Oral health practice and status, knowledge and attitude, and oral health-related quality of life among pregnant women

Abstract

Introduction: Along with significant hormonal changes during pregnancy, women’s oral health (OH) status may be altered as well. Pregnancy offers opportune time for promoting women’s health-related behaviours, including OH practices.

Aim of the cross-sectional study: To investigate the OH practices and experience, knowledge and attitude, and oral health-related quality of life (OHRQoL) among pregnant women in Hong Kong. Methods: Pregnant women attending antenatal check-up were invited to participate in a self-completed questionnaire survey on OH behaviour, knowledge, attitude, perceived OH status and OHRQoL. Maternal and sociodemographic background information was also collected. Results: 781 pregnant women with a mean age of 32.4 years (SD=4.5) and a mean gestational age of 23.4 weeks (SD=9.1) participated in the questionnaire survey. Only 16% of the participants had visited a dentist after getting pregnant. The most frequently perceived dental problems during pregnancy were gum bleeding (37.4%), bad breath (21.6%) and tooth sensitivity (16.3%). The mean OHIP-14 score was 3.7 (SD=6.3). Those having perceived OH problems (IRR=2.50, p<0.001), perceiving poorer OH status (p=0.004. poor vs. good, IRR=2.66, p=0.001; fair vs. good, IRR=1.14, p>0.05), or having nausea-vomiting (IRR=1.44, p=0.009) had a higher OHIP-14 score (worse OHRQoL). Participants having higher OH attitude score had a lower OHIP-14 score (IRR=0.82, p=0.001). Conclusions: Dental visits are not common among pregnant women in Hong Kong, but experiencing OH problems is common. OHRQoL of these pregnant women is good. Experience of OH problems, poorer perceived OH status, less positive OH attitude and nausea-vomiting are associated with poorer OHRQoL.

Aim of the randomized controlled trial: To improve the OH practice, knowledge, attitude, and status among pregnant women by family-centered OH promotion starting from an initial stage of pregnancy. Methods: First-time pregnant women (around 12-20 gestational week) were recruited. The participants were randomly allocated to Group 1 (control: received OH pamphlets) and Group 2 (intervention: received pamphlets plus individualized personal OH education). Dental examination on caries, visible plaque and periodontal status and self-completed questionnaire on OH behaviours knowledge and attitude, and OHRQoL were conducted. Change in OH status, behaviour, knowledge and attitude as well as OHRQoL were evaluated at the 32nd gestational week follow-up. Results: 589 pregnant women with a mean age of 31.1 years (SD=4.0) and a mean gestational age of 14.4 weeks (SD=2.6) participated in the RCT. The baseline mean VPI score and BOP score were 0.20 (SD 0.16) and 0.58 (SD 0.27), respectively. In both groups of participants, their VPI score and BOP score were significantly lower at follow-up compared with baseline (p<0.05). BOP score in intervention group was significantly lower than that in control group at follow-up (0.35 vs. 0.53, p=0.031). In both groups, significantly higher proportion of participants used additional tooth cleaning methods at follow-up compared with baseline (Control group: from 70% to 76.8%, p=0.029. Test group: from 64% to 72.1%, p=0.006). Conclusions: Family-centered OH promotion in this study improved the OH status and practices among the pregnant women. Significant additional improvement in gingival health status through providing individualized OH education was found at follow-up.