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ORIGINAL ARTICLE
Year : 2018  |  Volume : 36  |  Issue : 3  |  Page : 240-243
 

Knowledge, attitudes, and practices among gynecologists regarding oral health of expectant mothers and infants in Bhubaneswar City, Odisha


1 Department of Pediatric and Preventive Dentistry, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
2 Department of Periodontics and Implantology, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India

Date of Web Publication24-Sep-2018

Correspondence Address:
Prof. Sonu Acharya
Institute of Dental Sciences, SOA (Deemed to be University), Bhubaneswar, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JISPPD.JISPPD_27_18

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   Abstract 


Objective: Early intervention is aimed at preventing or mitigating common pediatric oral diseases and conditions while initiating a relationship between the mother, the child, and the dental caregiver. Every expectant mother should receive oral health education and risk assessment. There are a number of reports that showed the association between oral diseases and preterm, low birth weight, and gestational diabetes. The purpose of this study is to understand the attitude and knowledge regarding prenatal as well as infant oral health care among gynecologists in the medical colleges in Bhubaneswar, Odisha, India. Materials and Methods: The study involved a survey involving gynecologists in medical colleges in Bhubaneswar, Odisha. A pretested questionnaire was provided to all the gynecologists (21) working in the medical colleges in Bhubaneswar regarding prenatal and perinatal oral health care. Results: The study gave an idea that most gynecologists working in a medical college in Bhubaneswar, Odisha, India, had adequate knowledge regarding oral health of expectant mothers, but lack in knowledge when it comes to imparting knowledge on infants' health care. Conclusion: There is an adequate knowledge among the gynecologists about oral health of expectant mothers and infants, but still, there is a need of a multidisciplinary collaboration among gynecologists, pediatricians, and pediatric dentists to prevent the dental diseases rather than treating them.


Keywords: Gynecologists, infant oral health, knowledge, mother, pediatric dentist, pediatrician


How to cite this article:
Acharya S, Acharya S, Mahapatra U. Knowledge, attitudes, and practices among gynecologists regarding oral health of expectant mothers and infants in Bhubaneswar City, Odisha. J Indian Soc Pedod Prev Dent 2018;36:240-3

How to cite this URL:
Acharya S, Acharya S, Mahapatra U. Knowledge, attitudes, and practices among gynecologists regarding oral health of expectant mothers and infants in Bhubaneswar City, Odisha. J Indian Soc Pedod Prev Dent [serial online] 2018 [cited 2019 Dec 13];36:240-3. Available from: http://www.jisppd.com/text.asp?2018/36/3/240/241970





   Introduction Top


The expectant mothers mostly do not access oral health care despite having poor oral hygiene. Oral health is an integral part of general health.[1] The oral diseases for years together have been neglected, and the basic approach is to treat the destruction rather than prevent the disease. The recommended guidelines put more emphasis on early professional intervention and primary preventive strategies for oral health, which are the essential public health priority.[2] Mothers play an important role in the overall development of child, in which oral health is also an integral part. Thus, oral health counseling becomes important for the expectant mothers. Gynecologists, due to frequent contacts with family, are the first ones who can provide information for improving oral health care to the mothers.[3] Pregnancy is a time when a woman takes utmost care of her health. Health information will be of much interest to her and her family, and health professionals can more easily motivate her to follow guidelines toward a sound physical health which in turn will also benefit the infant. Pregnancy is generally a good time to instill appropriate oral hygiene information and practices in expectant mothers. In 1976, Nowak et al. reported that parental exposure in prenatal counseling provides an excellent opportunity, for both parents, to establish their own oral health practice.[4] There are a plenty of reasons why health-care professionals have to be involved in expectant mothers' oral health education. There are reports of poor periodontal health in mothers leading to pre term low birth weight babies, transmission of caries causing bacteria. i.e.  Streptococcus mutans Scientific Name Search ansmitted from mother to the child and risk of tetracycline stains in child if mother taking these medications during pregnancy.[5],[6],[7] Thus, by increasing the involvement of gynecologists during pregnancy care visits, they may be able to play an important role in improving the oral health for their patients. However, it is unclear that to what extent these medical professionals are really aware of preventive strategies and to what extent they impart preventive dental counseling as a part of pregnancy visits. Therefore, the present study was designed to assess the knowledge, attitude, and practices regarding oral health of expectant mothers among the gynecologists of the medical colleges in Bhubaneswar.


   Materials and Methods Top


The city of Bhubaneswar in Odisha has one government medical college and three private medical colleges to meet the health-care needs of the population apart from various private hospitals, nursing homes, community health centers, and primary health center.

The study was designed to enquire the knowledge and attitude among the gynecologists in medical colleges in the city as they will impart their knowledge toward oral health to their students in their respective colleges.

The ethical approval was obtained from the ethical committee of the university as well as the head of the medical colleges in which the survey would be conducted.

There are 25 gynecologists working in all the four medical colleges who were approached for this questionnaire-based survey. The questionnaire was given on a day and collected on the next day. Informed consent was obtained from the participants too. The data were analyzed by applying descriptive and inferential statistical analysis.


   Results Top


There were 7 male gynecologists and 14 female gynecologists of the 21 gynecologists who undertook the study [Figure 1]. Most of the gynecologists (11) were between the age group of 40–50 years [Figure 2]. The gynecologists had more than 10 years of experience (15), with very few (3) having <3 years of experience [Figure 3].
Figure 1: Gender

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Figure 2: Years in practice

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Figure 3: Age

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Further results are shown in [Table 1].
Table 1: Questionnaire eliciting the responses from the gynaecologists involved in the study

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   Discussion Top


Optimal dental care and preventive measures during pregnancy can reduce poor prenatal outcomes and reduce the incidence of early childhood caries. The oral lesions, such as gingivitis and pregnancy tumors, are benign and do not require any complicated treatment, only reassurance and monitoring is all what is required.[8] Knowledge of oral health among the health-care professionals, especially the gynecologists, should be adequate to provide a preventive approach to dental diseases. There is always an advantage of doing a questionnaire-based study as it allows information to be collected and to be analyzed easily and it allows the concerned specialists to express their perception freely on oral health care.

In the present study, it was observed that most of the gynecologists had good knowledge, attitude, and practice regarding oral health of the expectant mother.

Nearly 71% of the gynecologists in our study did not recommend fluoridated toothpaste which was way below the results of the studies conducted earlier and needs to be taken care of.[9]

The expectant mothers were referred to dentists for dental evaluation by all the gynecologists (100%), which was better than studies done previously.[10]

Most of the gynecologists (67%) stated that maternal oral health examination is an integral part of overall health examination.[11]

Many of the gynecologists (61%) did not know whether periodontal disease in mothers may lead to preterm low-birth-weight babies, which again was lower than similar studies done.[12]

Infant oral health-care advice should be given to expectant mothers and most gynecologists (90.47%) agreed on this although they are unclear that dental caries in the mother can be transmitted to their child.[13]

There were certain questions regarding infant oral health for gynecologists. This was never assessed in any of the previous studies. Most gynecologists agreed that nighttime feeding has a greater caries risk (86%) in infants. Further, they also thought that the mother having a higher risk of caries will lead to the child having higher risk (71%). Most (62%) of the gynecologists also added that the first dental visit to a dentist should be before 1 year of age of the child, which is in line with the American Academy of Pediatric Dentistry specifications.[14]

The age and experience of the gynecologists also contributed in providing appropriate knowledge on infant oral health as seen in the present study. Those having more than 10 years of experience in their field were having good attitude, which may be attributed to the varied numbers of cases they are seeing.[15]

This study also established the fact that gynecologists are the primary health-care providers to impart proper knowledge on oral health of both the mother and the infant during and after the term of pregnancy. Increasing the role of gynecologists in providing oral health care can play an important role in improving the dental health of expectant mothers as well as infants. This is particularly important in developing countries with semiurban and rural populations, where access to professional dental care is poor. The emphasis should be on preventive measures rather than treatment of dental disease.

There should be more involvement of gynecologists and pediatricians in the dental forums and similarly of pediatric dentists in their conferences, so that both the groups are aware of their roles in the prevention of dental diseases at the earliest.


   Conclusion Top


The results of the study found most gynaecologists are having good knowledge on maternal and infant oral health but still there were few areas like use of fluoridated toothpastes, transmission of caries causing bacteria from mother to child which needs to be addressed.

There is a need for a multidisciplinary approach with all the health-care professionals including pediatric dentists, pediatricians, and gynecologists to frame a preventive protocol to prevent dental diseases to occur.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Di Giuseppe G, Nobile CG, Marinelli A, Angelillo IF. Knowledge, attitude and practices of pediatricians regarding the prevention of oral diseases in Italy. BMC Public Health 2006;6:176.  Back to cited text no. 1
    
2.
Huebner CE, Milgrom P, Conrad D, Lee RS. Providing dental care to pregnant patients: A survey of Oregon general dentists. J Am Dent Assoc 2009;140:211-22.  Back to cited text no. 2
    
3.
Da Costa EP, Lee JY, Rozier RG, Zeldin L. Dental care for pregnant women: An assessment of North Carolina general dentists. J Am Dent Assoc 2010;141:986-94.  Back to cited text no. 3
    
4.
Nowak AJ, Casamassimo PS, McTigue DJ. Prevention of dental disease from nine months in utero to eruption of the first tooth. J Am Soc Prev Dent 1976;6:6-12.  Back to cited text no. 4
    
5.
Tandon S, D'Silva I. Periodontal physiology during pregnancy. Indian J Physiol Pharmacol 2003;47:367-72.  Back to cited text no. 5
    
6.
Xiong X, Buekens P, Fraser WD, Beck J, Offenbacher S. Periodontal disease and adverse pregnancy outcomes: A systematic review. BJOG 2006;113:135-43.  Back to cited text no. 6
    
7.
Li Y, Caufield PW, Dasanayake AP, Wiener HW, Vermund SH. Mode of delivery and other maternal factors influence the acquisition of Streptococcus mutans in infants. J Dent Res 2005;84:806-11.  Back to cited text no. 7
    
8.
Gaffield ML, Gilbert BJ, Malvitz DM, Romaguera R. Oral health during pregnancy: An analysis of information collected by the pregnancy risk assessment monitoring system. J Am Dent Assoc 2001;132:1009-16.  Back to cited text no. 8
    
9.
Speirs RL. The relationship between fluoride concentrations in serum and in mineralized tissues in the rat. Arch Oral Biol 1986;31:373-81.  Back to cited text no. 9
    
10.
Subramaniam P, Babu KL, Babu PS, Naidu P. Oral health care of children: Gynecologists and pediatricians' perspective. J Clin Pediatr Dent 2008;32:253-8.  Back to cited text no. 10
    
11.
Al-Habashneh R, Aljundi SH, Alwaeli HA. Survey of medical doctors' attitudes and knowledge of the association between oral health and pregnancy outcomes. Int J Dent Hyg 2008;6:214-20.  Back to cited text no. 11
    
12.
Gazolla CM, Ribeiro A, Moysés MR, Oliveira LA, Pereira LJ, Sallum AW, et al. Evaluation of the incidence of preterm low birth weight in patients undergoing periodontal therapy. J Periodontol 2007;78:842-8.  Back to cited text no. 12
    
13.
Peralise FJ, Maciel SM, de Andrade FB, Garcia JE, Poli-Frederico RC. Detection of Streptococcus mutans of the spaP gene and dental caries in mother/child pairs. Rev Gaucha Odontol 2013;61:205-11.  Back to cited text no. 13
    
14.
American Academy of Pediatrics, Section on Pediatric Dentistry and Oral Health. A policy statement: Preventive intervention for pediatricians. Pediatrics 2008;122:1387-94.  Back to cited text no. 14
    
15.
Hashim R, Akbar M. Gynecologists' knowledge and attitudes regarding oral health and periodontal disease leading to adverse pregnancy outcomes. J Int Soc Prev Community Dent 2014;4:S166-72.  Back to cited text no. 15
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1]



 

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    Abstract
   Introduction
    Materials and Me...
   Results
   Discussion
   Conclusion
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