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Table of Contents
ORIGINAL ARTICLE
Year : 2013  |  Volume : 3  |  Issue : 1  |  Page : 18-20

Utilization of dental services due to dental pain by pregnant women in India: A qualitative analysis


1 Department of Public Health Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal University, Karnataka, India
2 Department of Pedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal University, Karnataka, India

Date of Web Publication25-Oct-2013

Correspondence Address:
Varghese Chacko
Department of Pedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal University, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5194.120519

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   Abstract 

Objectives: The purpose of this cross-sectional survey was to evaluate the utilization of dental services by pregnant women due to dental pain and also to evaluate the role of their educational qualification on utilization. Materials and Methods: The research tool was a semi-structured questionnaire, which was completed by 175 pregnant women attending various primary health centers, private clinics and nursing homes in Mangalore. The women were divided into two groups namely, Group 1: Who have not been graduated and Group 2: Who have been graduated. Comparisons were made between Group 1 and Group 2. The data collected was analyzed using descriptive statistics, Chi-square test and odds ratio (OR). Results: Decayed teeth were found to be the predominant factor of pain as reported by women in both groups. However, the number of women who utilized dental services during this period was almost identical in both the groups, with 23.5% women in Group 1 and 24.7% women in Group 2. However, the association between utilization of dental care among pregnant women in both groups who did not report dental pain during pregnancy and those who did report showed statistical significance (OR = 13.63; 95% confidence interval = 3.81, 48.75). Conclusion: The present study showed that despite the presence of pain due to dental causes, utilization of dental services by pregnant women was poor. It was also revealed that those with a graduate qualification were more likely to visit a dentist for preventive treatment during pregnancy
Clinical Relevance to Interdisciplinary Dentistry

  1. Utilization of oral health-care services will provide insight to dental clinicians about treatment planning and also to educate about the treatment option to patients.
  2. Pregnant women being one of the target groups for oral health services, oral health professionals must know in detail about their utilization history.
  3. Pain is an important factor for utilization of the dental services, which may be due to pulpal, periodontal and oral lesions. Etiology and treatment planning requires an interdisciplinary approach.

Keywords: Dental services, pain, pregnant women, utilization


How to cite this article:
Shenoy R, Chacko V. Utilization of dental services due to dental pain by pregnant women in India: A qualitative analysis. J Interdiscip Dentistry 2013;3:18-20

How to cite this URL:
Shenoy R, Chacko V. Utilization of dental services due to dental pain by pregnant women in India: A qualitative analysis. J Interdiscip Dentistry [serial online] 2013 [cited 2019 Jun 20];3:18-20. Available from: http://www.jidonline.com/text.asp?2013/3/1/18/120519


   Introduction Top


Dental pain is one of the major factors in quest of treatment. It is a common symptom of the oral health problems. It affects an individual's daily life activities, such as eating, sleeping and social functioning and also major cause of absenteeism (i.e., time lost from work or school). Obtaining information about oral pain and utilization of dental services has become an important part of national health surveys. [1] Utilization is the actual attendance by the members of the public at health-care facilities to receive care. Utilization, which measures the number of visits per year or the number of people with at least one visit during the previous year, serves as an important tool for oral health policy decision-making. [1],[2],[3],[4] Factors related to utilization would be knowledge about dental care, unpleasant experience and socioeconomic status. [3]

Pregnant women being one of the target groups for oral health-care, utilization of oral health-care services among them should be surveyed. Several reasons had been cited to prevent them to avail dental treatment like fear and anxiety of the treatment, low perception for dental problems and misconception regarding effects of dental treatment on the developing fetus. [5],[6],[7],[8] However, in the literature it showed uptake of oral health-care services among the antenatal mothers has been unsatisfactory. [9],[10] None of the research specifically focused on utilization of the dental services by pregnant women due to pain.

Hence, the present study was undertaken to evaluate the utilization of dental services by pregnant women due to dental pain and also to evaluate the role of their educational qualification on utilization.


   Materials and Methods Top


A cross-sectional study was carried out for a period of 3 months after obtaining the ethical clearance from the Institutional Ethics Committee. Written informed consent was obtained from the participants and participation was voluntary. A semi-structured questionnaire was given to the pregnant women which contained questions about the following variables; demographic details, oral hygiene practices, dental problems and visit to a Dentist. The questionnaire was completed by the participants in the presence of one of the investigators. A total of 175 pregnant women were participated in the study. These included women attending various primary health-care centers, private nursing homes/clinics in Mangalore. The pregnant women were then divided into two groups as follows:

  • Group 1: Subjects who have not completed graduation
  • Group 2: Subjects who have completed graduation.


Data will be analyzed using Statistical Package for Social Sciences (SPSS), version 11.5 (SPSS Inc., Chicago IL). Chi-square test and odds ratio (OR) were calculated to evaluate the utilization of dental services by pregnant women for pain and to also evaluate the influence of their educational qualifications on utilization.


   Results Top


Demographic characteristics

A total of 175 pregnant women within the age group of 20-35, participated in the survey. Demographic characteristics of the participants are mentioned in [Table 1].
Table 1: Demographic characteristics of study participants

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Oral health problems of Group 1 and Group 2 women are shown in [Table 2]. The predominant dental problem reported by women in Group 1 was dental pain (28.6%) and in Group 2 were decayed teeth (32.5%).
Table 2: Oral health problems with or without pain as reported by study subjects

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However, the number of women who utilized dental services during this period was almost identical in both groups, with 23.5% women in Group 1 and 24.7% women in Group 2. This did not show any statistical significance (OR = 1.17; 95% confidence interval [CI] = 0.57, 2.40) (P = 0.39).

The present study assessed the association between utilization of dental care among pregnant women in both groups who did not report dental pain during pregnancy and those who did report [Table 3]. Even though 28.57% of pregnant women had dental pain in Group 1, only 23.5% visited the Dentist for treatment. It was also noted that subjects in Group 2 had received dental care in the absence of dental pain (OR = 1.5; 95% CI = 0.42, 5.25) (P = 0.39).

It was also seen that, those who were in first pregnancy did not show any statistical significance in reporting pain and utilization of dental services in both the groups (OR = 1.5; 95% CI = 0.42, 5.25) [Table 4]. On the contrary to this one who had one or more children showed statistical significance in reporting pain and utilization of dental services as compared to who were in first pregnancy (OR = 3.62; 95% CI = 1.64, 10.72) [Table 5].
Table 3: Association between the presence of dental pain and utilization of dental services between group 1 and group 2

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Table 4: Association between the presence of dental pain and utilization of dental services between group 1 and group 2 in their first pregnancy

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Table 5: Association between the presence of dental pain and utilization of dental services between group 1 and group 2 with one or more children

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   Discussion Top


There is limited literature concerning the utilization of the dental services by pregnant women and very few published reports on utilization of dental services due to pain. In this survey done on pregnant women, it was found that even though many women reported the presence of decayed teeth and signs of periodontal disease, namely bleeding gums, bad taste, ulcers and pain, only 24% of the women reported visiting a Dentist during this period. This figure is comparable to figures seen in other countries like Australia, where Dinas et al. [8] reported that 30% of the women utilized dental services during the pregnancy [11] and in the US, where 22.7-34% of the pregnant women accessed dental care during pregnancy. [12] Even though 28.75% of pregnant women had dental pain in Group 1, only 23.5% visited a visit the Dentist for treatment. This is in agreement with the findings reported by Al-Shammari et al., [13] where half of the women had visited a Dentist during pregnancy mostly for dental pain.

The present study assessed the association between utilization of the dental care among pregnant women in both groups who did not report dental pain during pregnancy and those who did report. Even though 28.75% of pregnant women had dental pain in Group 1, only 23.5% visited the Dentist for treatment. Results also showed in Group 2 pregnant women who had no dental pain but received dental care. This may be due to higher educational level (OR = 13.63; 95% CI = 3.81, 48.75). Similar findings were observed by Ravaghi et al., [1] Al Habashneh et al. [7] and Lydon-Rochelle et al. [14]

Few of the important limitations of this study were its cross-sectional design, which precludes causal association of pain to oral status, socio-economic status, onset of pain to dental visits, recall bias for questions regarding previous experience of oral pain.

The present study showed that despite the presence of pain due to dental causes, utilization of dental services by pregnant women was poor. It was also revealed that those with a graduate qualification were more likely to visit a dentist for preventive treatment during pregnancy. Thus it can be recommended from the findings of this study that those without a graduate qualification need more assistance in accessing dental care, especially care for pain relief as this would result in an immediate improvement in oral health and related quality of life.

 
   References Top

1.Ravaghi V, Quiñonez C, Allison PJ. Oral pain and its covariates: Findings of a Canadian population-based study. J Can Dent Assoc 2013;79:d3.  Back to cited text no. 1
    
2.Manski RJ, Moeller JF, Maas WR. Dental services. An analysis of utilization over 20 years. J Am Dent Assoc 2001;132:655-64.  Back to cited text no. 2
    
3.Poudyal S, Rao A, Shenoy R, Priya H. Utilization of dental services in a field practice area in Mangalore, Karnataka. Indian J Community Med 2010;35:424-5.  Back to cited text no. 3
[PUBMED]  Medknow Journal  
4.Maserejian NN, Trachtenberg F, Link C, Tavares M. Underutilization of dental care when it is freely available: A prospective study of the New England Children's Amalgam Trial. J Public Health Dent 2008;68:139-48.  Back to cited text no. 4
    
5.Mangskau KA, Arrindell B. Pregnancy and oral health: Utilization of the oral health care system by pregnant women in North Dakota. Northwest Dent 1996;75:23-8.  Back to cited text no. 5
    
6.Le M, Riedy C, Weinstein P, Milgrom P. Barriers to utilization of dental services during pregnancy: A qualitative analysis. J Dent Child 2009;76:46-52.  Back to cited text no. 6
    
7.Al Habashneh R, Guthmiller JM, Levy S, Johnson GK, Squier C, Dawson DV, et al. Factors related to utilization of dental services during pregnancy. J Clin Periodontol 2005;32:815-21.  Back to cited text no. 7
    
8.Dinas K, Achyropoulos V, Hatzipantelis E, Mavromatidis G, Zepiridis L, Theodoridis T, et al. Pregnancy and oral health: Utilisation of dental services during pregnancy in northern Greece. Acta Obstet Gynecol Scand 2007;86:938-44.  Back to cited text no. 8
    
9.Hullah E, Turok Y, Nauta M, Yoong W. Self-reported oral hygiene habits, dental attendance and attitudes to dentistry during pregnancy in a sample of immigrant women in North London. Arch Gynecol Obstet 2008;277:405-9.  Back to cited text no. 9
    
10.Honkala S, Al-Ansari J. Self-reported oral health, oral hygiene habits, and dental attendance of pregnant women in Kuwait. J Clin Periodontol 2005;32:809-14.  Back to cited text no. 10
    
11.Thomas NJ, Middleton PF, Crowther CA. Oral and dental health care practices in pregnant women in Australia: A postnatal survey. BMC Pregnancy Childbirth 2008;8:13.  Back to cited text no. 11
    
12.Gaffield ML, Gilbert BJ, Malvitz DM, Romaguera R. Oral health during pregnancy: An analysis of information collected by the pregnancy risk assessment monitoring system. J Am Dent Assoc 2001;132:1009-16.  Back to cited text no. 12
    
13.Al-Shammari KF, Al-Ansari JM, Al-Khabbaz AK, Honkala S. Barriers to seeking preventive dental care by Kuwaiti adults. Med Princ Pract 2007;16:413-9.  Back to cited text no. 13
    
14.Lydon-Rochelle MT, Krakowiak P, Hujoel PP, Peters RM. Dental care use and self-reported dental problems in relation to pregnancy. Am J Public Health 2004;94:765-71.  Back to cited text no. 14
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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