Stressful life events, oral health, and barriers to dental care during pregnancy

Abstract

ObjectivesPoor oral health during pregnancy poses risks to maternal and infant well‐being. However, limited research has documented how proximate stressful life events (SLEs) during the prenatal period are associated with oral health and patterns of dental care utilization.MethodsData come from 13 states that included questions on SLEs, oral health, and dental care utilization in the Pregnancy Risk Assessment Monitoring System for the years 2016–2020 (n = 48,658). Multiple logistic regression analyses were used to assess the association between levels of SLE (0, 1–2, 3–5, or 6+) and a range of (1) oral health experiences and (2) barriers to dental care during pregnancy while controlling for socio‐demographic and pregnancy‐related characteristics.ResultsWomen with more SLEs in the 12 months before birth—especially six or more—reported worse oral health experiences, including not having dental insurance, not having a dental cleaning, not knowing the importance of caring for teeth and gums, needing to see a dentist for a problem, going to see a dentist for a problem, and unmet dental care needs. Higher levels of SLEs were also associated with elevated odds of reporting barriers to dental care.ConclusionsSLEs are an essential but often understudied risk factor for poor oral health, unmet dental care needs, and barriers to dental care services. Future research is needed to understand better the mechanisms linking SLEs and oral health.

Adverse Childhood Experiences and Dental Care Utilization During Pregnancy: Findings from the North and South Dakota PRAMS, 2017-2021

“…Dental care utilization is based on a survey question asking, “During your most recent pregnancy, did you have your teeth cleaned by a dentist or dental hygienist?” (1 = yes, 0 = no). 24 , 28 , 29 …”

“…(1 = yes, 0 = no). 24,28,29 Independent Variable ACEs were assessed through self-report by the respondents, focusing on 10 types of childhood adversity experienced before age 18, which align with the measures from the CDC-Kaiser ACE Study. 1 Appendix A provides detailed de nitions and prevalence rates for these ten items.…”

“…Given that ACEs can shape maternal and infant health, 7 , 21 , 22 and dental care is crucial during pregnancy, 23 it is important to understand how early ACE exposure may affect dental care patterns during this critical time. Moreover, while proximal stressful life events experienced among adults around pregnancy are associated with lower dental care utilization, 24 it remains unknown if exposure to more distal stressors, such as ACEs, affects dental care utilization during pregnancy. Finally, there is a lack of knowledge about how the relationship between ACEs and prenatal dental care utilization varies across racial and ethnic groups.…”

Adverse childhood experiences and dental cleaning during pregnancy: Findings from the North and South Dakota PRAMS, 2017–2021

“…Given that ACEs can shape maternal and infant health, 7,21,22 and dental care is crucial during pregnancy, 23 it is important to understand how early ACE exposure may affect dental care patterns during pregnancy. Moreover, while proximal stressful life events experienced among adults around pregnancy are associated with lower preventive dental care utilization, 24 it remains unknown if exposure to more distal stressors, such as ACEs, affects preventive dental care utilization during pregnancy.…”