Why do Women avoid Dental Visits During Pregnancy? A Cross-Sectional Survey in Al Madinah, Western Saudi Arabia

Najla Dar-Odeh, Sara M. Binsaad, Rafal A. Gasim, Razan Haidary, Amal Afandi, Shaden Abu-Hammad, Osama Abu-Hammad


Objective: To investigate why women avoid dental visits during pregnancy and to explore the possible association between this attitude and relevant socio-demographic factors. Material and Methods: An online questionnaire was distributed to pregnant women during their routine visits to antenatal clinics in Al Madinah, Saudi Arabia. The questionnaire explored socio-demographic factors of age, education, employment status and nationality. It also explored misconceptions/ reasons for avoiding dental visits during pregnancy. Results: A total of 360 pregnant women participated, and their mean age was 30.08 years (range=18-52 years, SD=5.96). The most commonly cited misconception/reason for avoiding dental visits was “local anesthesia is not safe during pregnancy”, followed by “transportation is difficult” and lastly, “dental treatment is not safe during pregnancy”, (43.6%, 37.5%, 18.9%, respectively). Illiterate participants were statistically significantly associated with the misconception of “unsafe dental treatment during pregnancy” (p=0.002), whereas school-level and unemployed participants were statistically significantly associated with the misconception of “unsafe local anesthesia during pregnancy” (p=0.02, p=0.036 respectively). Conclusion: Pregnant women avoid dental visits mainly due to the misconception that local anesthesia is not safe during pregnancy. Difficult transportation seems to be another important deterrent in preventing pregnant women to visit dentists in this geographic area. Changing the misconceptions should be the starting point in addressing this public health problem and this should involve the three parties involved: pregnant women, oral healthcare providers and obstetric care providers.


Pregnancy; Dental Care; Local Anesthesia

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Le M, Riedy C, Weinstein P, Milgrom P. Barriers to utilization of dental services during pregnancy: A qualitative analysis. J Dent Child 2009; 76(1):46-52.

George A, Johnson M, Blinkhorn A, Ajwani S, Bhole S, Yeo AE, Ellis S. The oral health status, practices and knowledge of pregnant women in south-western Sydney. Aust Dent J 2013; 58(1):26-33. doi: 10.1111/adj.12024.

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(5):405-9. doi: 10.1007/s00404-007-0480-8.

Adeniyi AA, Ogunbanjo BO, Sorunke ME, Onigbinde OO, Agbaje MO, Braimoh M. Dental attendance in a sample of Nigerian pregnant women. Nig Q J Hosp Med 2010; 20(4):186-91.

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(7):809-14. doi: 10.1111/j.1600-051X.2005.00770.x.

Lee RS, Milgrom P, Huebner CE, Conrad DA. Dentists' perceptions of barriers to providing dental care to pregnant women. Womens Health Issues 2010; 20(5):359-65. doi: 10.1016/j.whi.2010.05.007.

Machuca G, Khoshfeiz O, Lacalle JR, Machuca C, Bullon P. The influence of general health and socio-cultural variables on the periodontal condition of pregnant women. J Periodontol 1999; 70(7):779-85. doi: 10.1902/jop.1999.70.7.779.

Boggess KA, Edelstein BL. Oral health in women during preconception and pregnancy: Implications for birth outcomes and infant oral health. Matern Child Health J 2006; 10(5 Suppl):S169-74. doi: 10.1007/s10995-006-0095-x.

Wasylko L, Matsui D, Dykxhoorn SM, Rieder MJ, Weinberg S. A review of common dental treatments during pregnancy: Implications for patients and dental personnel. J Can Dent Assoc 1998; 64(6):434-9.

Morgan MA, Crall J, Goldenberg RL, Schulkin J. Oral health during pregnancy. J Matern Fetal Neonatal Med 2009; 22(9):733-9. doi: 10.3109/14767050902926954.

Strafford KE, Shellhaas C, Hade EM. Provider and patient perceptions about dental care during pregnancy. J Matern Fetal Neonatal Med 2008; 21(1):63-71. doi: 10.1080/14767050701796681.

Vergnes JN, Sixou M. Preterm low birth weight and maternal periodontal status: A meta-analysis. Am J Obstet Gynecol 2007; 196(2):135.e1-7. doi: 10.1016/j.ajog.2006.09.028.

Jared H, Boggess KA, Moss K, Bose C, Auten R, Beck J, Offenbacher S. Fetal exposure to oral pathogens and subsequent risk for neonatal intensive care admission. J Periodontol 2009; 80(6):878-83. doi: 10.1902/jop.2009.080642.

El Khateeb SM, Abu-Hammad O, Fadel H, Dar-Odeh N. A retrospective analysis of radiographic jaw findings in young women: Prevalence and predictors. J Int Soc Prev Community Dent 2017; 7(1):22-7. doi: 10.4103/2231- 0762.200707.

Khateeb SH B, Gafar A, Jaber S, Dar-Odeh N. Prevalence of dental caries among young women in central western region of Saudi Arabia. Int J Adv Dent Med Sci 2015; 1(2):46-9.

Ouanounou A, Haas DA. Drug therapy during pregnancy: Implications for dental practice. Br Dent J 2016; 220(8):413-7. doi: 10.1038/sj.bdj.2016.299.

Hagai A, Diav-Citrin O, Shechtman S, Ornoy A. Pregnancy outcome after in utero exposure to local anesthetics as part of dental treatment: A prospective comparative cohort study. J Am Dent Assoc 2015; 146(8):572-80. doi: 10.1016/j.adaj.2015.04.002.

Haas DA. An update on local anesthetics in dentistry. J Can Dent Assoc 2002; 68(9):546-51.

Lee JM, Shin TJ. Use of local anesthetics for dental treatment during pregnancy; safety for parturient. J Dent Anesth Pain Med 2017; 17(2):81-90. doi: 10.17245/jdapm.2017.17.2.81.

Giglio JA, Lanni SM, Laskin DM, Giglio NW. Oral health care for the pregnant patient. J Can Dent Assoc 2009; 75(1):43-8.

Dar-Odeh NS, Aleithan FA, Alnazzawi AA, Al-Shayyab MH, Abu-Hammad SO, Abu-Hammad OA. Factors affecting oral health determinants in female university students: A cross-sectional survey in Saudi Arabia. Int J Adolesc Med Health 2017; doi: 10.1515/ijamh-2017-0084.

Albarakati SF. Appointments failure among female patients at a dental school clinic in Saudi Arabia. J Dent Educ 2009; 73(9):1118-24.

WHO. Country cooperation strategy for WHO and Saudi Arabia 2012-2016. Available at: http://www.who.int/countryfocus/cooperation_strategy/ccs_sau_en.pdf. [Accessed 01 Dec 17].

Saudi Ministry of Labor. Data & Statistics. The annual statistical book 2013. Available at: www.moh.gov.sa/en/Ministry/Statistics/book/. [Accessed 01 Dec 17].

DOI: http://dx.doi.org/10.4034/PBOCI.2018.181.31