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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 11  |  Issue : 6  |  Page : 331-334  

Evaluation of gynecologists’ awareness about oral health condition during pregnancy in Chennai city


1 Department of Prosthodontics and Crown and Bridge, Tagore Dental College and Hospital, Chennai, Tamil Nadu, India
2 Department of Prosthodontics and Crown and Bridge, KSR Institute of Dental Sciences and Research, Tiruchengode, Tamil Nadu, India

Date of Web Publication28-May-2019

Correspondence Address:
Dr. Muthuvignesh Jayaram
Department of Prosthodontics, KSR Institute of Dental Sciences and Research, Tiruchengode, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JPBS.JPBS_24_19

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   Abstract 

Background/Objectives: A cross-sectional study was conducted to evaluate the knowledge and practiced behaviors of gynecologists regarding oral health during pregnancy and association of periodontal disease with adverse pregnancy outcomes. Materials and Methods: This study was conducted among 200 gynecologists. A self-structured, close-ended questionnaire containing 22 questions was prepared. The principal investigator approached the gynecologists personally and distributed the questionnaire after obtaining their informed consent. Results: Of the 200 gynecologists approached, 200 filled the questionnaire, yielding a response rate of 100%. The majority (87%) acknowledged a connection between oral health and pregnancy and 63% agreed that periodontal disease can affect the outcome of pregnancy. However, only 60% gynecologists advise major/minor surgery during pregnancy, and many of them (74%) said that second trimester is the safe period for dental treatment. Almost three-quarters of the participants (79%) regarded dental radiograph and more than half (74%) considered administration of local anesthesia to be unsafe during pregnancy. Conclusion: This study demonstrated that gynecologists have a relatively certain level of knowledge regarding oral health status during pregnancy and the relationship of periodontal disease to pregnancy outcomes. However, there clearly exist misconceptions regarding the provision of dental treatment during pregnancy. To provide better oral health care, more knowledge needs to be made available to the pregnant women and medical community, mainly to the gynecologists who are primary health-care providers for pregnant women, and misconception regarding the types of dental treatments during pregnancy should be clarified.

Keywords: Gynecologist, knowledge, misconceptions, oral health status, periodontal disease, pregnancy outcomes


How to cite this article:
Paneer S, Muthusamy N, Manickavel RP, Venkatakrishnan CJ, Rathnavelu P, Jayaram M. Evaluation of gynecologists’ awareness about oral health condition during pregnancy in Chennai city. J Pharm Bioall Sci 2019;11, Suppl S2:331-4

How to cite this URL:
Paneer S, Muthusamy N, Manickavel RP, Venkatakrishnan CJ, Rathnavelu P, Jayaram M. Evaluation of gynecologists’ awareness about oral health condition during pregnancy in Chennai city. J Pharm Bioall Sci [serial online] 2019 [cited 2019 Jun 18];11, Suppl S2:331-4. Available from: http://www.jpbsonline.org/text.asp?2019/11/6/331/258820




   Introduction Top


Pregnancy involves complex physical and hormonal changes that have a significant effect on almost every organ system, including the oral cavity. Oral problems associated with pregnancy primarily include gingivitis and periodontal infection.[1] Oral health during pregnancy has long been a focus of interest. It involves multiple substantial and hormonal changes that have a momentous impact at the time of pregnancy.[2] Pregnant women with periodontitis may be at a higher risk of preterm birth/low birth weight (PLBW).[3] Studies showed 18.2% of all PLBW cases may be attributable to the periodontal disease.[4] Although the mechanisms by which periodontal diseases may cause preterm birth and/or low birth weight have not been elucidated, one proposed mechanism relates to the seeding of urinary tract infections with bacteria from periodontal disease in the mother.[5],[6],[7]

Gynecologists are the primary health-care providers who are in constant contact with the pregnant women and are often involved in the assessment and treatment of women all over their lives.[8],[9] Understanding the level of their knowledge on the association of periodontal disease with the pregnancy outcomes can improve pregnancy outcomes and prevent preterm deliveries.[10] Hence, the aim of this study was to evaluate the knowledge, awareness, and practiced behaviors of gynecologists regarding oral health care during pregnancy and association of periodontal disease with adverse pregnancy outcomes in Chennai city.


   Materials and Methods Top


The present cross-sectional study was conducted among randomly selected gynecologists in Chennai city. In this study, 200 gynecologists participated and returned completely filled questionnaires. All the data were collected from gynecologists who are practicing in both the government and private hospitals/clinics in Chennai. A self-structured, closed-ended questionnaire containing 22 questions was prepared. The principal investigator approached the gynecologists personally and distributed the questionnaire after obtaining their informed consent. Their confidentiality was assured. The questions were answered immediately in 5 minutes and handed over to the investigator. Questions are summarized in [Table 1].
Table 1: Questionnaire

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Statistical analysis

All returned questionnaires were coded and analyzed. Results were expressed as the number and percentage of respondents for each question and this descriptive statistics was analyzed using SPSS statistical package.


   Results Top


Of the 200 eligible gynecologists, all agreed to participate in this study and returned completely filled questionnaires, yielding a response rate of 100%; the results obtained are summarized in [Table 2].
Table 2: Results

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[Table 2] and [Figure 1], [Figure 2], [Figure 3] display response of the gynecologists to the questions. More than 64% of the participants agreed that pregnancy increases the likelihood of gingival inflammation. Similarly, a high percentage (87%) of the gynecologists acknowledged a positive association between oral health and pregnancy. In addition, 67% believed that gingival/periodontal inflammation can affect the outcome of pregnancy and 63% agreed that periodontal disease can lead to preterm labor and low birth weight.
Figure 1: Gynecologists’ awareness about relationship between periodontal disease and pregnancy

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,
Figure 2: Gynecologists’ attitude and opinion regarding dental treatments during pregnancy

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,
Figure 3: Safest trimester of dental treatment—opinion by gynecologists

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This study also shows that 74% of the gynecologists considered second trimester to be the safest time for dental procedures, 67% of them advised their patients to visit dentist during pregnancy, 21% considered intra and extra oral radiographs to be safe, and 74% considered administration of local anesthesia containing vasoconstrictor to be unsafe during pregnancy.


   Discussion Top


To our knowledge, this is the first published study conducted in Chennai to assess the level of knowledge of the gynecologists in relation to the association of periodontal disease with pregnancy outcomes. Although the overall knowledge level of the gynecologists was satisfactory in this study, there still exist minor misconceptions among gynecologists regarding provision of dental treatments during pregnancy. In response to the question whether it is safe to take intra/extraoral radiographs for a pregnant patient, most of the gynecologists (79%) answered “No.” Dental radiographs play an important role in diagnosis and treatment of many dental conditions.[11],[12] Many studies have reported that it is safe to take necessary intra/extraoral dental radiographs of pregnant women, and that they do not pose any risk to developing fetus.

Another frequent misconception in relation to dental treatment of pregnant women is avoiding the use of local anesthetic agents containing vasoconstrictors. The majority (74%) did not believe that local anesthesia containing vasoconstrictor is safe for pregnant women.[10],[13] Research[14] has shown that the use of regular dental anesthetics containing vasoconstrictors during pregnancy is safe. Certain limitations exist in this study. However, this study might provide baseline information for continuing education programs in future that are provided to gynecologists working in Chennai.


   Conclusion Top


Maternal health-care professionals play a vital role in promoting good oral health by connecting pregnant women to the source of dental care. Gynecologists in this study displayed certain level of knowledge, but some misconceptions exist among them regarding the types of dental treatment performed during pregnancy. So to provide better oral health care, more awareness and knowledge needs to be made available to the pregnant women and medical community, mainly to the gynecologists who are primary health-care providers for pregnant women and misconception regarding the types of dental treatments during pregnancy should be clarified and can thereby reduce the incidence of maternal and neonatal complications.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Gajendra S, Kumar JV. Oral health and pregnancy: A review. N Y State Dent J 2004;70:40-4.  Back to cited text no. 1
    
2.
Krejci CB, Bissada NF. Women’s health: Periodontitis and its relation to hormonal changes, adverse pregnancy outcomes and osteoporosis. Oral Health Prev Dent 2012;10:83-92.  Back to cited text no. 2
    
3.
Nutalapati R, Ramisetti A, Mutthineni RB, Jampani ND, Kasagani SK. Awareness of association between periodontitis and PLBW among selected population of practising gynecologists in Andhra Pradesh. Indian J Dent Res 2011;22:735.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G, et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 1996;67 (Suppl 10S): 1103-13.  Back to cited text no. 4
    
5.
Cengiz SB. The pregnant patient: Considerations for dental management and drug use. Quintessence Int 2007;38:e133-42.  Back to cited text no. 5
    
6.
American Dental Association. Women’s oral health issues. Chicago: American Dental Association; 1995.  Back to cited text no. 6
    
7.
Annan B, Nuamah K. Oral pathologies seen in pregnant and non-pregnant women. Ghana Med J 2005;39:24-7.  Back to cited text no. 7
    
8.
Reese HH. Significance of endocrine and vitamin deficiencies as etiologic factors in dental abnormalities. J Am Dent Assoc 1930;17:2198-208.  Back to cited text no. 8
    
9.
Patil SN, Kalburgi NB, Koregol AC, Warad SB, Patil S, Ugale MS. Female sex hormones and periodontal health-awareness among gynecologists—A questionnaire survey. Saudi Dent J 2012;24:99-104.  Back to cited text no. 9
    
10.
Wilder R, Robinson C, Jared HL, Lieff S, Boggess K. Obstetricians’ knowledge and practice behaviors concerning periodontal health and preterm delivery and low birth weight. J Dent Hyg 2007;81:81.  Back to cited text no. 10
    
11.
Rainchuso L. Improving oral health outcomes from pregnancy through infancy. J Dent Hyg 2013;87:330-5.  Back to cited text no. 11
    
12.
Kumar J, Samelson R. Oral health care during pregnancy recommendations for oral health professionals. N Y State Dent J 2009;75:29-33.  Back to cited text no. 12
    
13.
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. 13
    
14.
Mendia J, Cuddy MA, Moore PA. Drug therapy for the pregnant dental patient. Compend Contin Educ Dent 2012;33:568-70, 572, 574-6 passim; quiz 579, 596.  Back to cited text no. 14
    


    Figures

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

  [Table 1], [Table 2]



 

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