Prenatal Care Providers' Perceptions of Oral Health During Pregnancy Open Access

Abstract

Evidence suggests that poor oral health during pregnancy may be associated with
adverse pregnancy outcomes, such as preterm delivery. Even though periodontal disease
is prevalent among pregnant women and preterm birth is a leading cause of neonatal
mortalities, research indicates that fewer than half of pregnant were advised by a health
care provider to seek dental services during pregnancy. Consequently, few women visit a
dentist during pregnancy. In spite of the fact that poor oral health can have serious
consequences for a pregnant woman and her fetus, little is known to date about why so
few prenatal care providers discuss the importance of oral health care with their patients.
Therefore, the purpose of the present research was to explore prenatal care providers'
perceptions of and attitudes about oral health during pregnancy. Sixteen prenatal care
providers, including four certified nurse midwives and four obstetrics and gynecology
residents from a hospital that serves a low-income population and four certified nurse
midwives and four obstetrician/gynecologists from a hospital that serves a more affluent
population, were recruited to participate in face-to-face, qualitative interviews. Their
perceptions of oral health during pregnancy, including the facilitators, barriers, and
motivations for oral health promotion, were explored using qualitative methods,
phenomenology, and thematic analysis. Themes surrounding their perceptions of access
to dental services during pregnancy, patients' vulnerability, time, extent of oral health
education, apprehension towards dental services during pregnancy, additional factors that
encourage oral health promotion, and behavior emerged from the data. Similarities and
differences within and across the provider types and hospitals were identified. Providers'
perceptions related to the themes influenced their obstetric practices. Most of the
providers had received little, if any, oral health training and reported that dentists are
apprehensive to provide care to pregnant women. By connecting prenatal care providers
and dentists, as well as increasing their knowledge and awareness of oral health during
pregnancy, oral health promotion behaviors may increase and, therefore, improve
utilization of dental services among pregnant women. This will have profound effects on
the health of the expectant women, as well as the health of their fetuses.

Table of Contents

TABLE OF CONTENTS

I. Introduction 1

II. Literature Review 2

III. Methods 11

IV. Results 17

Table 1. Participant and Hospital Patient Demographics 18

Table 2. Themes and Subthemes 18

V. Discussion 42

VI. Appendices 51

A. Interview Guide 51

B. Informed Consent 54

VII. References 55

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Obstetrics and Gynecology Health Sciences, Dentistry Health Sciences, Public Health
Keyword	oral health prenatal obstetrician dental dentist periodontal disease
Committee Chair / Thesis Advisor	Cooper, Hannah, Emory University
Committee Members	Tedesco, Lisa A, Emory University Owen-Smith, Ashli Anthony, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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