Title: Social Determinants in access and dental care for pregnant women
Abstract:
Dental care during pregnancy is an opportunity to enhance behaviors and habits for promoting health and prevention of disease and to contribute to reduce childbirth-related complications and low birth weight.
The purpose of this paper is to share the results of different studies of the line of research on social determinants in dental care for pregnant women from the Pacific XXI research group of the School of Dentistry at the University of Valle in Cali, Colombia.
The first study carried out in 2009 evaluated the presence of inequities in dental care in a health network in Cali-Colombia; it was a retrospective descriptive study, where it was found that the uninsured population had a DMF index of 11.12 while the DMF index of the insured was 9.41. In restorative dentistry, treatments were completed in 63.7% of the insured population, 33.3% of the uninsured population.
The following study aimed to describe the differences or similarities between the prevalence of caries, gingivitis and oral hygiene in pregnant and non-pregnant women in 13 municipalities of Valle del Cauca in Colombia between 2009 and 2011. In this study, we found that The prevalence of caries and gingivitis was higher in pregnant women; The existence of differences between pregnant and non-pregnant women in relation to age, prevalence of gingivitis, percentage of plaque, DMF index, oral health knowledge and food consumption between meals were also identified.
The third study was a review of accessibility using the Guide on implementation of the narrative synthesis used in systematic Reviews of research evidence. The most frequently identified relating to access to dentistry-related factors were: age of the pregnant woman, schooling level, ethnicity, marital status, income, occupation, socioeconomic level and attention-related social dynamics as access to information, health assurance and use of dental service according to trimester of gestation.
A cross-sectional analytical study was conducted in a sample of 993 postpartum women who had given birth in public and private clinics in 2012. Multivariate analysis showed that dental care was associated with: economic resources (86.6% sufficient resources versus 72.5% insufficient resources; OR = 1.8; 95%CI: 1.1-2.8), schooling (88% complete versus 74% incomplete secondary school, OR = 1.7; 95%CI: 1.1- 2.7), and receiving information on oral health and dental care during prenatal care (86.4%: yes versus 42.9%: no, OR = 5.7; 95%CI: 3.1-10.0). The rate of attendance to dental appointments during pregnancy was 83%, and the distribution was unequal. Social determinants such as the socioeconomic and lifestyle levels were associated with the pregnant mothers’ access to dental services.
Analyzed the database of the IV National Oral Health Study for 1050 pregnant women evaluated, we found results similar to the study of accessibility to dentistry that we had done in Cali in 2012; Attendance at the dentistry service was associated with remission performed from prenatal control, urban / rural location, social security, ethnicity and Have received education and brushing instruction in the last year.
