Disparities in Oral Health Status During Pregnancy

Objective: Pregnancy presents unique challenges to good oral health (OH) -increased gingival inflammation, limited access to dental care- putting women and their infants at increased risk for developing dental problems. This research examines sociodemographic and behavior-related disparities in oral health status during pregnancy for this vulnerable population using baseline data from an ongoing study, CenteringPregnancy® Oral Health Promotion (CPOP).

Methods: CPOP, a pilot study (n=99), tests an educational intervention aiming to promote maternal and infant OH in pregnant women, many from underserved communities, attending a group prenatal care program, CenteringPregnancy® (CP®). Baseline assessment from 4 San Francisco CP® sites during their 2^nd trimester of pregnancy included a dental exam and questionnaire. Exam data (n=94) included full mouth periodontal probing, bleeding on probing, and visual determination of untreated decay. The questionnaire included demographics (race/ethnicity, income, education, dental insurance) and OH-related behaviors (oral hygiene practices and dental care utilization). Chi-squared, one-way ANOVA, and logistic or multivariable regression analyses were conducted to examine the relationship between sociodemographic and behavioral factors with OH status during pregnancy.

Results: Hispanic ethnicity, lower household income, public dental insurance, and lacking a dental visit in the past year were significantly associated with poorer outcomes for all 3 OH variables (untreated decay, probing depths, gingival bleeding) in the bivariate analyses. After controlling for other variables, insurance status, education, and dental visit were significantly associated with untreated decay while only lack of dental visit was significantly associated with higher probing depth (p<0.01); and suboptimal oral hygiene was marginally associated with greater bleeding on probing (p=0.08).

Conclusion: Although sociodemographic disparities in OH status during pregnancy were found, behaviors (oral hygiene, dental care utilization) remained the strongest predictors of gingival health after controlling for other variables. This indicates that interventions focused on promoting behavior change, such as CPOP, could help address these OH disparities.