Oral Health Knowledge, Practices, and Awareness of Oral Health Guidelines and Dental Coverage Policies among Midwives

Abstract

Introduction Good oral health during the prenatal period translates into better oral and overall health for women and their infants. Although the importance of oral health during pregnancy is well established, oral health assessments are not routinely included in prenatal care visits. The purpose of this study was to explore prenatal care providers’ practices regarding oral health assessments and identify reasons for the gap in oral health integration in prenatal care. Data were gathered from midwives in Virginia, United States. Information on midwives’ knowledge about oral health, education, practices, and awareness of oral health guidelines and the pregnancy‐related Medicaid dental benefit policy in Virginia was collected. Methods An online survey was distributed to midwives practicing in Virginia through their state‐level professional organization. The data were collected online, and descriptive data analyses were conducted. Results A total of 30 midwives (mean age 51.9 years) participated in the survey for an overall response rate of 13.6%. Among survey participants, knowledge of oral health was high (score of 4.69 out of 5). Nearly 20% of participants reported receiving no education about oral health during professional training, and 72.4% reported no receipt of continuing education about oral health in the past year. Although 86% of the participants reported discussing oral health in clinical practice, only 10.3% reported conducting oral health assessments. Awareness of Virginia's Medicaid dental benefit policy was high (75.9%), but less than half of the participants were aware of oral health guidelines (44.1%). Although many midwives did not conduct oral health assessments, 79.3% reported that they provided oral health referrals to pregnant patients. Discussion Enhancing and integrating education about oral health in the academic curriculum for midwives and providing them with opportunities for continuing education about oral health can improve their engagement with oral health. Sharing of evidence‐based guidelines through organizational newsletters, meetings, and other venues can be ways to increase awareness of new guidelines and health coverage benefits among midwives.

Knowledge, attitudes, and practices of prenatal care practitioners regarding oral health in pregnancy—A systematic review

“…There were only a few cases of PCP performing oral examinations after the diagnosis of pregnancy (5.3% of gynecologists) 24 and periodically or routinely in appointments (37.6% of PCP including midwives, nurses, general physicians, and residents) 26 . When considering referral to oral health care, 15.0% 24 to 80.0% 27 of gynecologists recommended their patients to go to the dentist, rates that were similar to those of midwives (17.2% 35 to 79.3% 30 ). 24,26,27,29,30,32,35,37,38 Regarding referral during the preconception period, 28% (gynecologists) to 55.0% (gynecologists and midwives) of the professionals reported doing it, 34,37 whereas in one study only 21.9% (midwives and midwifery students) never referred 40 .…”

“…The level of knowledge of PCP was adequate in 14 out of 24 studies, with the subgroup of gynecologists/obstetricians presenting adequate knowledge in 65.0% of the studies (10 out of 16 studies; Table S1), followed by general and family physicians (60.0%; 3 out of 5 studies; Table S2), midwifes (33.0%; 3 out of 9 studies; Table S3), and nurses (25.0%; 1 out of 4 studies; Table S4). 19,20,23–26,29,30,32,33,36,37,40,41 …”

“…40 The second trimester was named the safest during which to perform dental procedures by 46.0%-74.0% of gynecologists/ obstetricians. 20,24,27,32,37 Concerning their attitudes, 19,23,24,29,[31][32][33][34]40 (6 out of 10 studies; Table S1), 19,[23][24][25]28,[32][33][34]37,38 contrasting with midwives (43.0%; 3 out of 7 studies; Table S3), 26,30,31,34,35,40,42 general physicians (0.0%; 0 out of 2 studies; Table S2), 25,26 and nurses (0.0%; 0 out of 4 studies; Table S4). 21,26,35,42 Regarding practices, these were only adequate in 25.0% of the studies evaluating gynecologists and obstetricians (2 out of 8 studies; Table S1), 19,24,25,28,[32]…”

“…Table S3), 26,30,31,[34][35][36]39,40,42 33.0% of studies evaluating general practitioners (1 out of 3 studies; Table S2), 25,26,29 and 0.0% of the studies evaluating nurses (0 of 4 studies; Table S4). 21,26,35,42 Although the majority of PCP acknowledged the importance of oral health care during pregnancy, most professionals did not interview pregnant women on their oral health status and the reasons presented were lack of oral health training, the subject not being a priority, or because asking about oral health care was considered outside the scope and responsibility of PCP.…”

“…The questionnaires implemented in the different studies varied in the number of questions (ranged from 15 21,36 to 82 questions 40 ), and the authors resorted to "Yes/ No" questions, 19,20,23,25,27,32,33,36,37,41,43 multiple-choice, 22,31 and Likert scales. 21,24,26,[28][29][30]34,37,38,40,42 All questionnaires were selfanswered, 10 of which were carried out online. 23,[26][27][28]30,31,36,39,41 The content of the questionnaires applied is summarized in Table 2.…”