Self-reported oral hygiene habits, dental attendance and attitudes to dentistry during pregnancy in a sample of immigrant women in North London

Abstract

Aims

The aim of this study was to describe self-reported oral health, oral hygiene habits, frequency of visits to a dentist and factors associated with dental attendance among pregnant women at a North London Hospital, the majority of whom are immigrants.

Background

Peridontal disease is associated with an increased risk of adverse pregnancy outcomes. The aim of this study is to describe self-reported oral health, oral hygiene habits, frequency of visits to a dentist and factors associated with dental attendance among pregnant women at a North London Hospital, the majority of whom are immigrants.

Materials and methods

A questionnaire designed by the authors was completed by postnatal women within 3 days of delivery. Data collected included past dental attendance, reasons for attendance and information about age, parity and socio-economic group.

Results

In total, 206 women completed the questionnaires within 3 days of delivery; 74.2% of the mothers were not born in the UK and 38.3% were Black African. The mean age of was 28.19 ± 6.07 years. The majority reported good oral hygiene habits such as brushing their teeth twice a day (73.7%) and using mouthwash (51%). However, their dental attendance was poor and the average time since their last visit to a dentist was 1.8 ± 1.61 years. Over a third of the women questioned did not know about the availability of free dental care during pregnancy and for 12 months after; 33% visited a dentist in pregnancy and half of them needed and received treatment; 15% of mothers had more than one pregnancy and yet were still unaware of free dental care provided during pregnancy and 12 months after birth. Only 36% of questioned women regularly visited a dentist. Pregnancy did little to change their attitudes to dental care. There appears no difference in attitudes to dental care between immigrant and British born pregnant women.

Conclusion

Efforts to improve the uptake of dental care should be directed towards immigrant groups in order to promote better maternal health. Further research is required into the provision of dental care during pregnancy, as the high level of non-attendance demonstrated by mothers is undesirable.

Appendices

Appendix 1: Patient questionnaire

Patient identifier	…
1. How old are you?	…
2. What is your ethnicity?	…
3. What is your occupation?	…
4. If you are married please state your spouses’ occupation	…
5. Were you born in the UK?	Yes/No
6. Is English your first language?	Yes/No
7. Do you smoke?	Yes/No
8. Is this your first child?	First/Second/Third/Fourth/Other
9. Do you think your teeth have become worse during your pregnancy?	Yes/No
10. How often do you brush your teeth?	Once a day More than once a day Not everyday
11. Do you use any other oral hygiene methods?	Dental floss/Mouthwash/Other/None
12. Have you had problems with your gums during your pregnancy?	Yes/No
13. Did you know about free dental care in pregnancy and for 12 months after birth?	Yes/No
If “Yes” Where did you learn about free dental care?
GP/Antenatal Clinic/Midwife/Dentist/Family/Friend/Other
14. Do you visit the dentist regularly?	Yes/No
15. Have you seen dentist during this pregnancy?	Yes/No
If “Yes” please state the reason why?	For a routine check-up
	Because you had toothache For planned treatment For cleaning
16. When did you last have dental pain?	…
17. When did you last visit a dentist before your pregnancy?	…
18. What was the reason for your last visit?	Routine check-up
	Because you had toothache For planned treatment For cleaning Other
19. Are you planning to see dentist soon?	Yes/No
If “No” please state the reason	I do not think I need to
I have no time
I am afraid of dentists
Other
20. Has your pregnancy changed your attitude to the dental care?	Yes/No
If “Yes” What do you intend to do?	Visit the dentist
	Brush your teeth more frequently
Change your diet
Other

Appendix 2

The Registrar General’s classification of socioeconomic groups was used in this study as this is the most widely used in medical research. It divides the population into five social classes, I–V, with social class III being further subdivided into non-manual (IIIN) and manual (IIIM). This system of classification is based on occupation, and it groups occupations into social classes according to their skill level and general social standing in the community. For women, married women are allocated on the basis of their husband’s occupation, single women on the basis of their own occupation and unemployed women on that of their last significant period of employment [2] (Appendix 1, Table 2).

Table 2 Registrar General’s classification of social class