Evaluation of gynecologists’ awareness about oral health condition during pregnancy in Chennai city

Abstract

Background/Objectives: A cross-sectional study was conducted to evaluate the knowledge and practiced behaviors of gynecologists regarding oral health during pregnancy and association of periodontal disease with adverse pregnancy outcomes. Materials and Methods: This study was conducted among 200 gynecologists. A self-structured, close-ended questionnaire containing 22 questions was prepared. The principal investigator approached the gynecologists personally and distributed the questionnaire after obtaining their informed consent. Results: Of the 200 gynecologists approached, 200 filled the questionnaire, yielding a response rate of 100%. The majority (87%) acknowledged a connection between oral health and pregnancy and 63% agreed that periodontal disease can affect the outcome of pregnancy. However, only 60% gynecologists advise major/minor surgery during pregnancy, and many of them (74%) said that second trimester is the safe period for dental treatment. Almost three-quarters of the participants (79%) regarded dental radiograph and more than half (74%) considered administration of local anesthesia to be unsafe during pregnancy. Conclusion: This study demonstrated that gynecologists have a relatively certain level of knowledge regarding oral health status during pregnancy and the relationship of periodontal disease to pregnancy outcomes. However, there clearly exist misconceptions regarding the provision of dental treatment during pregnancy. To provide better oral health care, more knowledge needs to be made available to the pregnant women and medical community, mainly to the gynecologists who are primary health-care providers for pregnant women, and misconception regarding the types of dental treatments during pregnancy should be clarified.

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

“…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 …”

“…20,[22][23][24][25]28,32,37,41 In fact, in this subgroup of PCP, more than 50.0% of the professionals knew about this association in the majority of studies. [22][23][24]28,32,37,41 On the other hand, around 13.7% 26 to 58.0% 25 of general physicians and 7.8% 31 to 59.6% 40 of midwives and nurses believed in this association. 25,26,31,40 There were still professionals, namely gynecologists (74.6%), 23 general physicians (29.0%), 29 and gynecologists and midwives (28.8%), 34 who believed that calcium is removed from the mother's teeth by the developing fetus.…”

“…6 A large proportion of gynecologists believed that the use of anesthesia with a vasoconstrictor was not safe, whereas only 6.4% of midwives/midwifery students believed so. 20,23,32,40 However, evidence demonstrates that the use of local anesthesia with vasoconstrictor is safe during pregnancy. 48 In fact, a prospective observational study that followed 210 pregnancies exposed to dental local anesthetics versus 794 pregnancies not exposed to them reported no differences between groups in the rate of miscarriages, gestational age at delivery, or birth weight.…”

“…Regarding the overall knowledge of PCP about oral health, the findings illustrate that the importance of oral health during pregnancy is acknowledged particularly by gynecologists/obstetricians and general/family physicians, who presented adequate knowledge in the majority of the studies. On the other hand, and although the attitudes of gynecologists/obstetricians were adequate in most studies, 19,[30][31][32]39,40 the practices of healthcare professionals towards oral health are still insufficient. Moreover, it was also possible to observe that the years of experience seem to be associated with a higher knowledge about oral health in pregnancy.…”

Factors influencing adoption of oral health promotion by antenatal care providers in Moyo district, North-Western Uganda

“…This knowledge about the safety of dental procedures during pregnancy should be addressed to improve service utilization and oral health promotion among pregnant mothers. Similarly, a study conducted among gynaecologists indicated a knowledge gap about the safety of some of dental procedures for pregnant mothers [ 39 ]. Local anesthetics lidocaine commonly used during dental care are safe, although, with some negligible adverse effect [ 40 ], some of these effects may include immune response-mediated allergic reactions and others that are unrelated to the immune response and these allergic responses are very rare in practice [ 41 ].…”