Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Master of Science


Epidemiology and Biostatistics


Jessani, Abbas

2nd Supervisor

Campbell, M.Karen



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.

Summary for Lay Audience

Due to the higher susceptibility of pregnant women to oral and dental diseases such as dental cavities, gum diseases, and bad breath in addition to the suggested association between oral conditions and pre-term birth and low birth weight, it is recommended that pregnant women have regular dental visits. Concerningly, there are factors that prevent pregnant women from utilizing dental care services. We aimed to investigate factors related to oral health status and dental visit patterns. First, for a better understanding of one of the inhibiting factors for dental care access during pregnancy, we reviewed the findings of 45 studies regarding common oral health misbeliefs during pregnancy. Our review revealed that misbeliefs such as “pregnant women lose their teeth because of pregnancy”, “dental treatments are harmful to the fetus”, and “the fetus absorbs calcium from the mother’s teeth” were discussed by most of the studies. We further conducted a survey-based study on women recruited from an obstetrics clinic that served women who do not have family physicians. We gathered self-reported information on their social circumstances, their perception of their oral health, oral symptoms, their dental visit patterns, and reasons for (not) visiting a dentist during pregnancy. We found that less than one-fourth of the participants perceived their oral health as poor or fair. Most pregnant women visited a dentist within the last two years. However, less than one-fourth had a dental visit while pregnant. Pregnant women with higher education levels and those who used dental floss on a daily basis had better oral health. Also, women who had dental insurance and better oral health were more likely to visit a dentist within the last two years. Education improvement and dental insurance provision policies may benefit oral health and dental visit patterns of this group of people. Further analyses need to be conducted on more subjects to reveal any associations which might have been concealed due to the small sample.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Available for download on Friday, April 25, 2025