Abstract
Despite increasing recognition of the importance of oral health to overall health, dental care utilization remains low in the US. Given the established link between maternal oral health and child oral health, this study examined factors related to preventive dental care utilization at two critical time points, before and during pregnancy. Data were obtained from a sample of 6,171 women who delivered a live birth during 2004–2008 and completed the Maryland Pregnancy Risk Assessment Monitoring System postpartum survey. Multinomial logistic analyses examined associations between predisposing and enabling factors with dental cleaning before and during pregnancy. Women with less than a high school education or a history of physical abuse and non-Hispanic black and Hispanic women were less likely to report teeth cleaning before and during pregnancy. Having no insurance at the start of pregnancy was associated with significantly lower risk of teeth cleaning before pregnancy and both before and during pregnancy. Receipt of oral health counseling during pregnancy was positively related to teeth cleaning during pregnancy. Dental cleaning is associated with insurance, oral health counseling and maternal factors such as race, ethnicity, education and history of physical abuse. Better integration of oral health into prenatal health care, particularly among ethnic and racial minority groups, may be beneficial to maternal and infant well-being. Oral health promotion, disease prevention and health care should be a part of the local, state and national health policy agendas.
Similar content being viewed by others
References
Kumar, J., & Samelson, R. (Eds.) (2006). Oral health care during pregnancy and early childhood: Practice guidelines. New York, NY: New York State Department of Health, 2006. Retrieved July 2, 2010 from http://www.health.state.ny.us/publications/0824.pdf.
Nuamah, I., & Annan, B. D. R. T. (1998). Periodontal status and oral hygiene practices of pregnant and non-pregnant women. East African Medical Journal, 75(12), 712–714.
Jensen, J., Liljemark, W., & Bloomquist, C. (1981). The effect of female sex hormones on subgingival plaque. Journal of Periodontology, 52(10), 599–602.
Ferris, G. M. (1993). Alteration in female sex hormones: Their effect on oral tissues and dental treatment. Compendium (Newtown, Pa.), 14(12), 1558–1564. 1566; quiz 1571.
Silk, H., Douglass, A. B., Douglass, J. M., & Silk, L. (2008). Oral health during pregnancy. American Family Physcian, 77(8), 1139–1144.
Grembowski, D., Spiekerman, C., & Milgrom, P. (2009). Linking mother access to dental care and child oral health. Community Dentistry and Oral Epidemiology, 37, 381–390.
Wan, A. K., Seow, W. K., Purdie, D. M., et al. (2001). Oral colonization of streptococcus mutans in six-months old perdentate infants. Journal of Dental Research, 80, 2060–2065.
Wan, A. K., Seow, W. K., Walsh, L. J., et al. (2001). Association of streptococcus mutans infection and oral developmental nodules in pre-dentate infants. Journal of Dental Research, 80, 1945–1948.
Berkowitz, R. J. (2003). Acquisition and transmission of mutans streptococci. Journal of the California Dental Association, 31(2), 135–138.
Okado, M., Kawamura, M., Hayashi, Y., et al. (2008). Simultaneous interrelationship between the oral health behavior and oral health status of mothers and their children. Journal of Oral Science, 50(4), 447–452.
Humphrey, L. L., Fu, R., Buckley, D. I., et al. (2008). Periodontal disease and coronary heart disease incidence: A systematic review and meta-analysis. Journal of General Internal Medicine, 23(12), 2079–2086.
Slavkin, H. C. (1999). Does the mouth put the heart at risk? Journal of American Dental Association, 130, 109–113.
Genco, R. J. (1998). Periodontal disease and risk for myocardial infarction and cardiovascular disease. Cardiovascular Reviews and Reports, 19(3), 34–40.
Mercado, F., Marshall, R. I., Klestov, A. C., & Bartold, P. M. (2000). Is there a relationship between rheumatoid arthritis and periodontal disease? Journal of Clinical Periodontology, 27, 267–272.
Xiong, X., Buekens, P., Vastardis, S., & Yu, S. M. (2007). Periodontal disease and pregnancy outcomes: state of the science. Obstetrical and Gynecological Survey, 62(9), 605–615.
Vergnes, J. N., & Sixou, M. (2007). Preterm low birth weight and maternal periodontal status: A meta-analysis. American Journal of Obstetrics and Gynecology, 196(2), 135.e1–135.e7.
Gomes-Filho, I. S., Cruz, S. S., Rezende, E. J. C., et al. (2007). Exposure measurement in the association between periodontal disease and prematurity/low birth weight. Journal of Clinical Periodontology, 34(11), 957–963.
Jeffcoat, M. K., Geurs, N. C., Reddy, M. S., et al. (2001). Periodontal infection and preterm birth. Results of a prospective study. Journal of the American Dental Association, 132(7), 875–889.
Brambilla, E., Felloni, A., Gagliani, M., et al. (1998). Caries prevention during pregnancy: Results of a 30 month study. Journal of the American Dental Association, 129(7), 871–877.
Lopez, N. J., Da Silva, I., Ipinza, J., & Gutierrez, J. (2005). Periodontal therapy reduces the rate of preterm low birth weight in women with pregnancy-associated gingivitis. Journal of Periodontology, 76(11), 2144–2153.
Jeffcoat, M. K., Hauth, J. C., Geurs, N. C., et al. (2003). Periodontal disease and preterm birth: Results of a pilot intervention study. Journal of Periodontology, 74(8), 1214–1218.
Michalowicz, B. S., Hodges, J. S., DiAngelis, A. J., et al. (2006). Treatment of periodontal disease and the risk of preterm birth. The New England Journal of Medicine, 355(18), 1885–1894.
Offenbacher, S., Beck, J. S., Jared, H. L., et al. (2009). Effects of periodontal therapy on rate of preterm delivery: A randomized controlled trial. Obstetrics and Gynecology, 114(3), 551–559.
Macones, G. A., Parry, S., Nelson, D., et al. (2010). Treatment of localized periodontal disease in pregnancy does not reduce the occurrence of preterm birth: Results from the Periodontal infections and Prematurity Study (PIPS). American Journal of Obstetrics and Gynecology, 202((2), 147e1–147e8.
Boggess, K. A. (2008). Maternal oral health in pregnancy. Obstetrics and Gynecology, 111(4), 976–986.
American Academy of Periodontology. (2010). AAP statement on the periodontal management of the pregnant patient. Available at www.perio.org. Accessed July 2, 2010.
Gaffield, M. L., Colley Gilbert, B. J., Malvitz, D. M., & Romaguera, R. (2001). Oral health during pregnancy: An analysis of information collected by the Pregnancy Risk Assessment Monitoring System. Journal of the American Dental Association, 132, 1009–1016.
Center for Disease Control and Prevention. (2010). Healthy people 2010: Oral health. Atlanta, GA: Health Resources and Services Administration, Indian Health Service, National Institutes of Health.
Kim, S. S., Kronenfeld, J. J., & Rivers, P. A. (2006). Racial and socioeconomic differences in predictors of dental care use. Research in the Sociology of Health Care, 24, 61–79.
Kumar, J. V., & Green, E. L. (2005). Oral health disparities in New York state. The New York State Dental Journal, 71(7), 43–47.
Gilbert, G. H. (2005). Racial and Socioeconomic disparities in health from population-based research to practice-based research: The example of oral health. Journal of Dental Education, 69(9), 1003–1014.
Adams, M. M., Shulman, H. B., Bruce, C., et al. (1991). The pregnancy risk assessment monitoring system: Design, questionnaire, data collection and response rates. Paediatric and Perinatal Epidemiology, 5, 333–346.
Gilbert, B., Shulman, H. B., Fischer, L. A., & Rogers, M. M. (1999). The Pregnancy Risk Assessment Monitoring System (PRAMS): Methods and 1996 response rates from 11 states. Maternal Child Health Journal, 3(4), 199–209.
StataCorp. (2009). Stata statistical software: Release 11. College Station, TX: StataCorp LP.
Lyndon-Rochelle, M. T., Krakowiak, P., Hujoel, P. P., & Peters, R. M. (2004). Dental care use and self-reported dental problems in relation to pregnancy. American Journal of Public Health, 94(5), 765–771.
Mangskau, K. A., & Arrindell, B. (1996). Pregnancy and oral health: utilization of the oral health care system by pregnant women in North Dakota. Northwest Dentistry, 75, 23–28.
Hwang, S. S., Smith, V. C., McCormick, M. C., & Barfield, W. D. (2011). Racial/Ethnic disparities in maternal oral health experiences, in 10 states, pregnancy risk assessment monitoring system, 2004–2006. Maternal and Child Health Journal, 15, 722–729.
Zuvekas, S. H., & Taliaferro, G. S. (2003). Pathways to access: Health insurance, the healthcare delivery system and racial/ethnic disparities, 1996–1999. Health Affairs, 22(2), 139–153.
National Center for Health Statistics. (2003). Health, United States, 2003. Hyattsville, MD: National Center for Health Statistics.
Mikhail, B. I. (1999). Perceived impediments to prenatal care among low-income women. Western Journal of Nursing Research, 21(3), 335–350.
Byrd, T. L., Mullen, P. D., Selwyn, B. J., & Lorimor, R. (1996). Initiation of prenatal care by low-income Hispanic women in Houston. Public Health Reports, 111(6), 536–540.
Viera, A. J., Pathman, D. E., & Garrett, J. M. (2006). Adults’ lack of a usual source of care: A matter of preference? Annals of Family Medicine, 4, 359–365.
Grembowski, D., Spiekerman, C., & Milgrom, P. (2007). Disparities in regular source of dental care among mothers of Medicaid-enrolled preschool children. Journal of Health Care for the Poor and Underserved, 18, 789–813.
Kaiser Family Foundation. (2007). Issue brief. Medicaid’s role for women. Menlo Park CA: Henry J. Kalsen Family Foundation. http://www.kff.org/womenshealth/upload/7213_03.pdf. Accessed on July 2, 2010.
Russell, S. L., & Mayberry, L. J. (2008). Pregnancy and oral health. Maternal Child Nursing, 33(1), 32–37.
Al-Habashneh, R., Aljundi, S. H., & Alwaeli, H. A. (2008). Survey of medical doctors’ attitudes and knowledge of the association between oral health and pregnancy outcomes. International Journal of Dental Hygiene, 6, 214–220.
Milgrom, P., Ludwig, S., Shirtcliff, M., et al. (2008). Providing a dental home for pregnant women: A community program to address dental care-access, a brief communication. Journal of Public Health Dentistry, 68(3), 170–173.
Huebner, C. E., Milgrom, P., Conrad, D., et al. (2009). Providing dental care to pregnant patients: A survey of Oregon general dentists. The Journal of the American Dental Association, 140, 211–222.
Acknowledgments
The authors gratefully acknowledge the Division of Reproductive Health, Centers for Disease Control and Prevention (CDC) for its support and guidance of the PRAMS project in Maryland.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Thompson, TA., Cheng, D. & Strobino, D. Dental Cleaning Before and During Pregnancy Among Maryland Mothers. Matern Child Health J 17, 110–118 (2013). https://doi.org/10.1007/s10995-012-0954-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-012-0954-6