Knowledge, Attitudes and Practice Behaviour of Midwives Concerning Periodontal Health of Pregnant Patients
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Knowledge and Attitudes Towards Periodontal Disease
3.2. Attitudes and Practice Behaviour
3.3. Midwives and Practice Location
4. Discussion
4.1. Attitudes and Practice Behaviour
4.2. Differences in Practice Location
4.3. Limitations
4.4. Future Directions
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
- How would you classify periodontal diseases?
- a.
- Auto-immune disorder
- b.
- Inflammation and bacterial infection
- c.
- Degenerative process
- d.
- Osteoporosis
- e.
- Metastatic process
- Which clinical signs are associated with periodontal diseases?
- a.
- Caries
- b.
- Tooth mobility
- c.
- Gingival bleeding
- d.
- Alveolar bone destruction
- e.
- Tooth loss
- In your opinion, which risk factors contribute to gum disease initiation? (Choose maximum 4 answers)
- a.
- Tooth decay
- b.
- Excessive sugar consumption
- c.
- Genetics
- d.
- Smoking
- e.
- Dental plaque
- f.
- Pregnancy
- g.
- Poor oral hygiene
- In your opinion, which risk factors contribute to gum disease progression? (Choose maximum 4 answers)
- a.
- Tooth decay
- b.
- Excessive sugar consumption
- c.
- Genetics
- d.
- Smoking
- e.
- Dental plaque
- f.
- Pregnancy
- g.
- Poor oral hygiene
- Which oral signs are often observed related to pregnancy?
- a.
- Gingival overgrowth
- b.
- Gingival bleeding
- c.
- Caries
- d.
- Tooth loss
- Do periodontal diseases influence pregnancy outcomes?
- a.
- No
- b.
- Yes – Increased incidence of low genital-tract infection
- c.
- Yes – Increased incidence of pre-eclampsia
- d.
- Yes – Increased incidence of preterm birth
- e.
- Yes – Increased incidence of low-weight newborn
- f.
- Yes – Increased incidence of spontaneous abortion
- Are periodontal diseases preventable during pregnancy?
- a.
- No – They’re an expected side effect during pregnancy.
- b.
- Yes – They can be prevented or arrested during pregnancy.
- Periodontal diseases can be prevented by:
- a.
- Using fluoridated toothpaste
- b.
- Using dental floss or interdental brushes
- c.
- Effective tooth-brushing technique
- d.
- Control of psychological stress
- e.
- Smoking cessation
- For patients with periodontal disease, periodontal treatment is beneficial for improving oral health.
- a.
- Strongly agree, Agree, Neutral, Disagree, Strongly disagree
- Periodontal disease can have an adverse effect on pregnancy outcomes.
- a.
- Strongly agree, Agree, Neutral, Disagree, Strongly disagree
- Treatment of periodontal disease during pregnancy positively affects pregnancy outcomes.
- a.
- Strongly agree, Agree, Neutral, Disagree, Strongly disagree
- Asking pregnant patients about their oral health is outside the routine practices of a midwife.
- a.
- Strongly agree, Agree, Neutral, Disagree, Strongly disagree
- Conducting an examination of the oral cavity during pregnancy is outside the routine practices of a midwife
- a.
- Strongly agree, Agree, Neutral, Disagree, Strongly disagree
- It is important for a pregnant woman to receive routine dental care during her pregnancy.
- a.
- Strongly agree, Agree, Neutral, Disagree, Strongly disagree
- There is not sufficient time to address oral health during a care visit with a midwife.
- a.
- Strongly agree, Agree, Neutral, Disagree, Strongly disagree
- I am up to date on the topic of oral health and pregnancy.
- a.
- Strongly agree, Agree, Neutral, Disagree, Strongly disagree
- I routinely ask questions related to oral health during consultation with pregnant patients.
- a.
- Yes, No
- I routinely perform a visual oral examination during consultation with pregnant patients.
- a.
- Yes, No
- I provide oral health-related information during consultation with pregnant patients.
- a.
- Routinely
- b.
- If patient is considered at risk
- c.
- Never
- I refer patients to their dentist for a check-up.
- a.
- Routinely
- b.
- If patient is considered at risk
- c.
- Never
- Participant’s Sex: Male, Female, Other
- Participant’s Age: (years)
- How long have you practiced as a midwife?
- a.
- Current Midwifery student
- b.
- ≤10 years
- c.
- 10–20 years
- d.
- 21–30 years
- e.
- 31–40 years
- f.
- 40+ years
- What is your current occupation?
- a.
- Currently practicing in Australia
- b.
- Retired midwife
- c.
- Current midwifery student
- d.
- Unemployed
- Midwifery practice location: (Postal code)
- Midwifery practice location:
- a.
- Urban
- b.
- Rural
- Midwifery practice setting
- a.
- Hospital
- b.
- Private practice
- c.
- Hospital and private practice
- How would you rate your oral health?
- a.
- Excellent
- b.
- Good
- c.
- Neutral
- d.
- Poor
- e.
- Very poor
- On average, how often do you visit the dentist?
- a.
- Every 6 months
- b.
- Every 12 months
- c.
- Every 12–18 months
- d.
- Only if in pain
- e.
- Never
- Have you ever been diagnosed with periodontal disease? Yes/No
- Have you ever been diagnosed with periodontal disease and received treatment for this condition? Yes/No
Appendix B
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% | n | ||
---|---|---|---|
Gender | Female | 100.0% | 100 |
Male | 0.0% | 0 | |
Other | 0.0% | 0 | |
Number of years in midwifery practice | Current midwifery student | 32.0% | 32 |
Less than 10 years | 44.0% | 44 | |
10–20 years | 11.0% | 11 | |
21–30 years | 10.0% | 10 | |
31–40 years | 6.0% | 6 | |
40+ years | 0.0% | 0 | |
Current occupation | Currently practicing midwife in Australia | 68.0% | 68 |
Current midwifery student | 32.0% | 32 | |
Unemployed | 0.0% | 0 | |
Retired midwife | 0.0% | 0 | |
Midwifery practice location | Urban | 77.0% | 77 |
Rural | 23.0% | 23 | |
Midwifery practice setting | Hospital | 85.0% | 85 |
Hospital and private practice | 13.0% | 13 | |
Private practice | 2.0% | 2 | |
How would you rate your oral health? | Excellent | 22.0% | 22 |
Good | 58.0% | 58 | |
Neutral | 14.0% | 14 | |
Poor | 6.0% | 6 | |
Very poor | 0.0% | 0 | |
How often do you visit the dentist? | Every 6 months | 33.0% | 33 |
Every 12 months | 33.0% | 33 | |
Every 12-18 months | 21.0% | 21 | |
Only if in pain | 12.0% | 12 | |
Never | 1.0% | 1 | |
Have you ever been diagnosed with periodontal disease? | Yes | 23.0% | 23 |
No | 77.0% | 77 | |
Have you ever been diagnosed and received treatment for periodontal disease? | Yes | 22.0% | 22 |
No | 78.0% | 78 |
Survey Question | Respondent Answer | % | n |
---|---|---|---|
Definition of periodontal disease (N = 154) | Inflammation and bacterial infection | 63.0% | 97 |
Degenerative process | 31.8% | 49 | |
Auto-immune disorder | 2.0% | 3 | |
Osteoporosis | 2.0% | 3 | |
Metastatic process | 1.3% | 2 | |
Clinical signs associated with periodontal disease (N = 343) | Gingival bleeding | 28.9% | 99 |
Tooth mobility | 21.6% | 74 | |
Tooth loss | 21.0% | 72 | |
Caries | 16.0% | 55 | |
Alveolar bone destruction | 12.5% | 43 | |
Risk factors for gum disease initiation (N = 409) | Poor oral hygiene | 23.5% | 96 |
Smoking | 20.0% | 82 | |
Excessive sugar consumption | 14.7% | 60 | |
Tooth decay | 10.0% | 41 | |
Dental plaque | 14.2% | 58 | |
Genetics | 9.0% | 37 | |
Pregnancy | 8.6% | 35 | |
Risk factors for gum disease progression (N = 396) | Poor oral hygiene | 23.5% | 93 |
Smoking | 18.2% | 72 | |
Excessive sugar consumption | 16.4% | 65 | |
Tooth decay | 11.6% | 46 | |
Dental plaque | 15.9% | 63 | |
Genetics | 3.0% | 12 | |
Pregnancy | 11.4% | 45 | |
Oral signs often related to pregnancy (N = 162) | Gingival bleeding | 61.1% | 99 |
Gingival overgrowth | 20.4% | 33 | |
Caries | 9.3% | 15 | |
Tooth loss | 9.3% | 15 | |
Do periodontal diseases influence pregnancy outcomes? (N = 192) | Yes – Increased incidence of preterm birth | 34.9% | 67 |
Yes – Increased incidence of low-weight newborn | 20.3% | 39 | |
Yes – Increased incidence of spontaneous abortion | 17.7% | 34 | |
Yes – Increased incidence of low genital-tract infection | 10.4% | 20 | |
Yes – increased incidence of pre-eclampsia | 7.8% | 15 | |
No | 8.9% | 17 | |
Are periodontal diseases preventable during pregnancy? (N = 100) | Yes – They can be prevented or arrested during pregnancy | 98.0% | 98 |
No – They’re an expected side effect during pregnancy | 2.0% | 2 | |
Periodontal diseases can be prevented by: (N = 382) | Effective toothbrushing technique | 25.4% | 97 |
Using dental floss or interdental brushes | 25.1% | 96 | |
Smoking cessation | 22.5% | 86 | |
Using fluoridated toothpaste | 19.1% | 73 | |
Control of psychological stress | 7.9% | 30 |
Likert-Scale Questions | Strongly Agree %(N) | Agree % (N) | Neutral % (N) | Disagree % (N) | Strongly Disagree % (N) |
---|---|---|---|---|---|
For patients with periodontal disease, periodontal treatment is beneficial for improving oral health | 82.0%(82) | 18.0%(18) | 0%(0) | 0%(0) | 0%(0) |
Periodontal disease can have an adverse effect on pregnancy outcomes | 41.0%(41) | 40.0%(40) | 11.0%(11) | 8.0%(8) | 0%(0) |
Treatment of periodontal disease during pregnancy positively affects pregnancy outcomes | 38.0%(38) | 42.0%(42) | 17.0%(17) | 2.0%(2) | 1.0%(1) |
Asking pregnant patients about their oral health is outside the routine practices of a midwife | 9.0%(9) | 16.0%(16) | 6.0%(6) | 34.0%(34) | 35.0%(35) |
Conducting an examination of the oral cavity during pregnancy is outside the routine practices of a midwife | 41.0%(41) | 40.0%(40) | 5.0%(5) | 10.0%(10) | 4.0%(4) |
It is important for a pregnant woman to receive routine dental care during her pregnancy | 57.0%(57) | 37.0%(37) | 5.0%(5) | 1.0%(1) | 0%(0) |
There is not sufficient time to address oral health during a care visit with a midwife | 16.0%(16) | 26.0%(26) | 18.0%(18) | 33.0%(33) | 7.0%(7) |
I am up to date on the topic of oral health and pregnancy | 3.0%(3) | 13.0%(13) | 28.0%(28) | 42.0%(42) | 14.0%(14) |
Additional questions | % (N) | ||||
I routinely ask questions related to oral health during consultation with pregnant patients | Yes | 60.0%(60) | |||
No | 40.0%(40) | ||||
I routinely perform a visual oral examination during consultation with pregnant patients | Yes | 7.0%(7) | |||
No | 93.0%(93) | ||||
I provide oral-health-related information during consultation with pregnant patients | Routinely | 39.0%(39) | |||
If patient is considered at risk | 40.0%(40) | ||||
Never | 21.0%(21) | ||||
I refer patients to their dentist for a check-up | Routinely | 49.0%(49) | |||
If patient is considered at risk | 33.0%(33) | ||||
Never | 18.0%(18) |
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Nguyen, J.G.-l.; Nanayakkara, S.; Holden, A.C.L. Knowledge, Attitudes and Practice Behaviour of Midwives Concerning Periodontal Health of Pregnant Patients. Int. J. Environ. Res. Public Health 2020, 17, 2246. https://doi.org/10.3390/ijerph17072246
Nguyen JG-l, Nanayakkara S, Holden ACL. Knowledge, Attitudes and Practice Behaviour of Midwives Concerning Periodontal Health of Pregnant Patients. International Journal of Environmental Research and Public Health. 2020; 17(7):2246. https://doi.org/10.3390/ijerph17072246
Chicago/Turabian StyleNguyen, Jennifer Gia-linh, Shanika Nanayakkara, and Alexander C. L. Holden. 2020. "Knowledge, Attitudes and Practice Behaviour of Midwives Concerning Periodontal Health of Pregnant Patients" International Journal of Environmental Research and Public Health 17, no. 7: 2246. https://doi.org/10.3390/ijerph17072246