Have You Seen A Dentist -- Lately?
Researchers from the Centers for Disease Control and Prevention in Atlanta and the Health Resources Service Administration in Washington examined data from 25 geographical areas obtained through the 1997-98 Pregnancy Risk Assessment Monitoring System (PRAMS), a questionnaire survey of women who recently gave birth. Of the 25 areas, four states -- Arkansas, Illinois, Louisiana and New Mexico -- included oral health questions on the PRAM Survey, resulting in a study sample size of 9,040 women.
According to the study, fewer than 35 percent of pregnant women in these states sought dental care. Three states, New Mexico, Illinois and Louisiana, asked pregnant women if they needed to see a dentist for a problem during pregnancy. Researchers found only about half of the women who reported dental problems during pregnancy sought dental care.
"Because most adults would be due for a routine dental visit during any nine-month period and because the need for periodontal care actually may increase during pregnancy, our findings raise serious concerns about dental care-seeking behaviors during pregnancy," says lead researcher Mary Lyn Gaffield, PhD, MPH.
Previous research has documented the effects of hormones on the oral
health of pregnant women. Changes in estrogen and progesterone levels
affect the nature of the body's response to the bacteria responsible for
causing periodontal infections. These infections may pose a threat to
the placenta and fetus, increasing the likelihood of pre-term delivery,
according to the researchers.
According to the study, the strongest factors associated with a reluctance to see a dentist, even while experiencing dental problems during pregnancy, include:
- Type of prenatal insurance. Women on Medicaid were 24 to 53 percent less likely to seek dental care.
- Timing of initial prenatal care. Women in New Mexico who began their prenatal care after the first trimester were 53 percent less likely to seek dental care; Illinois women were 44 percent and Louisiana women were 42 percent less likely to seek dental care in the same situation.
- Income. Women with an annual household income of less than $20,000 per year were significantly less likely to seek dental care.
According to the researchers, few programs in the United States aim to achieve widespread improvements in the oral health of pregnant women or their infants. A coordinated effort from the dental and obstetric communities to establish guidelines could benefit maternal oral health and newborn infant outcomes, the researchers conclude.
The American Dental Association recommends that pregnant women eat a
balanced diet, brush their teeth thoroughly with an ADA-accepted
fluoride toothpaste at least twice daily, floss at least once a day and
schedule regular dental visits and periodic professional teeth