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 Table of Contents  
ORIGINAL RESEARCH
Year : 2014  |  Volume : 1  |  Issue : 2  |  Page : 66-69

Oral health awareness and experience among pregnant women in a Nigerian tertiary health institution


Department of Preventive Dentistry, Faculty of Dentistry, College of Health Sciences, University of Port Harcourt, Choba Port Harcourt, Rivers State, Nigeria

Date of Web Publication5-Jun-2014

Correspondence Address:
Braimoh Omoigberai Bashiru
Department of Preventive Dentistry, Faculty of Dentistry, College of Health Sciences, University of Port Harcourt, Choba Port Harcourt, Rivers State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2348-2915.133936

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  Abstract 

Background: Data on oral health experiences among pregnant women in developing countries are lacking. The objective of this study was to assess the oral health awareness and experience among pregnant women attending antenatal clinic at the University of Port Harcourt Teaching Hospital, Rivers State Nigeria. Materials and Methods: This was a cross-sectional study carried out during the period between February and March 2013. Pretested, well-structured, and self-administered questionnaire allowing open and closed responses was used for data collection. Results: The age of the subjects ranged from 18 to 49 years and the age group 28-37 years was significantly more (P < 0.00). Majority, 241 (82.0%) significantly had at least secondary education than 53 (18.0%) who had primary education or less (P < 0.01). Less than 10% of the participants were aware of the effect of pregnancy on oral health and the impact of oral disease on pregnancy outcome. In general, the experienced oral health problems among the pregnant women were tooth decay 21.1%, dental pain 42.2%, pain from the gum 22.8%, swollen gum, 23.5%, gum bleeding 32.7%, and excessive salivation 46.1%. However, only 27.9% had visited the dental clinic most of whom, were those with more than three children (P < 0.01). Excessive salivation was significantly experienced more than other oral health problems and in women with three or less children. Conclusion: Oral health awareness among the subjects was poor and a sizeable number of pregnant women experienced oral health problems during pregnancy. There is a need for the development of guidelines that will promote referral and visit of pregnant women for dental consultation.

Keywords: Awareness, dental consultation, guidelines, oral health, pregnancy


How to cite this article:
Bashiru BO, Anthony IN. Oral health awareness and experience among pregnant women in a Nigerian tertiary health institution. J Dent Res Rev 2014;1:66-9

How to cite this URL:
Bashiru BO, Anthony IN. Oral health awareness and experience among pregnant women in a Nigerian tertiary health institution. J Dent Res Rev [serial online] 2014 [cited 2021 Mar 6];1:66-9. Available from: https://www.jdrr.org/text.asp?2014/1/2/66/133936


  Introduction Top


Alarge proportion of pregnant women report oral health problems involving hard- and soft-tissues during pregnancy. [1] Majority of women believe that such problems are normal to occur in pregnancy and would disappear after birth. [2] As a result of this, most pregnant women either do not seek professional dental care or are reluctant to undergo certain dental procedures during pregnancy with fear of possible harm to themselves or their babies. [2],[3] In many antenatal clinics, oral health screening is not routinely done and there are no guidelines to ensure that pregnant women are routinely screened, treated or referred to a dentist for oral care as part of prenatal care. [4],[5] Most times, pregnant women are referred to dentists by obstetricians only when they have oral complaints. [1]

Studies have reported that good oral health in pregnancy is advantageous to both the mother and her baby. Maternal periodontal disease has been linked to preterm birth, low birth weight, and preterm low birth weight. [4],[6] Periodontal disease is both preventable and treatable. Controlling plaque by brushing, flossing and professional prophylaxis, including scaling and root planning help to achieve good oral health in pregnancy. [4]

Prevalence of periodontitis is known to increase in pregnancy. [7],[8] Despite the high prevalence of oral health problems during pregnancy and the established association between pregnancy and oral health, a lot of pregnant women do not seek dental care during pregnancy. [9],[10],[11],[12] The nonutilization of dental health care might be related to lack of awareness of the association between pregnancy and oral health. In addition, there is minimal information available on women's understanding of oral. In Nigeria for instance, only 36.7% of pregnant women are reported to have information on oral care. [13] Furthermore, oral health experience among pregnant women during pregnancy has been reported from the developed countries; [14],[15],[16] however such studies are lacking in developing countries.

The objective of this study therefore, was to assess the oral health awareness and experience among pregnant women attending antenatal clinic at the University of Port Harcourt Teaching Hospital, Rivers State Nigeria.


  Materials and Methods Top


The descriptive cross-sectional study was carried out among pregnant women attending antenatal clinic at the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria between February and March 2013. Pregnant women attending the clinic who gave their informed consent were recruited for the study.

Pretested, well-structured, and self-administered questionnaire allowing open and closed responses was used for data collection. Completion of the questionnaire was interview-guided in local English language (Broken English) for illiterate women. Information on sociodemographic characteristics of subjects was collected. These include age at last birthday, level of education, and number of children. Educational status was further divided into participants with primary education or less and participants with at least secondary education. Information to assess the utilization of dental services and experience of oral health problems during pregnancy was also obtained. In addition, subjects were asked whether or not they were aware of any relationship between oral health and pregnancy.

Data were sorted, organized, and entered into SPPS version 20 (IBM SPSS ® statistics, Armonk, New York, United States) for analysis. Frequency statistics and cross tabulations were done and Chi-square test was used to test for significance between variables at the critical value P < 0.05.


  Results Top


Of the 320 questionnaire distributed, 294 were properly filled and used for the study. The sociodemographic characteristics of the subjects are shown in [Table 1]. The mean age of the subjects was 32.34 ± 4.22 years. The age ranged from 18 to 49 years, with those ≤27 years; 74 (25.2%), 18-37 years; 177 (60.2%) and >37 years; 43 (14.6%). The age group 28-37 years was significantly more (P < 0.00). Majority, 241 (82.0%) significantly had at least secondary education than 53 (18.0%) who had primary education or less P < 0.01). Women having more than three children constitute 54% of the study population.
Table 1: Frequency distribution of the subjects according to sociodemographic characteristics


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Less than 10% of the participants were aware of the effect of pregnancy on oral health and the impact of oral disease on pregnancy outcome. Similarly, <20% of the sample had received oral health education and oral hygiene instructions during pregnancy [Table 2].
Table 2: Number and percent distribution of the association between oral health and pregnancy and information on oral health


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In general, the experienced oral health problems among the pregnant women were tooth decay 21.1%, dental pain 42.2%, pain from the gum 22.8%, swollen gum, 23.5%, gum bleeding 32.7%, and excessive salivation 46.1%. However, only 27.9% had visited the dental clinic most of whom, were those with more than three children (P < 0.01). Excessive salivation was significantly experienced more than other oral health problems and in women with three or less children. Furthermore, women with more than three children and primary education or less significantly experienced dental pain, swollen gum, and bleeding from the gum than those with three or less children [Table 3].
Table 3: Number and percent distribution of participants' oral health experience in a previous pregnancy


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  Discussion Top


Oral diseases impact negatively on pregnancy outcome, yet a number of pregnant women experience oral health problems without seeking dental care. Efforts should be made therefore, to educate, screen and provide dental care for pregnant women with oral health problems in order to improve pregnancy outcome.

In this study, one-third of the women experienced soft- and hard-tissue problems, but only a quarter had visited the dentist. Besides, the presumption that oral health problems in pregnancy is normal, [2],[3] poor utilization of dental services during pregnancy may be related to lack of awareness of the association between pregnancy and oral health and limited availability of oral health information to pregnant women as seen in this current study. The study showed that few pregnant women were aware of the association between pregnancy and oral health; and has received information on oral health education and oral hygiene instructions. It is expected that the health seeking behavior among the pregnant women would be poor due to the poor awareness and limited available information. This is consistent with the findings of other studies that have reported lack of awareness and knowledge of possible connection between oral health and pregnancy outcomes as a barrier to utilization of dental services during pregnancy. [10],[17]

The current study reported only 18% and 16.7% of the pregnant women recalled to have received oral health education and oral hygiene instruction from a dentist respectively when pregnant. This is similar to that reported in Tanzania; [18] but in contrast to a study in Florida USA [16] where it was reported that most pregnant women did not obtain dental care and did not recall to have received any dental information during prenatal visits.

The most common oral condition found in this study was excessive salivation and this was significantly more in women with less parity than women with higher parity. This is in consonance with the of Bukar et al., [19] but in contrast with the work of Bassey et al., [20] who reported gingival bleeding as the most common complaint. The difference might be due to late presentation in second and third trimester of pregnancy during which time some women would have either forgotten such complaint or would consider excessive salivation as normal.

Difference in social class may affect oral health seeking behavior generally. Although largely preventable through evidence-based interventions, both periodontal disease and caries in women of childbearing age are prevalent, particularly among low-income women and members of racial and ethnic minority groups. This study showed that dental pain, swollen, and bleeding gingival significantly occurs in women with primary education or less than those with at least secondary education. This might be due to the fact that Women with primary education or less are of lower socioeconomic status with low-income; they are less likely to seek dental care as seen in this study and more likely to have poor oral hygiene. Poor oral hygiene amplifies gum disease in pregnancy.


  Conclusion Top


Quite a number of pregnant women experienced oral health problems during pregnancy with poor utilization of dental services. The poor utilization of dental services was due to poor oral health awareness and lack of information on oral health. Excessive salivation was reported as the most common oral complaint and experienced oral problems were significantly more in women with not more than primary education. Routine oral screening and health education is required to improve oral health status in pregnancy. There is the also need for the development of guidelines that will promote referral and visit of pregnant women for dental consultation.


  Acknowledgement Top


The authors wish to express their gratitude to Drs. Osagbemiro Babatope and Abe Adesuwa who assisted in the distribution of the questionnaire to the respondents.

 
  References Top

1.Murphey C, Fowles E. Dental health, acidogenic meal, and snack patterns among low-income women during early pregnancy: A pilot study. J Midwifery Womens Health 2010;55:587-92.  Back to cited text no. 1
    
2.Ressler-Maerlender J, Krishna R, Robison V. Oral health during pregnancy: Current research. J Womens Health (Larchmt) 2005;14:880-2.  Back to cited text no. 2
    
3.Dinas K, Achyropoulos V, Hatzipantelis E, Mavromatidis G, Zepiridis L, Theodoridis T, et al. Pregnancy and oral health: Utilisation of dental services during pregnancy in northern Greece. Acta Obstet Gynecol Scand 2007;86:938-44.  Back to cited text no. 3
    
4.Mills LW, Moses DT. Oral health during pregnancy. MCN Am J Matern Child Nurs 2002;27:275-80.  Back to cited text no. 4
    
5.Zanata RL, Fernandes KB, Navarro PS. Prenatal dental care: Evaluation of professional knowledge of obstetricians and dentists in the cities of Londrina/PR and Bauru/SP, Brazil, 2004. J Appl Oral Sci 2008;16:194-200.  Back to cited text no. 5
    
6.Dasanayake AP, Gennaro S, Hendricks-Muñoz KD, Chhun N. Maternal periodontal disease, pregnancy, and neonatal outcomes. MCN Am J Matern Child Nurs 2008;33:45-9.  Back to cited text no. 6
    
7.Jeffcoat MK, Geurs NC, Reddy MS, Cliver SP, Goldenberg RL, Hauth JC. Periodontal infection and preterm birth: Results of a prospective study. J Am Dent Assoc 2001;132:875-80.  Back to cited text no. 7
    
8.Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G, et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 1996;67:1103-13.  Back to cited text no. 8
    
9.Gaffield ML, Gilbert BJ, Malvitz DM, Romaguera R. Oral health during pregnancy: An analysis of information collected by the pregnancy risk assessment monitoring system. J Am Dent Assoc 2001;132:1009-16.  Back to cited text no. 9
    
10.Mangskau KA, Arrindell B. Pregnancy and oral health: Utilization of the oral health care system by pregnant women in North Dakota. Northwest Dent 1996;75:23-8.  Back to cited text no. 10
    
11.Marchi KS, Fisher-Owen SA, Weintraub JA, Yu Z, Braveman PA. Most pregnant women in California do not receive dental care: Findings from a population-based study. Public Health Rep 2010;125:831-42.  Back to cited text no. 11
    
12.Adeniyi AA, Ogunbanjo BO, Sorunke ME, Onigbinde OO, Agbaje MO, Braimoh M. Dental attendance in a sample of Nigerian pregnant women. Nig Q J Hosp Med 2010;20:186-91.  Back to cited text no. 12
    
13.Orenuga OO, Sofola OO. A survey of the knowledge, attitude and practices of antenatal mothers in Lagos, Nigeria about the primary teeth. Afr J Med Med Sci 2005;34:285-91.  Back to cited text no. 13
    
14.Al Habashneh R, Guthmiller JM, Levy S, Johnson GK, Squier C, Dawson DV, et al. Factors related to utilization of dental services during pregnancy. J Clin Periodontol 2005;32:815-21.  Back to cited text no. 14
    
15.Boggess KA, Urlaub DM, Massey KE, Moos MK, Matheson MB, Lorenz C. Oral hygiene practices and dental service utilization among pregnant women. J Am Dent Assoc 2010;141:553-61.  Back to cited text no. 15
    
16.Detman LA, Cottrell BH, Denis-Luque MF. Exploring dental care misconceptions and barriers in pregnancy. Birth 2010;37:318-24.  Back to cited text no. 16
    
17.Obuna JA, Ugboma HA, Igbinedion H, Ejikeme BN, Agwu UM, Ugboma EW. Awareness of pregnancy related oral diseases in women attending ante-natal clinic in a University Teaching Hospital in Nigeria. Int J Trop Med 2012;7:61-3.  Back to cited text no. 17
    
18.Nwangosi IE, Kiango MM. Oral health experience during pregnancy and dental service utilisation in Bariadi District, Tanzania. Tanzania J Health Res 2012;4:1-7.  Back to cited text no. 18
    
19.Bukar M, Audu BM, Adesina OA, Marupa JY. Oral health practices among pregnant women in North Eastern Nigeria. Niger J Clin Pract 2012;15:302-5.  Back to cited text no. 19
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20.Bassey GO, Anyanechi CE, Ekabua KJ, Ekabua JE. Oral health among antenatal care attendees in Calabar, Nigeria. J Obstet Gynaecol 2010;30:143-6.  Back to cited text no. 20
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]


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Introduction
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