Dental care in pregnancy – the state of knowledge among Polish dentists and gynaecologists, and factors affecting knowledge about dental management in pregnancy

Abstract

Introduction. The overall health condition, as well as the course and duration of pregnancy are important determinants of the term of delivery and child’s well-being, including birth weight and oral health. Unfortunately, dental attendance of pregnant women is insufficient. This may result from the poor oral health knowledge of dentists and obstetrician-gynaecologists. Aim. The aim of the study was to assess the knowledge of Polish dentists and obstetrician-gynaecologists on oral health and dental care in pregnant women, as well as its socio-economic determinants. Material and methods. An anonymous questionnaire for dentists and obstetrician-gynaecologists, which included questions on the demographic characteristics of respondents, as well as 29 single-choice questions on dental issues in pregnancy, which we classified into 4 thematic categories (I ? relationship between maternal periodontal diseases and the course of pregnancy/child’s health; II ? dental management and oral physiological changes in pregnancy; III ? the safety of dental procedures in pregnancy; IV ? providing health advice) was carried out. The data were analysed statistically. Results. A total of 485 dentists and 185 obstetrician-gynaecologists (670 doctors in total) completed the questionnaire. Dentists were more likely to know the relationship between oral conditions in pregnancy and birth weight, the future risk of periodontal diseases and caries in the child. However, they were less likely to provide correct answers to questions on the safety of diagnostic radiology in pregnancy. On the other hand, obstetrician-gynaecologists were more likely to have doubts about performing some dental procedures, including fluoride varnish application and scaling. The mean number of correct answers to all questions was higher in the group of dentists vs. gynaecologists. Correlations with age and a longer period of practice were found in the group of dentists, while correlations with age and the type of practice were observed among gynaecologists. Conclusions. The poor level of knowledge of Polish dentists and gynaecologists on dental treatment and its safety in pregnant women indicates the need for education of dental and obstetric practitioners. The level of knowledge in both these professional groups is associated with age and, additionally, with the length of practice in the case of dentists, and the type of practice in the case of obstetrician-gynaecologists.

Knowledge, attitudes, and practices of prenatal care practitioners regarding oral health in pregnancy—A systematic review

“…About 20.0%–60.0% of gynecologists considered radiographing pregnant women safe, 20,22,27,28,32,33 whereas 76.6% of midwives/midwifery students considered dental radiographs safe 40 . The second trimester was named the safest during which to perform dental procedures by 46.0%–74.0% of gynecologists/obstetricians 20,24,27,32,37 …”

“…Regarding the safety of dental procedures during pregnancy, 43.1%–73.0% of gynecologists considered that the use of anesthesia with a vasoconstrictor was not safe during pregnancy, 20,23,32 while only 6.4% of midwives/midwifery students believed so 40 . About 20.0%–60.0% of gynecologists considered radiographing pregnant women safe, 20,22,27,28,32,33 whereas 76.6% of midwives/midwifery students considered dental radiographs safe 40 . The second trimester was named the safest during which to perform dental procedures by 46.0%–74.0% of gynecologists/obstetricians 20,24,27,32,37 …”

“…The questionnaires implemented in the different studies varied in the number of questions (ranged from 15 21,36 to 82 questions 40 ), and the authors resorted to “Yes/No” questions, 19,20,23,25,27,32,33,36,37,41,43 multiple‐choice, 22,31 and Likert scales 21,24,26,28–30,34,37,38,40,42 . All questionnaires were self‐answered, 10 of which were carried out online 23,26–28,30,31,36,39,41 . The content of the questionnaires applied is summarized in Table 2.…”

“…26 When considering referral to oral health care, 15.0% 24 to 80.0% 27 of gynecologists recommended their patients to go to the dentist, rates that were similar to those of midwives (17.2% 35 to 79.3% 30 ). 24,26,27,29,30,32,35,37,38 Regarding referral during the preconception period, 28% (gynecologists) to 55.0% (gynecologists and midwives) of the professionals reported doing it, 34,37 whereas in one study only 21.9% (midwives and midwifery students) never referred. 40 The main results of each study are presented in Table 3.…”

“…In each of the included studies, the study population was mostly gynecologists/obstetricians (n = 16), 19,20,[22][23][24][25]27,28,[32][33][34][36][37][38][39]41 but there were also studies including and/or focused on midwives (n = 9), 26,30,31,[34][35][36]39,40,42 general or family physicians/practitioners (n = 5), 25,26,29,36,39 and nurses (n = 4). 21,26,35,42 The level of knowledge of PCP was adequate in 14 out of 24 studies, with the subgroup of gynecologists/obstetricians presenting adequate knowledge in 65.0% of the studies (10 out of 16 studies; Table S1), followed by general and family physicians (60.0%; 3 out of 5 studies; Table S2), midwifes (33.0%; 3 out of 9 studies; Table S3), and nurses (25.0%; 1 out of 4 studies; Table S4)…”