205894 Risk factors for insufficient oral health care during pregnancy

Monday, November 9, 2009: 11:11 AM

Kristen S. Marchi, MPH , Family and Community Medicine, University of California, San Francisco, San Francisco, CA
Susan A. Fisher-Owens, MD, MPH , Department of Pediatrics, University of California, San Francisco, San Francisco, CA
Jane A. Weintraub, DDS, MPH , Center to Address Disparities in Children's Oral Health, University of California, San Francisco, San Francisco, CA
Zhiwei Yu, MPH , Maternal, Child and Adolescent Health Program, California Department of Public Health, Sacramento, CA
Paula A. Braveman, MD, MPH , Family and Community Medicine, University of California, San Francisco, San Francisco, CA
Objectives: Examine prevalence of dental care during pregnancy and reasons for insufficient care.

Methods: Using self-reports from a population-based survey of postpartum women in California during 2002-2007, rates of dental problems and non-receipt of dental care during pregnancy were calculated. Logistic regression was used to estimate odds of non-receipt of care by maternal characteristics. Reasons for not receiving care were examined.

Results: Overall, 65.5% of women had no dental visit during pregnancy; 52.3% reported a dental problem prenatally; with 62.0% of those women not receiving care. After adjustment for age, parity, marital status, and pregnancy intention, risk factors for lack of dental care included non-White race/ethnicity, education less than a college degree, incomes less than 401% of the federal poverty level, no prenatal insurance in first trimester, no private prenatal insurance, non-English-speaking, and no regular source of pre-pregnancy medical care. The primary reason for non-receipt of dental care during pregnancy was lack of perceived need for care, followed by financial barriers.

Conclusions: The majority of pregnant women receive insufficient dental care. Odds are elevated not only among poorest and least educated mothers, but also among those with moderate incomes or some college. Many women do not feel they need dental care during pregnancy. The importance of oral health during pregnancy must be promoted widely among the public and among both primary care and dental providers. Continued efforts must be made to address financial barriers to dental care.

Learning Objectives:
List rates of insufficient dental care during pregnancy, overall and among subgroups. Assess risk of insufficient dental care during pregnancy. Identify the main reasons for insufficient dental care during pregnancy.

Keywords: Oral Health, Access to Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the Project Director for the past 10 years on the study which collects the data analyzed here, and I conducted all analyses for the study I will present. I have prior experience presenting at APHA, and have been a co-author on many peer-reviewed articles.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.