IADR Abstract Archives
Referral criteria for pregnant women to the periodontist: qualitative exploration
Objectives: Periodontal diseases are a public health problem. Though still controversial, a relationship with adverse pregnancy outcomes has been reported. The Clinical Practice Guideline of the "Comprehensive Oral Health for pregnant woman" (COHPW) program recommends a basic periodontal examination for all the beneficiaries in primary healthcare , as part of their periodontal evaluation, and a referral to the periodontist if required. In the Western Metropolitan Health Service (WMHS) in 2015, only 1.3% of pregnant women were referred to the secondary level. Objective: to qualitatively explore the referral criteria for pregnant women to the periodontist, used by dentists from primary care establishments of the WMHS.
Methods: A grounded theory-type qualitative research design with axial open coding was conducted to explore the topic “Referral and periodontal examination concept”. Transcripts of semi-structured interviews of 10 dentists, who participate in the IOHPW program in primary care in WMHS, were analyzed.
Results: Despite the use of a referral card, there is no consensus, and pregnant women are referred according to disease severity criteria, observing late signs of periodontal destruction. Little communication is reported between primary and secondary care level. In addition, there is a need to be more decisive. The basic periodontal exam (BPE) is considered a tool to define the referral criteria to the specialist, but there is a variation of what is understood by BPE, and the appropriate instruments are not used either. The BPE is considered an easy tool to conduct, serving as screening. However, it reduces the work time to carry out curative actions, which limits its application.
Conclusions: We did not find a unified criterion for periodontal examination and referral of pregnant women to the periodontal specialist. There may be an undervaluation and under-treatment of periodontal diseases in pregnant women in the WMHS primary care level.
Methods: A grounded theory-type qualitative research design with axial open coding was conducted to explore the topic “Referral and periodontal examination concept”. Transcripts of semi-structured interviews of 10 dentists, who participate in the IOHPW program in primary care in WMHS, were analyzed.
Results: Despite the use of a referral card, there is no consensus, and pregnant women are referred according to disease severity criteria, observing late signs of periodontal destruction. Little communication is reported between primary and secondary care level. In addition, there is a need to be more decisive. The basic periodontal exam (BPE) is considered a tool to define the referral criteria to the specialist, but there is a variation of what is understood by BPE, and the appropriate instruments are not used either. The BPE is considered an easy tool to conduct, serving as screening. However, it reduces the work time to carry out curative actions, which limits its application.
Conclusions: We did not find a unified criterion for periodontal examination and referral of pregnant women to the periodontal specialist. There may be an undervaluation and under-treatment of periodontal diseases in pregnant women in the WMHS primary care level.