Dental Anxiety Amongst Pregnant Women: Relationship With Dental Attendance and Sociodemographic Factors

Etiology of Dental Anxiety and Dental Phobia: Review

This article examines the etiology of dental anxiety, a common yet often overlooked condition in dental practice. Ranging from mild discomfort to severe dental phobia, dental anxiety significantly affects a patient's ability to receive necessary care. Despite its prevalence, it remains underexplored in scientific research, leading to inadequate treatment and insufficient attention. Understanding the factors behind dental anxiety is crucial for prevention and for providing effective psychotherapeutic and pharmacological interventions.The review was based on a comprehensive search of several scientific databases, including PubMed, Cochrane Database, and Dentistry & Oral Sciences Source. Predefined keywords, such as "Dental Anxiety," "Dental Phobia," and "Etiology," were used to ensure broad coverage of relevant studies. The factors contributing to dental anxiety are multifactorial and involve both internal and external influences. Internal factors, such as genetic predispositions and central nervous system dysfunctions, interact with external influences, including personal experiences, negative past dental encounters, and environmental stimuli. Demographic factors, such as age, gender, and socioeconomic status, along with personal characteristics like temperament and coping mechanisms, further contribute to the development of anxiety.Previous negative dental experiences and self-reported poor oral health exacerbate anxiety, increasing the likelihood of developing dental phobia, which often results in care avoidance. This avoidance worsens oral health, resulting in conditions such as caries and periodontal disease, and significantly diminishes the quality of life. Addressing dental anxiety is critical for improving patient cooperation and ensuring better long-term oral health outcomes. A more comprehensive understanding of dental anxiety will help identify at-risk patients early, prevent severe forms of dental phobia, and ensure dental care is accessible to all individuals.In conclusion, dental anxiety is a multifactorial issue that impacts access to dental care and overall oral health. The most significant factor contributing to dental anxiety is trauma associated with previous dental procedures. Expanding the understanding of its causes enables dental professionals to identify at-risk patients and develop tailored interventions. By addressing anxiety early and adopting evidence-based strategies, dental professionals can reduce the prevalence of dental anxiety and improve patient care.

Oral healthcare access: self-perceived barriers faced during pregnancy - a systematic review

BACKGROUND

Pregnancy encompasses physiological changes that impact oral health. Despite oral health care's importance, pregnant women underutilize these services due to various barriers. This systematic review aims to assess the self-reported barriers that hinder pregnant women's access to oral healthcare worldwide.

METHODS

The PRISMA checklist was followed and PubMed, Web of Science, and Scopus were screened for articles. The barriers that prevent pregnant women from accessing oral healthcare were analysed based on three dimensions - availability, affordability, and acceptability.

RESULTS

From a total of 942 articles, 31 were selected. The predominant barriers were the costs of dental care, lack of literacy, namely the misconception about dental care safety to the foetus, and limited oral health awareness.

CONCLUSION

Addressing these barriers requires a comprehensive policy framework and resource allocation, integrating oral health into perinatal care, and raising awareness among non-dental healthcare professionals.

Development and Validation of Chinese Version of Dental Pain Screening Questionnaire

INTRODUCTION

Dental pain is one of the most prevalent oral complaints. This study aimed to establish a Chinese version of Dental Pain Screening Questionnaire (DePaQ) to help classify patients into three groups of dental pain diseases (group 1, reversible pulpitis and dentine hypersensitivity; group 2, acute periapical periodontitis and irreversible pulpitis; and group 3, pericoronitis).

METHODS

The DePaQ was translated from English to Chinese. The clinical subjects (CS, n = 290) and nonclinical subjects (NS, n = 100) with dental pain were collected. The CS were randomly divided into two subsamples: CS1 (n = 203) and CS2 (n = 87). The Fisher discriminant functions of the final 13-item Chinese version of the DePaQ were obtained from the CS1 group, and discriminant validity was further verified in the CS2 and NS groups.

RESULTS

The discriminant functions of the final 13-item DePaQ obtained from the CS1 group were capable of correctly distinguishing 93.1% and 89.0% cases of the CS2 and NS groups, respectively. In the CS2 group, the sensitivity for groups 1, 2, and 3 was 88.0%, 80.0%, and 83.0%, respectively, and the specificity was 95.0%, 95.0%, and 86.0%, respectively. In the NS group, the sensitivity for groups 1, 2, and 3 was 82.0%, 80.0%, and 86.0%, respectively, and the specificity was 91.0%, 97.0%, and 90.0%, respectively.

CONCLUSIONS

The Chinese version of DePaQ could help classify the three groups of dental pain diseases and guide medical treatment.

Oral Health, Anxiety, Depression, and Stress in Pregnancy: A Rapid Review of Associations and Implications for Perinatal Care

Research demonstrates associations between oral health and specific mental health conditions in the general population, yet these relationships remain understudied during pregnancy, despite pregnancy's profound effects on both oral and psychological well-being. Our rapid review examines current evidence on associations between oral health conditions and psychological states (anxiety, depression, and stress) during pregnancy, aiming to inform and strengthen integrated prenatal care strategies. Following PRISMA-RR guidelines, we conducted a systematic search on OVID Medline, CINAHL, and PsycINFO (January 2000-November 2024) for studies examining relationships between oral health conditions (periodontal disease, dental caries) and psychological status during pregnancy and up to one year postpartum. Systematic screening of 1201 records yielded 22 eligible studies (13 cross-sectional studies, 3 longitudinal cohort studies, 3 comparative studies, 2 prospective studies, and 1 case-control study). Analysis confirmed significant associations between oral health and psychological well-being during pregnancy through three pathways: psychological (dental anxiety directly limits oral healthcare utilization), behavioral (maternal depression reduces oral health self-efficacy), and physiological (elevated stress biomarkers correlate with periodontal disease, and periodontal therapy is associated with reduced salivary cortisol). These interactions extend intergenerationally, with maternal psychological distress showing significant associations with children's caries risk. Evidence suggests interactions between oral health conditions and psychological states during pregnancy, warranting integrated care approaches. We recommend: (1) implementing combined oral-mental health screening in prenatal care, (2) developing interventions targeting both domains, and (3) establishing care pathways that address these interconnections. This integrated approach could improve both maternal and child health outcomes.

Oral health knowledge, literacy and behavior of pregnant women: a qualitative study in a northeastern province of Thailand

BACKGROUND

Pregnancy is a unique period of women's lives, and oral health is an important public health indicator during this period. Pregnant women have increased vulnerability to oral health problems. The study aimed to describe oral health knowledge, literacy and behavior of pregnant women in a northeastern province of Thailand.

METHODS

A descriptive study was used. Twenty pregnant women who attended antenatal care clinics of eight public hospitals in the province were recruited by use of purposive sampling. They participated voluntarily in individual interview. The Health Belief Model was used as conception framework. All data were transcribed and subjected to content analysis.

RESULTS

Five categories emerged: Misbelief and lack of knowledge, Oral health problems and dental care seeking, Oral health information from different persons, Self-care management of oral health, and Fear of and anxiety towards dental treatment. The findings showed that low knowledge of need for treatment, little importance to oral health and low priority of dental needs affect the demand for dental care. Fear of and anxiety towards dental treatment were the results of negative past experiences of neglecting dental care. Some women perceived health benefits of practicing self-care of oral health during pregnancy.

CONCLUSION

The findings help to better understand the oral health issues of pregnant women and provide baseline information for oral health promotion. Such promotion and culturally appropriate care should be integrated in maternal health education classes.

Oral Manifestations in Pregnant Women: A Systematic Review

Background: The period of pregnancy is characterized by a multitude of diverse changes that exert a notable impact on the oral cavity of women. During this gestational phase, patients necessitate tailored oral care and specific recommendations to preempt and address potential oral diseases. This systematic review aimed to perform a detailed analysis of the research studies that focused on the oral manifestations observed in pregnant women. Methods: A meticulous search was conducted in the databases Medline, Scopus, and Scielo by employing the following search terms: ((pregnant OR pregnancy)) AND (("oral manifestation*") OR ("oral health")). Articles that were published between 2013 and 2023 and written in English or Spanish and studies that scrutinized oral manifestations in pregnant women and included a diagnosis conducted by a qualified dentist were selected; we excluded articles published before 2013, articles that could not be accessed in full text, studies whose patients were not pregnant women at the time of the study, studies where patients were selected because they had a specific disease, studies where the clinical examination was not performed by a dentist, and articles written in languages other than English or Spanish. Subsequently, the risk of bias in the chosen articles was assessed in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) scale. Results: A total of 20 studies were included in the analysis, following the exclusion and inclusion criteria. These studies were categorized as cross-sectional, cohort, longitudinal, or case-control. Various oral manifestations in pregnant women were examined, with five studies comparing these manifestations with those observed in nonpregnant women. Conclusions: The most prevalent oral manifestations associated with pregnancy encompass dental caries, periodontitis, gingivitis, pyogenic granuloma, and candidiasis. Nonetheless, less common lesions may also emerge during the course of pregnancy.

Social and Preventive Factors That Explain Oral Health among Pregnant Women in the Canton of Cuenca, Ecuador

(1) Background: pregnant women in underprivileged areas may face challenges that affect their oral health. The analysis of these issues such as toothaches or cavities, among others could be crucial for them. However, no studies have been conducted in Cuenca, Ecuador. Thus, this study aimed to create a model explaining how social factors and healthy habits impact oral health in Cuenca, Ecuador. (2) Methods: An observational study was performed using a questionnaire developed from scratch. Principal component factor analysis was performed to calculate the oral disease index based on the oral health issues reported by women during pregnancy. (3) Results: 1971 women participated in the research. In total, 88% reported at least one oral health problem, with cavities (34%) and bleeding gums (33%) as the most prevalent. The rate of preventive visits and frequent brushing were the two variables that most impacted the oral disease index. The consumption of sweets, age, and the belief that visiting the dentist harms their unborn child were also important factors. However, income, education, and ethnic background showed little to no effect. (4) Conclusions: The most beneficial determinants of oral health factors in pregnant women in Cuenca, Ecuador, are preventive dentist visits, frequent brushing, and a contained consumption of sweets. The main harmful factors are age and the misconception that dental visits can harm their unborn child. Surprisingly, income, education, and ethnic background have little effect. This study can be replicated in other countries and cultures.

Maternal Periodontal Status as a Factor Influencing Obstetrical Outcomes

Background and Objectives: Preterm birth as a complex phenomenon is influenced by numerous endogenic and exogenic factors, although its exact cause often remains obscure. According to epidemiological studies, maternal periodontal diseases, in addition to affecting general health, can also cause adverse pregnancy outcomes. Nonetheless, the existing results in the literature regarding this topic remain controversial. Consequently, our study aimed to determine the connection between poor maternal periodontal status and neonatal birth weight. Materials and Methods: A total of 111 primigravida-primiparous pregnant, healthy women underwent a periodontal examination in the second trimester of their pregnancies. Probing depth (PD) and bleeding on probing (BOP) were determined, and based on these diagnostic measurements, the patients were divided into three subgroups according to their dental status: healthy (H, n = 17), gingivitis (G, n = 67), and periodontitis (P, n = 27). Results: Considering that poor maternal oral status is an influencing factor for obstetrical outcomes, the presence of PD and BOP (characterized by the sulcus bleeding index, SBI) was evaluated. In the case of P, defined as PD ≥ 4 mm in at least one site and BOP ≥ 50% of the teeth, a significant correlation between BOP and a low neonatal birth weight at delivery (p = 0.001) was found. An analysis of the relationship between SBI and gestational age (GA) at the time of the periodontal examination in the different dental status groups showed a significant correlation between these parameters in the G group (p = 0.04). Conclusions: Our results suggest that a worse periodontal status during pregnancy may negatively affect obstetrical outcomes, especially the prematurity rate and newborn weight. Therefore, the importance of periodontal screening to prevent these complications is undeniable.