Oral Health Literacy and Related Factors among Pregnant Women Referring to Health Government Institute in Kerman, Iran

Marzieh Karimi  Afshar; Molook  Torabi; Mahshid  Bahremand; Mehrnaz Karimi  Afshar; Fatemeh  Najmi; Iman  Mohammadzadeh

Authors

Marzieh Karimi Afshar
Molook Torabi
Mahshid Bahremand
Mehrnaz Karimi Afshar
Fatemeh Najmi
Iman Mohammadzadeh

Keywords:

Oral Health, Health Literacy, Health Behavior, Pregnancy

Abstract

Objective: To evaluate oral health literacy among pregnant women in Kerman, Iran. Material and Methods: The present cross-sectional study was conducted on 169 pregnant women referring to government institute. Data were collected by demographic profile (including age, number of children, educational level, dental attendance before pregnancy and economic status), 17-item oral health literacy questionnaire consisting of four domains (including reading comprehension, numeracy, listening, and decision-making skills), self-assessment oral health status, DMFT index and oral health behavior. Data were analyzed by SPSS version 21 software using ANOVA and Chi-square tests at a significance level of 0.05. Results: The mean age of participants was 27.92 ± 5.25 years, 38.2% of them had bachelor's degree, 35.8% had dental attendance before pregnancy and 29.1% brushed daily their teeth twice or more. Dentists were the most frequent source of oral health information. Moreover, 60.0% believed their oral health was to be moderate, and 59.4% had inadequate oral health literacy. There was also a significant correlation between educational level, monthly income and dental attendance before pregnancy. Conclusion: Our results showed inadequate oral health literacy among pregnant women, highlighting the necessity of dental consultation before pregnancy.

References

Cengiz SB. The pregnant patient: considerations for dental management and drug use. Quintessence Int 2007; 38(3):e133-42.

Xiong X, Buekens P, Fraser WD, Beck J, Offenbacher S. Periodontal disease and adverse pregnancy outcomes: a systematic review. BJOG 2006; 113(2):135-43. https://doi.org/10.1111/j.1471-0528.2005.00827.x

George A, Shamim S, Johnson M, Ajwani S, Bhole S, Blinkhorn A, et al. Periodontal treatment during pregnancy and birth outcomes: A meta-analysis of randomised trials. Int J Evid Based Healthc 2011; 9(2):122-47. https://doi.org/10.1111/j.1744-1609.2011.00210.x

American Academy of Pediatric Dentistry. Clinical Affairs Committee. Infant Oral Health Subcommittee. Guideline on infant oral health care. Pediatr Dent 2012; 34(5):e148-52.

Cucó G, Fernández-Ballart J, Sala J, Viladrich C, Iranzo R, Vila J, et al. Dietary patterns and associated lifestyles in preconception, pregnancy and postpartum. Eur J Clin Nutr 2006; 60(3):364-71. https://doi.org/10.1038/sj.ejcn.1602324

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

Ramos-Gomez FJ, Crystal YO, Wai M, Crall JJ, Featherstone JD. Pediatric dental care: prevention and management protocols based on caries risk assessment. J Calif Dent Assoc 2010; 38(10):746-61.

Kamate WI, Vibhute NA, Baad RK. Estimation of DMFT, salivary streptococcus mutans count, flow rate, pH, and salivary total calcium content in pregnant and non-pregnant women: a prospective study. J Clin Diagn Res 2017; 11(4):ZC147-ZC151. https://doi.org/10.7860/JCDR/2017/24965.9516

Mills LW, Moses DT. Oral health during pregnancy. MCN Am J Matern Child Nurs 2002; 27(5):275-80.

Buerlein J, Peabody H, Santoro K. NIHCM Foundation. Improving Access to Perinatal Oral Health Care: Strategies and Considerations for Health Plans: Issue Brief July 2010 National Institute for Health Care Management. Available from: www.nihcm.org/pdf/NIHCM-OralHealth-Final.pdf. [Accessed on Dec 01, 2014].

Thomas NJ, Middleton PF, Crowther CA. Oral and dental health care practices in pregnant women in Australia: a postnatal survey. BMC PregnancyChildbirth 2008; 8:13. https://doi.org/10.1186/1471-2393-8-13

George A, Johnson M, Blinkhorn A, Ellis S, Bhole S, Ajwani S. Promoting oral health during pregnancy: current evidence and implications for Australian Midwives. J Clin Nurs 2010; 19(23-24):3324-33. https://doi.org/10.1111/j.1365-2702.2010.03426.x

Pitiphat W, Joshipura KJ, Gillman MW, Williams PL, Douglass CW, Rich-Edwards JW. Maternal periodontitis and adverse pregnancy outcomes. Community Dent Oral Epidemiol 2008; 36(1):3-11. https://doi.org/10.1111/j.1600-0528.2006.00363.x

Oral Health Care During Pregnancy Expert Workgroup. Oral Health Care During Pregnancy: A National Consensus Statement. Washington: National Maternal and Child Oral health Resource Center; 2012.

Nielsen-Bohlman L, Panzer A, Hamlin B, Kindig D. Institute of Medicine. Health literacy: a prescription to end confusion. Committee on Health Literacy, Board on Neuroscience and Behavioral Health. Washington, DC: National Academies Press; 2004.

Protheroe J, Wallace LS, Rowlands G, DeVoe JE. Health literacy: setting an international collaborative research agenda. BMC Fam Pract 2009; 10:51. https://doi.org/10.1186/1471-2296-10-51

Nutbeam D. The evolving concept of health literacy. Soc Sci Med 2008; 67(12):2072-8. https://doi.org/10.1016/j.socscimed.2008.09.050

Dickson-Swift V, Kenny A, Farmer J, Gussy M, Larkins S. Measuring oral health literacy: a scoping review of existing tools. BMC Oral Health 2014; 14:148. https://doi.org/10.1186/1472-6831-14-148

Dewalt DA, Berkman ND, Sheridan S, Lohr KN, Pignone MP. Literacy and health outcomes: a systematic review of the literature. J Gen Intern Med 2004, 19(12):1228-39. https://doi.org/10.1111/j.1525-1497.2004.40153.x

Andrus MR, Roth MT. Health literacy: a review. Pharmacotherapy 2002; 22(3):282-302. https://doi.org/10.1592/phco.22.5.282.33191

Mohammadi TM, Malekmohammadi M, Hajizamani HR, Mahani SA. Oral health literacy and its determinants among adults in Southeast Iran. Eur J Dent 2018; 12(3):439-42. https://doi.org/10.4103/ejd.ejd_429_17

Horowitz AM, Kleinman DV. Oral health literacy: a pathway to reducing oral health disparities in Maryland. J Public Health Dent 2012; 72(Suppl 1):S26-30. https://doi.org/10.1111/j.1752-7325.2012.00316.x

Burgette JM, Lee JY, Baker AD, Vann WF Jr. Is dental utilization associated with oral health literacy? J Dent Res 2016; 95(2):160-6. https://doi.org/10.1177/0022034515617457

Vilella KD, Alves SG, de Souza JF, Fraiz FC, Assunção LR. The association of oral health literacy and oral health knowledge with social determinants in pregnant Brazilian women. J Community Health 2016; 41(5):1027-32. https://doi.org/10.1007/s10900-016-0186-6

Hom JM, Lee JY, Divaris K, Baker AD, Vann WF Jr. Oral health literacy and knowledge among patients who are pregnant for the first time. J Am Dent Assoc 2012; 143(9):972-80. https://doi.org/10.14219/jada.archive.2012.0322

Arnold CL, Davis TC, Berkel HJ, Jackson RH, Nandy I, London S. Smoking status, reading level, and knowledge of tobacco effects among low-income pregnant women. Prev Med 2001; 32(4):313-20. https://doi.org/10.1006/pmed.2000.0815

Cho RN, Plunkett BA, Wolf MS, Simon CE, Grobman WA. Health literacy and patient understanding of screening tests for aneuploidy and neural tube defects. Prenat Diagn 2007; 27(5):463-7. https://doi.org/10.1002/pd.1712

Gazmararian JA, Parker RM, Baker DW. Reading skills and family planning knowledge and practices in a low- income managed-care population. Obstet Gynecol 1999; 93(2):239-44. https://doi.org/10.1016/s0029-7844(98)00431-1

Endres LK, Sharp LK, Haney E, Dooley SL. Health literacy and pregnancy preparedness in pregestational diabetes. Diabetes Care 2004; 27(2):331-4. https://doi.org/10.2337/diacare.27.2.331

Shieh C, Mays R, McDaniel A, Yu J. Health literacy and its association with the use of information sources and with barriers to information seeking in clinic-based pregnant women. Health Care Women Int 2009; 30(11):971-88. https://doi.org/10.1080/07399330903052152

Naghibi Sistani MM, Montazeri A, Yazdani R, Murtomaa H. New oral health literacy instrument for public health: development and pilot testing. J Investig Clin Dent 2014; 5(4):313-21. https://doi.org/10.1111/jicd.12042

Boggess KA, Urlaub DM, Massey KE, Moos MK, Matheson MB, Lorenz C. Oral hygiene practices and dental service utilization among pregnant women. J Am Dent Assoc 2010; 141(5):553-61. https://doi.org/10.14219/jada.archive.2010.0228

Astrøm AN, Ekback G, Ordell S, Nasir E. Long-term routine dental attendance:influence on tooth loss and oral health-related quality of life in Swedish older adults. Community Dent Oral Epidemiol 2014; 42(5):460-9. https://doi.org/10.1111/cdoe.12105

Rahman B, Al Kawas S. The relationship between dental health behavior, oral hygiene and gingival status of dental students in the United Arab Emirates. Eur J Dent 2013; 7(1):22-7.

Pirie M, Cooke I, Linden G, Irwin C. Dental manifestations of pregnancy. Obstet Gynaecol 2007; 9(1):21-6. https://doi.org/10.1576/toag.9.1.021.27292

Jain K, Kaur H. Prevalence of oral lesions and measurement of salivary pH in the different trimesters of pregnancy.

Singapore Med J 2015; 56(1):53-7. https://doi.org/10.11622/smedj.2015010

Ueno M, Takeuchi S, Oshiro A, Kawaguchi Y. Relationship between oral health literacy and oral health behaviors and clinical status in Japanese adults. J Dent Sci 2013; 8(2):170-6. https://doi.org/10.1016/j.jds.2012.09.012

Jones K, Brennan DS, Parker EJ, Mills H, Jamieson L. Does self-efficacy mediate the effect of oral health literacy on self-rated oral health in an Indigenous population? J Public Health Dent 2016; 76(4):350-5. https://doi.org/10.1111/jphd.12162

Sandhu KS, Gupta N, Bansal M, Arora V, Gupta P, Thakar S. Health literacy and oral health literacy: are they associated? A cross sectional survey among undergraduate students of tricity (Chandigarh, Mohali, Panchkula), India. Przegl Epidemiol 2017; 71(1):111-8.

Sistani MM, Yazdani R, Virtanen J, Pakdaman A, Murtomaa H. Oral health literacy and information sources among adults in Tehran, Iran. Community Dent Health 2013; 30(3):178-82.

Vann WF, Lee JY, Baker D, Divaris K. Oral health literacy among female caregivers: impact on oral health outcomes in early childhood. J Dent Res 2010; 89(12):1395-1400. https://doi.org/10.1177/0022034510379601

Khodadadi E, Niknahad A, Naghibi Sistani MM, Motallebnejad M. Parents' oral health literacy and its impact on their children’s dental health status. Electron Physician 2016; 8(12):3421-5. https://doi.org/10.19082/3421

Guo Y, Logan HL, Dodd VJ, Muller KE, Marks JG, Riley JL 3rd. Health literacy: a pathway to better oral health. Am J Public Health 2014; 104(7):e85-91. https://doi.org/10.2105/AJPH.2014.301930

Afshar MK, Torabi M, Khosravi M. Association between oral health literacy and self-reported oral health behavior in adults( Kerman-Iran). J Fundam Appl Sci 2018; 10(6S):2813-25.

Martin LT, Ruder T, Escarce JJ, Ghosh-Dastidar B, Sherman D, Elliott M, et al. Developing predictive models of health literacy. J Gen Intern Med 2009; 24(11):1211-6. https://doi.org/10.1007/s11606-009-1105-7

Roncalli AG, Sheiham A, Tsakos G, Watt RG. Socially unequal improvements in dental caries levels in Brazilian adolescents between 2003 and 2010. Community Dent Oral Epidemiol 2015; 43(4):317-24. https://doi.org/10.1111/cdoe.12156

Jones M, Lee JY, Rozier RG. Oral health literacy among adult patients seeking dental care. J Am Dent Assoc 2007; 138(9):1199-208. https://doi.org/10.14219/jada.archive.2007.0344

Atchison KA, Gironda MW, Messadi D, Der-Martirosian C. Screening for oral health literacy in an urban dental clinic. J Public Health Dent 2010; 70(4):269-75. https://doi.org/10.1111/j.1752-7325.2010.00181.x

Javadzade SH, Sharifirad G, Radjati F, Mostafavi F, Reisi M, Hasanzade A. Relationship between health literacy, health status, and healthy behaviors among older adults in Isfahan, Iran. J Educ Health Promot 2012; 1:31. https://doi.org/10.4103/2277-9531.100160

Wyne AH, Chohan AN, Al-Dosari KH, Al-Dokheil MA. Oral health knowledge and sources of information among male Saudi school children. Odontostomatol Trop 2004; 27(106):22-6.