Skip to main content

Advertisement

SpringerLink
Log in

Disparities in Unmet Dental Need and Dental Care Received by Pregnant Women in Maryland

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

To examine prenatal dental care needs, utilization and oral health counseling among Maryland women who delivered a live infant during 2001–2003 and identify the factors associated with having a dental visit and having an unmet dental need during pregnancy. Pregnancy Risk Assessment Monitoring System is an ongoing population based surveillance system that collects information of women’s attitudes and experiences before, during, and shortly after pregnancy. Logistic regression was used to model dental visits and unmet dental need using predictor variables for Maryland 2001–2003 births. Less than half of all women reported having a dental visit and receiving oral health advice during pregnancy. Twenty-five percent of women reported a need for dental care, of which 33 % did not receive dental care despite their perceived need. Multivariate modeling revealed that racial minorities, women who were not married and those with annual income <$40,000 were least likely to have a dental visit. Women who were not married, had low annual income, were older than 40 years of age, had an unintended pregnancy and received prenatal care later than desired were most likely to have an unmet dental need during pregnancy. Despite reported needs and existing recommendations to include oral health as a component of prenatal care, less than half of pregnant women have a dental visit during their pregnancy. One-third of women with a dental problem did not have a dental visit highlighting the unmet need for dental care during pregnancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Offenbacher, S., Katz, V., Fertik, G., Collins, J., Boyd, D., Maynor, G., et al. (1996). Periodontal infection as a possible risk factor for preterm low birth weight. Journal of Periodontology, 67(10 Suppl), 1103–1113.

    Article  CAS  PubMed  Google Scholar 

  2. Dasanayake, A. P. (1998). Poor periodontal health of the pregnant woman as a risk factor for low birth weight. Ann Periodontol, 3(1), 206–212.

    Article  CAS  PubMed  Google Scholar 

  3. Chambrone, L., Guglielmetti, M. R., Pannuti, C. M., & Chambrone, L. A. (2011). Evidence grade associating periodontitis to preterm birth and/or low birth weight: I. A systematic review of prospective cohort studies. Journal of Clinical Periodontology, 38(9), 795–808.

    Article  PubMed  Google Scholar 

  4. Madianos, P. N., Bobetsis, G. A., Kinane, D. F. (2002). Is periodontitis associated with an increased risk of coronary heart disease and preterm and/or low birth weight births? Journal of Clinical Periodontology 29(Suppl 3):22,36; discussion 37–38.

    Google Scholar 

  5. Hwang, S. S., Smith, V. C., McCormick, M. C., Barfield, W. D. (2011). The association between maternal oral health experiences and risk of preterm birth in 10 states, pregnancy risk assessment monitoring system, 2004–2006. Maternal and Child Health Journal.

  6. Michalowicz, B. S., Hodges, J. S., DiAngelis, A. J., Lupo, V. R., Novak, M. J., Ferguson, J. E., et al. (2006). Treatment of periodontal disease and the risk of preterm birth. New England Journal of Medicine, 355(18), 1885–1894.

    Article  CAS  PubMed  Google Scholar 

  7. Offenbacher, S., Beck, J. D., Jared, H. L., Mauriello, S. M., Mendoza, L. C., Couper, D. J., et al. (2009). Effects of periodontal therapy on rate of preterm delivery: A randomized controlled trial. Obstetrics and Gynecology, 114(3), 551–559.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Chambrone, L., Pannuti, C. M., Guglielmetti, M. R., & Chambrone, L. A. (2011). Evidence grade associating periodontitis with preterm birth and/or low birth weight: II: A systematic review of randomized trials evaluating the effects of periodontal treatment. Journal of Clinical Periodontology, 38(10), 902–914.

    Article  PubMed  Google Scholar 

  9. Ramos-Gomez, F. (2012). Early maternal exposure to children’s oral health may be correlated with lower early childhood caries prevalence in their children. Journal of Evidence Based Dental Practice, 12(2), 113–115.

    Article  PubMed  Google Scholar 

  10. Kaaja, R. J., & Greer, I. A. (2005). Manifestations of chronic disease during pregnancy. The Journal of the American Medical Association, 294(21), 2751–2757.

    Article  CAS  Google Scholar 

  11. Carrillo-de-Albornoz, A., Figuero, E., Herrera, D., & Bascones-Martinez, A. (2010). Gingival changes during pregnancy: II. Influence of hormonal variations on the subgingival biofilm. Journal of Clinical Periodontology, 37(3), 230–234.

    Article  PubMed  Google Scholar 

  12. Kornman, K. S., & Loesche, W. J. (1980). The subgingival microbial flora during pregnancy. Journal of Periodontal Research, 15(2), 111–122.

    Article  CAS  PubMed  Google Scholar 

  13. Laine, M. A. (2002). Effect of pregnancy on periodontal and dental health. Acta Odontologica Scandinavica, 60(5), 257–264.

    Article  PubMed  Google Scholar 

  14. Gursoy, M., Haraldsson, G., Hyvonen, M., Sorsa, T., Pajukanta, R., & Kononen, E. (2009). Does the frequency of prevotella intermedia increase during pregnancy? Oral Microbiology and Immunology, 24(4), 299–303.

    Article  CAS  PubMed  Google Scholar 

  15. Figuero, E., Carrillo-de-Albornoz, A., Herrera, D., & Bascones-Martinez, A. (2010). Gingival changes during pregnancy: I. Influence of hormonal variations on clinical and immunological parameters. Journal of Clinical Periodontology, 37(3), 220–229.

    Article  CAS  PubMed  Google Scholar 

  16. Vergnes, J. N., Kaminski, M., Lelong, N., Musset, A. M., Sixou, M., Nabet, C., et al. (2012). Frequency and risk indicators of tooth decay among pregnant women in France: A cross-sectional analysis. PLoS ONE, 7(5), e33296.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  17. Alaluusua, S., & Malmivirta, R. (1994). Early plaque accumulation—A sign for caries risk in young children. Community Dentistry and Oral Epidemiology, 22(5 Pt 1), 273–276.

    Article  CAS  PubMed  Google Scholar 

  18. Berkowitz, R. J. (2006). Mutans streptococci: Acquisition and transmission. Pediatric Dentistry28(2):106,9; discussion 192–198.

  19. Thakur, R., Singh, M. G., Chaudhary, S., & Manuja, N. (2012). Effect of mode of delivery and feeding practices on acquisition of oral Streptococcus mutans in infants. International Journal of Paediatric Dentistry, 22(3), 197–202.

    Article  PubMed  Google Scholar 

  20. Li, Y., & Caufield, P. W. (1995). The fidelity of initial acquisition of mutans streptococci by infants from their mothers. Journal of Dental Research, 74(2), 681–685.

    Article  CAS  PubMed  Google Scholar 

  21. Li, Y., Caufield, P. W., Dasanayake, A. P., Wiener, H. W., & Vermund, S. H. (2005). Mode of delivery and other maternal factors influence the acquisition of Streptococcus mutans in infants. Journal of Dental Research, 84(9), 806–811.

    Article  CAS  PubMed  Google Scholar 

  22. Caufield, P. W., Cutter, G. R., & Dasanayake, A. P. (1993). Initial acquisition of mutans streptococci by infants: Evidence for a discrete window of infectivity. Journal of Dental Research, 72(1), 37–45.

    Article  CAS  PubMed  Google Scholar 

  23. Kohler, B., Andreen, I., & Jonsson, B. (1984). The effect of caries-preventive measures in mothers on dental caries and the oral presence of the bacteria Streptococcus mutans and lactobacilli in their children. Archives of Oral Biology, 29(11), 879–883.

    Article  CAS  PubMed  Google Scholar 

  24. Soderling, E., Isokangas, P., Pienihakkinen, K., & Tenovuo, J. (2000). Influence of maternal xylitol consumption on acquisition of mutans streptococci by infants. Journal of Dental Research, 79(3), 882–887.

    Article  CAS  PubMed  Google Scholar 

  25. Zanata, R. L., Navarro, M. F., Pereira, J. C., Franco, E. B., Lauris, J. R., & Barbosa, S. H. (2003). Effect of caries preventive measures directed to expectant mothers on caries experience in their children. Brazilian Dental Journal, 14(2), 75–81.

    Article  PubMed  Google Scholar 

  26. Gunay, H., Dmoch-Bockhorn, K., Gunay, Y., & Geurtsen, W. (1998). Effect on caries experience of a long-term preventive program for mothers and children starting during pregnancy. Clinical Oral Investigations, 2(3), 137–142.

    Article  CAS  PubMed  Google Scholar 

  27. Brambilla, E., Felloni, A., Gagliani, M., Malerba, A., Garcia-Godoy, F., & Strohmenger, L. (1998). Caries prevention during pregnancy: Results of a 30-month study. Journal of the American Dental Association, 129(7), 871–877.

    Article  CAS  PubMed  Google Scholar 

  28. Kohler, B., Andreen, I., Jonsson, B., & Hultqvist, E. (1982). Effect of caries preventive measures on Streptococcus mutans and lactobacilli in selected mothers. Scandinavian Journal of Dental Research, 90(2), 102–108.

    CAS  PubMed  Google Scholar 

  29. Gomez, S. S., Weber, A. A., Emilson, C. G. (2001). A prospective study of a caries prevention program in pregnant women and their children five and six years of age. ASDC Journal of Dentistry for Children 68(3):191, 5, 152.

    Google Scholar 

  30. Kumar, J., & Samelson, R. (2009). Oral health care during pregnancy recommendations for oral health professionals. New York State Dental Journal, 75(6), 29–33.

    PubMed  Google Scholar 

  31. Ressler-Maerlender, J., Krishna, R., & Robison, V. (2005). Oral health during pregnancy: Current research. Journal of Women’s Health (Larchmt), 14(10), 880–882.

    Article  Google Scholar 

  32. Simon, K. I., & Handler, A. (2008). Welfare reform and insurance coverage during the pregnancy period: Implications for preconception and interconception care. Womens Health Issues, 18(6 Suppl), S97–S106.

    Article  PubMed  Google Scholar 

  33. Cohen, R. A., & Bloom, B. (2010). Access to and utilization of medical care for young adults ages 20–29 years: United states, 2008. NCHS Data Brief, 29(29), 1–8.

    PubMed  Google Scholar 

  34. Timothe, P., Eke, P. I., Presson, S. M., & Malvitz, D. M. (2005). Dental care use among pregnant women in the United States reported in 1999 and 2002. Preventing Chronic Disease, 2(1), A10.

    PubMed Central  PubMed  Google Scholar 

  35. Gaffield, M. L., Gilbert, B. J., Malvitz, D. M., & Romaguera, R. (2001). Oral health during pregnancy: An analysis of information collected by the pregnancy risk assessment monitoring system. Journal of the American Dental Association, 132(7), 1009–1016.

    Article  CAS  PubMed  Google Scholar 

  36. Hwang, S. S., Smith, V. C., McCormick, M. C., & Barfield, W. D. (2011). Racial/ethnic disparities in maternal oral health experiences in 10 states, pregnancy risk assessment monitoring system, 2004–2006. Maternal and Child Health Journal, 15(6), 722–729.

    Article  PubMed  Google Scholar 

  37. D’Angelo, D., Williams, L., Morrow, B., Cox, S., Harris, N., Harrison, L., et al. (2007). Preconception and interconception health status of women who recently gave birth to a live-born infant–pregnancy risk assessment monitoring system (PRAMS), United States, 26 reporting areas, 2004. MMWR Surveillance Summaries, 56(10), 1–35.

    Google Scholar 

  38. Michalowicz, B. S., DiAngelis, A. J., Novak, M. J., Buchanan, W., Papapanou, P. N., Mitchell, D. A., et al. (2008). Examining the safety of dental treatment in pregnant women. Journal of the American Dental Association, 139(6), 685–689.

    Article  PubMed  Google Scholar 

  39. Livingston, H. M., Dellinger, T. M., & Holder, R. (1998). Considerations in the management of the pregnant patient. Special Care in Dentistry, 18(5), 183–188.

    Article  CAS  PubMed  Google Scholar 

  40. Kloetzel, M. K., Huebner, C. E., Milgrom, P., Littell, C. T., Eggertsson, H. (2012). Oral health in pregnancy: Educational needs of dental professionals and office staff. Journal of Public Health Dentistry.

  41. Lee, R. S., Milgrom, P., Huebner, C. E., & Conrad, D. A. (2010). Dentists’ perceptions of barriers to providing dental care to pregnant women. Womens Health Issues, 20(5), 359–365.

    Article  PubMed Central  PubMed  Google Scholar 

  42. Kim, A. J., Lo, A. J., Pullin, D. A., Thornton-Johnson, D. S., Karimbux, N. Y. (2012). Scaling and root planing treatment for periodontitis to reduce preterm birth and low birth weight: A systematic review and meta-analysis of randomized controlled trials. Journal of periodontology.

  43. “PRAMS home” [Internet]. (2012). http://www.cdc.gov/PRAMS/index.htm.

  44. Detailed PRAMS methodology [Internet]. (2012). http://www.cdc.gov/prams/methodology.htm.

  45. Lydon-Rochelle, M. T., Krakowiak, P., Hujoel, P. P., & Peters, R. M. (2004). Dental care use and self-reported dental problems in relation to pregnancy. American Journal of Public Health, 94(5), 765–771.

    Article  PubMed Central  PubMed  Google Scholar 

  46. Centers for Disease Control and Prevention (CDC). (2010). Perceived health needs and receipt of services during pregnancy—Oklahoma and South Carolina, 2004–2007. MMWR. Morbidity and Mortality Weekly Report, 59(23), 710–714.

    Google Scholar 

  47. Thompson, T. A., Cheng, D., Strobino, D. (2012). Dental cleaning before and during pregnancy among Maryland mothers. Maternal and Child Health Journal.

  48. Lee, J. Y., Rozier, R. G., Norton, E. C., Kotch, J. B., & Vann, W. F, Jr. (2004). Effects of WIC participation on children’s use of oral health services. American Journal of Public Health, 94(5), 772–777.

    Article  PubMed Central  PubMed  Google Scholar 

  49. California Dental Association Foundation, American College of Obstetricians and Gynecologists, District IX. (2010). Oral health during pregnancy and early childhood: Evidence-based guidelines for health professionals. Journal of the California Dental Association 38(6):391,403, 405–440.

    Google Scholar 

Download references

Acknowledgments

This research was supported by Office of Science Policy and Analysis of the NIH, NIDCR. The views expressed in this article are that of the authors and do not necessarily represent the views of the National Institutes of Health or the US Government.

Author information

Authors and Affiliations

  1. Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, 52242, USA

    Astha Singhal

  2. Office of Science Policy and Analysis, NIH-NIDCR, Bethesda, MD, USA

    Amit Chattopadhyay & Amy B. Adams

  3. NIH-NIDCR, Bethesda, MD, USA

    A. Isabel Garcia

  4. Department of Health and Mental Hygiene, Baltimore, MD, USA

    Diana Cheng

Authors
  1. Astha Singhal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amit Chattopadhyay
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Isabel Garcia
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Amy B. Adams
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Diana Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Astha Singhal.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Singhal, A., Chattopadhyay, A., Garcia, A.I. et al. Disparities in Unmet Dental Need and Dental Care Received by Pregnant Women in Maryland. Matern Child Health J 18, 1658–1666 (2014). https://doi.org/10.1007/s10995-013-1406-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-013-1406-7

Keywords

Search

Navigation