Self-perceived Oral Health Status and Oral Healthcare Services Utilization among an Underserved Sample of Pregnant Women in London, Ontario.
Abstract
Background: Oral health during pregnancy is of high importance because of the impacts physiological alterations have on oral health and because adverse pregnancy outcomes can result from oral and dental conditions. Previous studies demonstrated a high dental visit avoidance among pregnant women due to barriers such as cost and misbeliefs.
Objectives: The main objective of this thesis was to investigate the unmet dental and oral needs during pregnancy, and associated factors, through two complementary studies.
Methods: A systematic literature review was conducted regarding misbeliefs about oral health and dental visits during pregnancy. A survey-based study was conducted on a clinic-based sample of pregnant women in London, Ontario.
Results: The most common misbeliefs discussed in the 45 studies included in our Systematic Review were related to the safety of dental care services utilization and treatments, and the supposed impacts of pregnancy on oral health. The pilot study recruited 67 of 76 eligible subjects, of whom 76.1% reported having good to excellent oral health and 82.1% had visited a dentist within the last two years. Of 51 who had no dental visit during pregnancy, 12 believed it was not necessary, while cost was a barrier for 18 individuals. Age (p=0.001), education (p=0.003), and dental flossing frequency (p=0.035) were significantly associated with self-reported oral health. Women with dental insurance (p=0.022) and good to excellent oral health status (p=0.029) were more likely to have visited a dentist within the last two years. Oral health status and dental visit patterns of the study sample were poorer than the Canadian general population, and may reflect the clinic which was a disadvantaged population.
Conclusion: Educational interventions regarding oral health awareness and policies improving access to dental insurance may improve the unmet oral and dental needs and access to dental care services. Further analyses of more diverse populations and larger samples are required to provide a better understanding of the unmet oral needs and dental visit patterns during pregnancy.