program for the disabled in Missouri. The article includes information based on analysis of productivity reports and patient records. Comparisons are made between the utilization by mentally retarded (MR) and other disabled patients (MCCS), their county of residence, and the location where service was provided (rural vs urban). The mean number of dental procedures provided per client was 7.3. More procedures (8.35) were provided to urban clients than rural clients (5.81). The utilization rate of urban MR clients was 63.9 percent, compared to 60 percent for rural MR clients. Other findings show 10.7 percent urban MCCS clients utilized the mobile dental program, versus 13.5 percent of the rural MCCS clients. The budgeted expenditures for providing care to this underserved group were $46,000 less than the estimated value of dental care provided in a private practice setting.     

The How and Why of the ADA''s Evaluation of Dental Materials, Instruments, and Equipment

The evaluation program of the Council on Dental Materials, Instruments, and Equipment of the American Dental Association is described.     

Recommended revisions to American Dental Association guidelines for acceptance of chemotherapeutic products for gingivitis control

This paper presents suggested revisions to the American Dental Association's 1985 guidelines for acceptance of anti-gingivitis chemotherapeutic agents. The areas of study design, choice and quality control of clinical gingivitis measurements, statistical analysis, and minimum strength of effect, are addressed. The revisions articulate certain aspects of study design which were implicit in the 1985 guidelines, clarify language on cross-over designs and independence of studies, and recommend use of a United States population in at least one trial supporting a product. Separate recording and analysis of a product's effect on gingival bleeding is proposed, and quality control of clinical measurements receives enhanced emphasis. Modestly elaborated statistical reporting guidelines and strengthened approval criteria, based on size of estimated effect as well as statistical significance, are advocated.     

Gains in Dental Care Use Not Shared by Minority Elders

Americans have steadily increased their reported use of dental services over the past 30 years. Persons aged 65 years and older have made the greatest gains, from 16 percent in 1957–58 to 43 percent in 1989. This article reviews national data on reported use of dental care over the past three decades, focusing on differences in rates of utilization on the basis of age, race, and national origin. In addition, differences in sample selection, definitions of race and national origin, and data collection methodology were reviewed to identify systematic sources of bias in comparing the data. Findings indicate that reported dental care use among minority elders has not increased parallel with elders of all races and national origins. In 1957–59, 17 percent of white elders versus 9 percent of nonwhite elders had seen a dentist within the past year. By 1989 percentages had improved to 45 percent of whites, but only 22 percent of blacks and 40 percent of Hispanics. In addition, reporting and recording race and national origin varied considerably during the three decades, hampering comparisons over time. Finally, published national data on usual correlates of dental care use (dentition status, insurance, age, income, and education) are inadequate to explain the causes of these discrepancies. More research is needed to identify barriers to use of dental care by all Americans, particularly those of African and Hispanic descent. Because these ethnic groups are aging faster than the rest of society, and because dental care use among Hispanic and African American elders lags behind use among all elders, dental and public health professions have a responsibility to investigate the barriers and to plan strategies for improving use of care.     

Issues in Financing Dental Care for the Elderly

The elderly make up an increasingly larger segment of the patient population in dental practices. This article reviews recent epidemiologic, demographic, and health services research, and concludes that significant segments of the elderly are at high risk for oral disease and/or limited access to dental treatment, and consequently warrant classification as high-risk groups for policy considerations. It then proposes policy options to the dental community and public decision makers. Oral care can be viewed as having three components. Two basic components are the primary care component--which includes diagnostic, preventive restorative, and periodontal care--and the acute care component--i.e., the treatment of oral pain, trauma, and infection. The third, rehabilitative component, has to do with the restoration of oral function, including prosthodontics and cosmetic dentistry. Viewing dental care in this perspective may help link funding for dental primary care services with that for other primary health services, and link restoration of function and improvement of quality of life with similar health services, like hearing, vision, and social services. In addition, approaching dental care policy makers on several levels--i.e., federal, state, and local--will contribute to our ability as a profession, in the decades ahead, to meet the oral health needs of more elders: including the frail, those at high risk for oral disease, and those with limited access to care.     

Eligible Veterans'' Choice Between VA-covered and Non-VA-covered Dental Care

Veterans who were eligible for dental care in Department of Veterans Affairs (VA) facilities at no monetary cost responded to a mailed questionnaire. Seventy-one percent were aware that they were actually eligible for VA dental care. However, only 48 percent reported the VA as their only or primary source of dental care. Eligibility status, perceived quality of VA dental care, use of VA medical care, perception that one's income meets expenses, and perceived need for dental care were significant correlates of using the VA as one's current source of dental care. Level of formal education, perception that one's income meets expenses, transportation pattern, geographic distance from a VA facility, and eligibility status were significant correlates of using the VA as one's current medical care source. Research on VA utilization offers the opportunity to study issues of access to, and use of, a large public health care system whose patients largely receive care at no monetary cost. Veterans' use of VA dental and medical care is apparently influenced by a wide variety of factors, ranging from barriers to access to non-VA systems, to characteristics of the VA delivery system itself, to need for treatment.     

Proposed guidelines for American Dental Association acceptance of products for professional, non-surgical treatment of adult periodontitis

Guidelines are suggested for determining efficacy of products to supplement scaling and root planing in professional, non-surgical treatment of adult periodontitis. They result from an extended process including a conference on clinical trials in gingivitis and periodontitis. a subsequent workshop, and commentary from industrial, academic, professional and governmental members of the periodontal research community on two drafts. Recommendations are made in the broad areas of basic study design, subject and periodontal site selection, clinical management, choice of outcome variables, statistical summarization and analysis, and criteria for acceptance. Prominent dissenting views, with justifications for positions taken here, are also provided. Groundwork is laid for possible future guidelines addressing products for primary prevention or over-the-counter uses, or for determining superiority or equivalence of competing products. However, issues are identified which require further exploration before responsible and widely acceptable recommendations can be made in these areas. The guidelines suggested here are meant to form the basis of an evolving document rather than a static standard. It is suggested that they be reviewed frequently in the light of improvement in the technology available for periodontal research, and the emergence of products representing new approaches to periodontal therapy.     

ADA Dental Product Evaluation: Case History

The ADA Acceptance Programs entail a rigorous evaluation of products and offer clear benefits to manufacturers, dental professionals, and consumers alike. This paper outlines the implications of the ADA product-evaluation programs for each of these three constituencies and concludes that while there may be an occasional downside from the manufacturer's standpoint, their net effect is to provide assurances that products are safe, efficacious, and promoted properly.     

Explorative study of the motives for non-utilization of the Danish Youth Dental Care Scheme

The present study attempted to develop an explanatory model for the lack of preventive dental behavior as demonstrated by the non-utilization of the Danish Youth Dental Care Scheme (YDCS). A focused interview was conducted with young, working class men by two carefully trained and experienced interviewers. Analysis of the interviews showed that no single factor could explain non-utilization of the YDCS. Rather a complex of factors partly on the individual social-psychologic, psychologic and economic level and partly on the social level, operating directly and indirectly with varying strength, needs to be considered. A new explanatory model for preventive dental behavior is developed and discussed in the light of recent theories on health behavior.