Background: Pregnant women are at risk of oral health problems. This qualitative study aims to understand dental care-seeking behaviours of pregnant women and their oral health-related information acquisition, to identify barriers to and motivators for, dental visits, and further explore their expectations and possible strategies to improve oral health care during pregnancy. Methods: Semi-structured interviews were conducted with 30 pregnant women (after 32 gestational weeks) enrolled in the antenatal care programme in a public hospital in Hong Kong. Two main areas of interest were probed: Dental care-seeking behaviour and oral health information acquisition. Their expectations and suggestions on oral health care service for pregnant women were also explored. An inductive thematic approach was adopted to analyse the data. Results: Pregnant women’s dental care-seeking behaviour was deterred by some internal factors, such as misunderstandings on oral health, and priority on other issues over oral health. External factors such as inconvenient access to dental service during pregnancy also affected their care-seeking behaviours. Oral health information was passively absorbed by pregnant women through mass media and the social environment, which sometimes led to confusion. Oral health information acquisition from antenatal institutions and care providers was rare. Greater attention was paid to dental visit when they obtained proper information from previous dental visit experience or family members. A potential strategy to improve oral health care suggested by the interviewees is to develop a health care system strengthened by inter-professional (antenatal-dental) collaboration. Efficient oral health information delivery, convenient access to dental service, and improved ‘quality’ of dental care targeting the needs of pregnant women were identified as possible approaches to improve dental care for this population. Conclusion: Dental care-seeking behaviour during pregnancy was altered by various internal and external factors. A lack of, or conflict between, information sources result in confusion that can restrict utilisation of dental service. Integrating dental care into antenatal service would be a viable way to improve dental service utilisation.
Background Poor oral hygiene and high hormone levels during pregnancy can lead to a deterioration in periodontal health. This study assessed the effectiveness of a family-centered behavioral and educational counselling program on improving the periodontal health of women during pregnancy and postpartum. Methods A randomized controlled trial was conducted among pregnant women (10th-22nd gestational week) and their husbands. Participating families were randomized into test and control groups. Intervention in the test group included explanation of oral health education (OHE) pamphlets, oral hygiene instruction, individualized feedback, and proposed solutions to overcome barriers in self-care. Reinforcements were implemented in the 3rd trimester of pregnancy and six months postpartum. In the control group, only OHE pamphlets were distributed. The assessed outcomes were bleeding on probing (BOP), periodontal pocket (Poc), loss of clinical attachment (LoA), and Visible Plaque Index (VPI). The data collection was carried out at baseline (T0), in the 32nd gestational week (T1), and 12 months postpartum (T2). Results Altogether 589 pregnant women were recruited, and 369 attended all three visits (test:188; control:181). In the test group, the mean VPI score at T0 was 0.19, which decreased to 0.14 at T1 and 0.15 at T2. In the control group, the mean VPI decreased from 0.19 at T0 to 0.16 at T1, but increased to 0.22 at T2. A main effect of time and intervention and an interaction between time and intervention were detected (all p < 0.05), indicating that the intervention effect differed between T1 and T2. The test group showed a significantly greater decrease over time than the control group did. Similarly, the mean BOP% decreased more significantly over time in the test group (T0:57%, T1:46%, T2:35%) than in the control group (T0:58%, T1:52%, T2:46%). For Poc and LoA, there were improvements in both study groups at 12 months postpartum, compared with during pregnancy (p < 0.001). Conclusions Providing family-centered, behavioral, and educational counselling to pregnant women at an early stage of pregnancy and with reinforcements can improve their oral hygiene and reduce gingival inflammation. The effect can be sustained over an extended period and is greater than that of distributing oral health leaflets alone. Trial registration Clinicaltrials.gov, #NCT02937194. Registered 18 October 2016. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02937194?cond=Family-centered+oral+health+promotion+for+new+parents+and+their+infants&draw=2&rank=1
Objectives: Poor oral hygiene and higher hormone levels during pregnancy always lead to poor periodontal health. Oral health education of the pregnant women to improve the periodontal outcomes might be ineffective and inconsistent. The aim of this study was to assess the effectiveness of a family-centered behavioral and educational counselling program on the pregnant women’s periodontal health and long-term effect after delivery. Methods: A randomized controlled trial was conducted among first-time pregnant women (10~20th gestational-week) in Hong Kong. Participating families were randomized into test and control group. The intervention in test group included: explanation on oral health education pamphlets, oral hygiene practice training by the “tell-show-do” technique, individualized feedback, and proposed solutions to overcome barriers on self-care. Reinforcement was implemented by interview, phone call or messaging to assess performance, identify barriers and to encourage participants on self-care, in around 32nd gestational-week and 6 months after delivery. Main outcomes assessed were periodontal health measurement including bleeding on probing (BOP), periodontal-pocket (Poc) and loss of clinical attachment levels (LoA); oral hygiene status was assessed by visible plaque index (VPI). The dental examinations were carried out at baseline, 32nd gestational-week and 12-months post-delivery.Results: 589 pregnant women were recruited and 369 completed all three visits (test 188; control 181). Mixed-effect model ANOVA indicated that in test group, % sites with visible plaque decreased from the baseline to the 32nd gestational-week and maintained to 12-months post-delivery while in control group the effect could not be sustained (p<0.001). Both groups showed significant decrease in BOP over time, and significantly lower % sites with BOP was found in test group than in control group at 12-months post-delivery (p<0.001). Generalized linear mixed model (GLMM) showed that there was significant less in sites with Poc and LoA in the both groups over time at 12-months post-delivery than during pregnancy (p<0.001), whereas there was no significant effect between the two groups (p>0.05). Conclusions: Providing family-centered, behavioral and educational counselling to pregnant women at early stage of pregnancy and reinforcements can improve their oral hygiene and periodontal health, the effect can be sustained over a longer period.
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