Title: Oral health status and barriers to utilization of dental services among pregnant women in sunsari, Nepal: A cross-sectional study
Objectives: Oral health is an integral part of preventive health care for pregnant women and their newborns and this has been well recognized by the World Health Organization. Several reasons have been cited as barriers to seeking oral health care services utilization among antenatal mothers. Although oral problems have been considerably seen more in pregnant women as compared to non-pregnant women, low use of dental services has been reported among pregnant women by several studies. Therefore, this study was conducted to assess oral hygiene practices, oral health status, and barriers to utilization of oral health care services among pregnant mothers attending two family health care clinics in Sunsari, Nepal.
Methods: A cross-sectional study was conducted among 139 women using a purposive sampling technique. The data collection was done using a pretested standard semi-structured questionnaire. Face-to-face interview of the participants was done by a single investigator in the local language (Nepali). Periodontal status (modified CPI), dentition status, and treatment needs were assessed by a single investigator using a mouth mirror and CPI probe. All teeth present in the mouth were examined for the absence or presence of gingival bleeding and the absence or presence of periodontal pockets. Categorical values are presented as percentages and continuous data are displayed as means ± SD. For bivariate statistical analysis, Independent Sample T-test and one-way ANOVA tests were used. Independent sample T-test was used to determine the correlation of DMFT scores, bleeding on probing, periodontal pockets and loss of attachment with gravidity, socioeconomic status, self-reported oral health status, forgetting to brush teeth, use of toothpaste, type of toothpaste, use of interdental cleaning aids frequency of interdental cleaning aids and dental visit. ANOVA test was used to determine the correlation of DMFT scores, bleeding on probing, periodontal pockets, and loss of attachment with age, trimester of pregnancy, occupation, education, self-reported oral health problems, frequency of toothbrushing, and types of interdental cleaning aids. The level of significance was set at p<0.05.
Results: The majority of pregnant mothers brushed their teeth once a day or less than once a day (n=106,76.3%) and self-reported perceived oral health status was poor/fair (n= 93, 66.9%). The prevalence of dental caries was found to be 69.8%. Bleeding on probing was present in all participants. DMFT, presence of bleeding on probing, and increased periodontal pocket were significantly high among women who had self-reported their oral health problems in comparison to those who had not reported any problem. The most common barriers reported by the participants were a lack of knowledge about a dental checkups and a lack of perceived need for dental care during pregnancy.
Conclusions: There was a high prevalence of dental caries and periodontal disease. Lack of knowledge and perceived need for dental care were the major barriers found in this study. Hence, this directs toward the utmost need for improvement in awareness level as well as oral hygiene practices.
Audience Takes Away:
- Oral hygiene practices and oral health status was not satisfactory among antenatal mothers.
- Oral health care services should be integrated with antenatal care services for all pregnant women.
- Oral health education can be included as a part of prenatal care which can improve their knowledge regarding the importance of oral health among pregnant women.
- Specific preventive oral health care programs should be made an integral part of antenatal care by including a dentist in the antenatal team.