The Routine Utilization of Dental Care during Pregnancy in Eastern China and the Key Underlying Factors: A Hangzhou City Study

Abstract

ObjectivesOral diseases are associated with adverse pregnancy outcomes. The routine utilization of dental care (RUDC) during pregnancy is an effective way to improve pregnant women’s oral health, and thus safeguard the health of their babies. As China has one fifth of the world’s population, it is especially meaningful to encourage RUDC there. However, the status of RUDC in China and the key underlying factors are largely unknown.MethodsThis cross-sectional survey investigated the current status of RUDC during pregnancy and the key underlying factors in Hangzhou City, Zhejiang Province, eastern China. We collected participants’ demographics, individual oral-hygiene behaviors, individual lifestyle, oral-health conditions and attitudes, and also their RUDC during pregnancy. Binary Logistic Regression Analysis was used to analyze the key underlying factors.ResultsOnly 16.70% of the participants reported RUDC during pregnancy. The percentage of RUDC was significantly lower among pregnant women with the following characteristics: aged 30 or less, an annual household income under $8,000, brushing once a day or less, never flossing or rinsing the mouth, paying no attention to pregnancy-related oral-health knowledge, and being dissatisfied with one’s individual dental hygiene behavior.ConclusionsRUDC during pregnancy is very low in eastern China and is greatly influenced not only by a woman’s age, annual income, individual hygiene behavior, but also by her attention and attitudes to oral health. To improve this population’s access to and use of dental care during pregnancy, appropriate programs and policies are urgently needed.

Determinants of Dental Care Attendance during Pregnancy: A Systematic Review

“…In a study conducted in Chapel Hill, NC, USA, the percentage of women aged 36 years or older who had routine dental care utilization during pregnancy was lower than in its younger counterpart [Boggess et al, 2010]. This result was in contrast to what was obtained from a study in China [Sun et al, 2014]. Additionally, in a large secondary data study encompassing a representative sample from California, USA, pregnant women who had not received dental care during pregnancy were primarily younger [Marchi et al, 2010].…”

“…Two studies [Singhal et al, 2014;Silveira et al, 2015] were considered to have a "high" risk of reporting bias. In relation to external validity, this domain was judged as "unclear" or "high" risk of bias in 7 full-text papers [Dinas et al, 2007;Boggess et al, 2010;Corchuelo Ojeda, 2013;Vergnes et al, 2013;Amin and ElSalhy, 2014;Corchuelo-Ojeda and Perez, 2014;Sun et al, 2014]. In regard to internal validity related to bias, 2 studies were considered "high" risk [Timothé et al, 2005;Dinas et al, 2007] and 3 were "unclear" [Boggess et al, 2010;Thompson et al, 2013;Silveira et al, 2015].…”

“…Dental visits or dental cleaning during pregnancy were the most frequent outcome variables, and they were assessed during various stages of pregnancy: 8 studies assessed postpartum women [Al Habashneh et al, 2005;Marchi et al, 2010;Corchuelo-Ojeda, 2013;Thompson et al, 2013;Vergnes et al, 2013;Amin and ElSalhy, 2014;Corchuelo-Ojeda and Perez, 2014;Singhal et al, 2014]; 1 study included women in the third trimester [Saddki et al, 2010]; and 3 studies focused on pregnant women in all trimesters [Dinas et al, 2007;Boggess et al, 2010;Sun et al, 2014]. Two 146 studies reported dental visits or dental cleaning in the 6 or 12 months preceding the interview regardless of the trimester of pregnancy [Timothé et al, 2005;Silveira et al, 2015].…”

“…For the studies that used routine dental care [Boggess et al, 2010;Sun et al, 2014] or dental cleaning during pregnancy [Thompson et al, 2013] as an outcome, the prevalence was between 16.7 and 37%. When a visit to a dentist acted as the dependent variable, values ranged from 27.3 to 83%; the lowest prevalence has been found in studies from Greece (27.3%) [Dinas et al, 2007] and Malaysia (29%) [Saddki et al, 2010].…”

“…Income was a significant predictor for not reporting dental service utilization in the previous 12 months [Timothé et al, 2005] or during pregnancy [Boggess et al, 2010;Marchi et al, 2010;Amin and ElSalhy, 2014;Corchuelo-Ojeda and Perez, 2014;Singhal et al, 2014]. Low-income pregnant women were less likely to have a routine dental care than high-income ones [Sun et al, 2014]. Two studies did not show a statistically significant association between dental service utilization during pregnancy and income [Al Habashneh et al, 2005;Saddki et al, 2010].…”