1
|
Bossouf A, Sabourin C, Fuchs F, Giraudeau N, Inquimbert C. Interprofessional survey on knowledge and attitudes of midwives regarding oral health, in France. Eur J Midwifery 2023; 7:37. [PMID: 38045473 PMCID: PMC10690821 DOI: 10.18332/ejm/172881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/19/2023] [Accepted: 10/03/2023] [Indexed: 12/05/2023] Open
Abstract
INTRODUCTION Oral health is essential for psychosocial well-being and general health. For expectant mothers, pregnancy increases the risk of oral diseases and has a subsequent impact on the oral health of a child once born. Midwives are in charge of pregnancy monitoring, childbirth and newborns' first days of life. They could have an important role in prevention. However, limited studies evaluating the knowledge, attitudes and practices on oral health among midwives have been conducted in Europe. METHODS We performed a cross-sectional study using a self-administered questionnaire. Two local midwifery associations sent out the questionnaire by email and social media networks to all registered midwives and practicing in the department of Herault (n=613), between April and May 2022. Statistical analyses on quantitative data and descriptive analyses of qualitative free-text responses were performed. RESULTS In total, 167 midwives were included. We found a lack of knowledge on many oral health topics and this was stated as the main reason that only 29% of midwives provided oral health information to their patients. Only 30% of the midwives had a training module on oral health during their initial training, and less than half of them considered the training adequate. To improve their lack of knowledge, participants expressed a preference for digital communication methods for themselves; however, they favored in-person interaction for public interventions. CONCLUSIONS This study showed a lack of training and knowledge about oral health among midwives and a lack of oral health discussion with expectant mothers who are a high-risk population for oral diseases.
Collapse
Affiliation(s)
- Abid Bossouf
- Department of Public Health, Faculty of Dental Medicine, University of Montpellier, Montpellier, France
- Center for Latin European Political Studies, UMR 5112, CNRS, University of Montpellier, Montpellier, France
| | - Céline Sabourin
- Department of Public Health, Faculty of Dental Medicine, University of Montpellier, Montpellier, France
- Team of Criminal Law and Forensic Sciences of Montpellier, UR-UM212, University of Montpellier, Montpellier, France
| | - Florent Fuchs
- Department of Obstetrics and Gynecology, Montpellier University Hospital Center, Montpellier, France
- National Institute of Health and Medical Research, Centre for Epidemiology and Population Health, Reproduction and child development, Paris, France
- Desbrest Institute of Epidemiology and Public Health, University of Montpellier, Montpellier, France
| | - Nicolas Giraudeau
- Department of Public Health, Faculty of Dental Medicine, University of Montpellier, Montpellier, France
- Center for Latin European Political Studies, UMR 5112, CNRS, University of Montpellier, Montpellier, France
| | - Camille Inquimbert
- Department of Public Health, Faculty of Dental Medicine, University of Montpellier, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, University of Montpellier, Montpellier, France
| |
Collapse
|
2
|
Vamos CA, Foti TR, Reyes Martinez E, Pointer Z, Detman LA, Sappenfield WM. Identification of Clinician Training Techniques as an Implementation Strategy to Improve Maternal Health: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6003. [PMID: 37297607 PMCID: PMC10252379 DOI: 10.3390/ijerph20116003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
Training is a key implementation strategy used in healthcare settings. This study aimed to identify a range of clinician training techniques that facilitate guideline implementation, promote clinician behavior change, optimize clinical outcomes, and address implicit biases to promote high-quality maternal and child health (MCH) care. A scoping review was conducted within PubMed, CINAHL, PsycInfo, and Cochrane databases using iterative searches related to (provider OR clinician) AND (education OR training). A total of 152 articles met the inclusion/exclusion criteria. The training involved multiple clinician types (e.g., physicians, nurses) and was predominantly implemented in hospitals (63%). Topics focused on maternal/fetal morbidity/mortality (26%), teamwork and communication (14%), and screening, assessment, and testing (12%). Common techniques included didactic (65%), simulation (39%), hands-on (e.g., scenario, role play) (28%), and discussion (27%). Under half (42%) of the reported training was based on guidelines or evidence-based practices. A minority of articles reported evaluating change in clinician knowledge (39%), confidence (37%), or clinical outcomes (31%). A secondary review identified 22 articles related to implicit bias training, which used other reflective approaches (e.g., implicit bias tests, role play, and patient observations). Although many training techniques were identified, future research is needed to ascertain the most effective training techniques, ultimately improving patient-centered care and outcomes.
Collapse
Affiliation(s)
- Cheryl A. Vamos
- USF’s Center of Excellence in Maternal and Child Health Education, Science & Practice, The Chiles Center, College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Tara R. Foti
- College of Public Health, University of South Florida, Tampa, FL 33612, USA; (T.R.F.); (Z.P.)
| | - Estefanny Reyes Martinez
- College of Public Health, Florida Perinatal Quality Collaborative, University of South Florida, Tampa, FL 33612, USA;
| | - Zoe Pointer
- College of Public Health, University of South Florida, Tampa, FL 33612, USA; (T.R.F.); (Z.P.)
| | - Linda A. Detman
- The Chiles Center, College of Public Health, Florida Perinatal Quality Collaborative, University of South Florida, Tampa, FL 33612, USA; (L.A.D.); (W.M.S.)
| | - William M. Sappenfield
- The Chiles Center, College of Public Health, Florida Perinatal Quality Collaborative, University of South Florida, Tampa, FL 33612, USA; (L.A.D.); (W.M.S.)
| |
Collapse
|
3
|
Knowledge, Attitude and Practices of Nurses and Midwives towards Oral and Dental Health Care during Pregnancy: A Cross Sectional Study. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2021. [DOI: 10.30621/jbachs.977546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
4
|
Abuhaloob L, Helles N, Mossey P, Freeman R. An ADePT evaluation for incorporating the TIPPS periodontal health intervention into primary care antenatal programmes to enhance infant birth weight in Palestine: a feasibility study. Pilot Feasibility Stud 2021; 7:91. [PMID: 33795025 PMCID: PMC8015161 DOI: 10.1186/s40814-021-00827-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 03/26/2021] [Indexed: 11/20/2022] Open
Abstract
Background A feasibility study was conducted to implement the Talk, Instruct, Practice, Plan and Support (TIPPS) intervention for pregnant women to enhance infant birth weight in a conflict area in Low- and Middle-Income Countries (LMIC). The decision tool, A process for Decision-making after Pilot and feasibility Trials (ADePT), examines the methodological factors identified in a feasibility study, that may require modification for a full trial. Thus, this study aimed to use the ADePT decision tool to evaluate if the feasibility study had achieved its objectives and to identify the need for intervention, clinical context and trial design modification. Methods A one-arm, pretest–posttest feasibility study recruited 25 pregnant women in their first trimester and clinic staff from a primary healthcare clinic located in Gaza City, Palestine. The TIPPS periodontal health intervention was delivered by antenatal care nurses to the pregnant women during their regular follow-up appointments. The ADePT framework was applied to evaluate the findings from the feasibility study. The ADePT checklist demonstrated sample size estimation, recruitment, consent, intervention adherence, intervention acceptability, costs and duration, completion and appropriateness of outcome assessments, retention, logistics, and synergy between protocol components. Results All recruited pregnant women (25, aged 16–35 years old) consented to participate in the study, and the adherence to the intervention was 88% (22 women). The TIPPS intervention was acceptable, but there was ambivalence over who should deliver it in the clinic. Only the cost of toothbrushing and TIPPS information materials was calculated, while the cost of nurses’ time was not included. The missing values of data were few (12% of gingival bleeding data and 22% from infant birth weight data). This intervention significantly reduced the mean percentage of plaque and bleeding scores after 3 months. The sample size for future randomised controlled trial was estimated around 400 participants. The participants stated the value of the intervention. The clinic staff voiced concerns regarding time and the cost of nurses providing the TIPPS intervention. This allowed suggestions to be made regarding the modification of trial design and context of implementation. Conclusions The ADePT evaluation showed it was possible to progress to full trial with modifications in the trial design.
Collapse
Affiliation(s)
- Lamis Abuhaloob
- Dental School and Hospital, University of Dundee, Park Place, Dundee, Scotland, DD1 4HN, UK.
| | - Nahla Helles
- Ministry of Health, Gaza Strip and West Bank, Palestine
| | - Peter Mossey
- Dental School and Hospital, University of Dundee, Park Place, Dundee, Scotland, DD1 4HN, UK
| | - Ruth Freeman
- Dental School and Hospital, University of Dundee, Park Place, Dundee, Scotland, DD1 4HN, UK
| |
Collapse
|
5
|
Miner J. Implementing E-Learning to Enhance the Management of Postpartum Hemorrhage. Nurs Womens Health 2020; 24:421-430. [PMID: 33144088 DOI: 10.1016/j.nwh.2020.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/30/2020] [Accepted: 09/01/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To determine if perinatal outcomes related to postpartum hemorrhage could be improved by blending existing strategies with the use of an online, assessment-driven electronic learning (e-learning) platform. DESIGN The Institute for Healthcare Improvement's Model for Improvement provided a structure for this performance improvement project. Outcome evaluation was further supported by the Kirkpatrick model. SETTING/LOCAL PROBLEM Reports of rising maternal morbidity and mortality in the United States prompted action within a multisite health system. Maternity care teams were determined to proactively support excellence in practice through enhancements to continuing education. PARTICIPANTS Maternity providers and nurses practicing within the organization completed the training. INTERVENTION/MEASUREMENTS Online, assessment-driven learning modules for maternity emergencies were blended with existing instructor-led courses, simulation, and Team Strategies to Enhance Performance and Patient Safety (TeamSTEPPS) training in early 2017. In addition, a postpartum hemorrhage safety bundle was implemented. Outcome measures included rates of hemorrhage, massive transfusion, and intensive care unit admission for women admitted for childbirth. Outcome measures were tracked using retrospective chart review with baseline period October 1, 2016, through March 31, 2017, and performance period April 1, 2017, through March 31, 2018. RESULTS Improvements in perinatal outcomes were observed. The average rate of hemorrhage decreased by 3% (from 56.4/1,000 to 54.7/1,000). Median massive transfusion rates decreased by 35% (from 2.3/1,000 to 1.5/1,000). Similarly, the median rate of maternal intensive care unit admissions decreased by 77% (from 3.1/1,000 to 0.7/1,000). A downward shift was supported with zero intensive care unit admissions for 6 of the last 7 months (n = 4,422 pregnant women or women who experienced birth during the current admission). CONCLUSION Excellence in the management of postpartum hemorrhage was supported through a multipronged approach that included the use of an online e-learning platform for maternity emergencies.
Collapse
|
6
|
Edward KL, Walpole L, Lambert G, Phillips S, Gow J, Morrow J, Huynh M, Hiller J. The influence of hospital location and 'level of care' on continuing professional development. Nurse Educ Pract 2019; 41:102634. [PMID: 31739239 DOI: 10.1016/j.nepr.2019.102634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 09/18/2019] [Accepted: 10/04/2019] [Indexed: 10/25/2022]
Abstract
Healthcare workers core skills are reinforced and knowledge of latest developments ensured by undertaking systematic continuing professional development. The current study explored the impact of health facility location and level of care provided on the continuing professional development offered to maternity services healthcare workers in Victoria, Australia. An online survey of middle to senior management staff of 71 public and private health services as well as 7 professional bodies was conducted, yielding 114 participants. Analysis was by location (metropolitan or regional/rural) and level of care provided. The findings revealed Australian Health Practitioner Regulation Agency registration is the predominant requirement to provide continuing professional development to staff. Dedicated education departments or educators are significantly underrepresented in Level 1&2 facilities, while Level 5&6 facilities are more likely to provide breastfeeding continuing professional development. Metropolitan locations provided more wide-ranging programmes compared with rural/regional locations. Key enablers are the capacity to share resources, have access to external courses and simulation equipment/centres, and the provision of relevant and timely continuing professional development programmes, indicating that 'Educational hubs' with credentialed staff working from better resourced regional facilities could deliver a complete array of CPD programmes to lower level facilities.
Collapse
Affiliation(s)
- Karen-Leigh Edward
- Swinburne University of Technology, PO Box 218, Hawthorn, 3122, Australia; University of Huddersfield Queengate, UK.
| | - Lyn Walpole
- Swinburne University of Technology, PO Box 218, Hawthorn, 3122, Australia.
| | - Gavin Lambert
- Swinburne University of Technology, PO Box 218, Hawthorn, 3122, Australia.
| | - Sarah Phillips
- Swinburne University of Technology, PO Box 218, Hawthorn, 3122, Australia.
| | - Jeffrey Gow
- School of Commerce, University of Southern Queensland, Toowoomba, Australia; School of Accounting, Economics and Finance, University of KwaZulu-Natal, Durban, South Africa.
| | - Jane Morrow
- Australian Catholic University, Locked Bag 4115, Fitzroy MDC Fitzroy, 3065, Australia.
| | - Minh Huynh
- Swinburne University of Technology, PO Box 218, Hawthorn, 3122, Australia.
| | - Janet Hiller
- Swinburne University of Technology, PO Box 218, Hawthorn, 3122, Australia.
| |
Collapse
|
7
|
George A, Sousa MS, Kong AC, Blinkhorn A, Patterson Norrie T, Foster J, Dahlen HG, Ajwani S, Johnson M. Effectiveness of preventive dental programs offered to mothers by non-dental professionals to control early childhood dental caries: a review. BMC Oral Health 2019; 19:172. [PMID: 31375106 PMCID: PMC6679429 DOI: 10.1186/s12903-019-0862-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/24/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Early childhood caries is a common chronic childhood disease and maternal oral health is a risk factor. Improving the oral health behaviours of pregnant women/young mothers can positively influence the oral health of children and reduce their caries risk. Such preventative strategies have been undertaken by non-dental professionals producing mixed results encompassing various interventions across the perinatal period. However, no comprehensive review of these studies has been undertaken. The aim of this review was to assess the effectiveness of maternal oral health programs undertaken during the antenatal and/or postnatal period by non-dental health professionals to reduce early childhood caries. METHODS A systematic search of five databases was undertaken using key search terms. Studies were included if they (a) involved quantitative study designs with a control; (b) were published in English; (c) reported on interventions delivered by non-dental professionals (d) delivered the intervention to expectant mothers or mothers with young infants up to 24 months; (e) measured outcomes when the child was under 5 years; (f) measured changes in oral health outcomes of children clinically and oral health behaviours of mothers or children. No restrictions were placed on the study quality and setting. RESULTS Nine studies met the inclusion criteria and involved interventions delivered by diverse non-dental professionals across the antenatal (n = 1), postnatal (n = 6) and perinatal period (n = 2). Most studies were of low methodological quality (n = 6). The interventions focussed on oral health education (n = 8), dental referrals (n = 3) and oral health assessments (n = 1). Interventions conducted in either the postnatal or antenatal periods showed meaningful improvements in children's clinical and mother's behavioural oral health outcomes. The outcomes appear to be sustained when a suite of interventions were used along with referral reminders. There were mixed results from interventions across the perinatal period. CONCLUSIONS Non-dental professionals can promote maternal oral health by providing oral health education, risk assessment and referrals. Combining these interventions could provide a sustained improvement in oral health outcomes for children although current evidence is weak. More high-quality studies are needed to confirm these findings and determine whether the antenatal and/or postnatal period is best suited to deliver these interventions.
Collapse
Affiliation(s)
- Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District, Liverpool, NSW 2170 Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
- Translational Health Research Institute, Campbelltown, NSW 2560 Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, 2050 Australia
| | - Mariana S. Sousa
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District, Liverpool, NSW 2170 Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
| | - Ariana C. Kong
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District, Liverpool, NSW 2170 Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
| | - Anthony Blinkhorn
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, 2050 Australia
| | - Tiffany Patterson Norrie
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District, Liverpool, NSW 2170 Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
| | - Jann Foster
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
- School of Nursing & Midwifery, Western Sydney University, Penrith, NSW 2560 Australia
| | - Hannah G. Dahlen
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
- School of Nursing & Midwifery, Western Sydney University, Penrith, NSW 2560 Australia
| | - Shilpi Ajwani
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, 2050 Australia
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital/University of Sydney, Sydney, 2010 Australia
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, North Sydney, NSW 2060 Australia
| |
Collapse
|
8
|
|
9
|
Ellington K. Web-Based Perinatal Education for the New Obstetrical Patient: A Quality Improvement Project. J Perinat Educ 2018; 27:115-120. [PMID: 30863009 PMCID: PMC6388675 DOI: 10.1891/1058-1243.27.2.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Mixed-methods quality improvement project improved the new obstetrical perinatal education curriculum by cultivating reliable delivery of evidenced-based initiatives linked to successful pregnancy. The web-based format enhanced family-centered care in a teaching format in the comfort of the home. The identification of at-risk populations resulted in improved referral for cell-free fetal DNA screening. A qualitative approach assessed overall provider satisfaction with web-based teaching. The patient survey identified barriers for noncompletion of web-based content. Quantitative data identified completion rate, high-risk populations for referral for advanced screening, and provider satisfaction with web-based curriculum content in a teaching platform linked to the provider's website.
Collapse
|
10
|
Ab Malik N, Mohamad Yatim S, Lam OLT, Jin L, McGrath CPJ. Effectiveness of a Web-Based Health Education Program to Promote Oral Hygiene Care Among Stroke Survivors: Randomized Controlled Trial. J Med Internet Res 2017; 19:e87. [PMID: 28363880 PMCID: PMC5392212 DOI: 10.2196/jmir.7024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 01/23/2017] [Accepted: 02/08/2017] [Indexed: 12/20/2022] Open
Abstract
Background Oral hygiene care is of key importance among stroke patients to prevent complications that may compromise rehabilitation or potentially give rise to life-threatening infections such as aspiration pneumonia. Objective The aim of this study was to evaluate the effectiveness of a Web-based continuing professional development (CPD) program on “general intention” of the health carers to perform daily mouth cleaning for stroke patients using the theory of planned behavior (TPB). Methods A double-blind cluster randomized controlled trial was conducted among 547 stroke care providers across 10 hospitals in Malaysia. The centers were block randomized to receive either (1) test intervention (a Web-based CPD program on providing oral hygiene care to stroke patients using TPB) or (2) control intervention (a Web-based CPD program not specific to oral hygiene). Domains of TPB: “attitude,” “subjective norm” (SN), “perceived behavior control” (PBC), “general intention” (GI), and “knowledge” related to providing oral hygiene care were assessed preintervention and at 1 month and 6 months postintervention. Results The overall response rate was 68.2% (373/547). At 1 month, between the test and control groups, there was a significant difference in changes in scores of attitude (P=.004) and subjective norm (P=.01), but not in other TPB domains (GI, P=.11; PBC, P=.51; or knowledge, P=.08). At 6 months, there were significant differences in changes in scores of GI (P=.003), attitude (P=.009), SN (P<.001) and knowledge (P=.001) between the test and control groups. Regression analyses identified that the key factors associated with a change in GI at 6 months were changes in SN (beta=.36, P<.001) and changes in PBC (beta=.23, P<.001). Conclusions The Web-based CPD program based on TPB increased general intention, attitudes, subjective norms, and knowledge to provide oral hygiene care among stroke carers for their patients. Changing subjective norms and perceived behavioral control are key factors associated with changes in general intention to provide oral hygiene care. Trial Registration National Medical Research Register, Malaysia NMRR-13-1540-18833 (IIR); https://www.nmrr.gov.my/ fwbLoginPage.jsp
Collapse
Affiliation(s)
- Normaliza Ab Malik
- Periodontology and Dental Public Health, The University of Hong Kong, Hong Kong SAR, China.,Faculty of Dentistry, Universiti Sains Islam Malaysia (USIM), Kuala Lumpur, Malaysia
| | | | - Otto Lok Tao Lam
- Department of Oral Rehabilitation, The University of Hong Kong, Hong Kong SAR, China
| | - Lijian Jin
- Periodontology and Dental Public Health, The University of Hong Kong, Hong Kong SAR, China
| | | |
Collapse
|
11
|
Duff M, Dahlen HG, Burns E, Priddis H, Schmied V, George A. Designing an oral health module for the Bachelor of Midwifery program at an Australian University. Nurse Educ Pract 2017; 23:76-81. [PMID: 28273559 DOI: 10.1016/j.nepr.2017.02.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 02/04/2017] [Accepted: 02/08/2017] [Indexed: 01/22/2023]
Abstract
Maternal oral health is important yet many pregnant women are unaware of its significance. Midwives are advised to promote oral health during pregnancy and are supported to do this in Australia through the Midwifery Initiated Oral Health training program. However, limited undergraduate education is being provided to midwifery students in this area. The objective of this paper is to describe how an innovative oral health education module for an undergraduate midwifery course in Australia was designed using a multidisciplinary approach. Midwives experienced in curriculum development and key investigators from the Midwifery Initiated Oral Health program designed the module using existing literature. Constructive alignment, blended learning and scaffolding were used in the design process. The draft module was then reviewed by midwifery academics and their feedback incorporated. The final module involves 4 h of teaching and learning and contains three components incorporated into first year course units. Each component is aligned with existing learning outcomes and incorporates blended learning approaches and tutorials/class activities as well as online quizzes and personal reflection. The module details key information (current evidence; basic anatomy/physiology; common oral conditions; and guidelines during pregnancy) that could better prepare students to promote oral health in clinical practice. This is the first time such an innovative, multidisciplinary approach has been undertaken embedding oral health in an undergraduate midwifery program in Australia.
Collapse
Affiliation(s)
- Margaret Duff
- School of Nursing & Midwifery, Western Sydney University, Sydney, NSW 2150, Australia
| | - Hannah G Dahlen
- School of Nursing & Midwifery, Western Sydney University, Ingham Institute Applied Medical Research, Sydney, NSW 2150, Australia
| | - Elaine Burns
- School of Nursing & Midwifery, Western Sydney University, Sydney, NSW 2150, Australia
| | - Holly Priddis
- School of Nursing & Midwifery, Western Sydney University, Sydney, NSW 2150, Australia
| | - Virginia Schmied
- School of Nursing & Midwifery, Western Sydney University, Sydney, NSW 2150, Australia
| | - Ajesh George
- Collaboration for Oral Health Outcomes, Research Translation and Evaluation (COHORTE) Research Group, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, University of Sydney, Locked Bag 7103, Liverpool BC, NSW 1871, Australia.
| |
Collapse
|
12
|
George A, Dahlen HG, Reath J, Ajwani S, Bhole S, Korda A, Chok HN, Miranda C, Villarosa A, Johnson M. What do antenatal care providers understand and do about oral health care during pregnancy: a cross-sectional survey in New South Wales, Australia. BMC Pregnancy Childbirth 2016; 16:382. [PMID: 27903257 PMCID: PMC5131399 DOI: 10.1186/s12884-016-1163-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 11/15/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is mounting evidence to support the lack of awareness among pregnant women about health consequences and long term risks associated with poor oral hygiene during pregnancy. A recognised and important point of influence is their interaction with health professionals, particularly when receiving Antenatal Care. However, there is limited evidence about the perceptions of ANC providers in Australia toward the provision of perinatal oral healthcare. This study was undertaken to explore the knowledge, attitudes and practices of Antenatal Care (ANC) providers in New South Wales (NSW), Australia providing perinatal oral healthcare and to identify barriers to and predictors of their practices in this area. METHODS A cross sectional survey was undertaken of ANC providers (general practitioners, obstetricians/gynaecologists and midwives) practising in NSW, Australia. Participants were recruited through their professional organisations via email, postal mail, and networking at conferences. The survey addressed the domains of knowledge, attitude, barriers and practices towards oral healthcare, along with demographics. Data was entered into SPSS software and analysed using descriptive and inferential statistics. RESULTS A total of 393 surveys (17.6% response rate) were completed comprising 124 general practitioners, 74 obstetricians/gynaecologists and 195 midwives. The results showed limited knowledge among ANC providers regarding the impact of poor maternal oral health on pregnancy/infant outcomes. Most (99%) participants agreed that maternal oral health was important yet few were discussing the importance of oral health or advising women to visit a dentist (16.4-21.5%). Further, less than a third felt they had the skills to provide oral health advice during pregnancy. ANC providers who were more knowledgeable about maternal oral health, had training and information in this area and greater experience, were more likely to engage in practices addressing the oral health of pregnant women. CONCLUSION The findings suggest that ANC providers in NSW are not focussing on oral health with pregnant women. ANC providers seem willing to discuss oral health if they have appropriate education/training and information in this area. Further research at a national level is required to confirm whether these findings are similar in all Australian states.
Collapse
Affiliation(s)
- Ajesh George
- Collaboration for Oral Health Outcomes, Research Translation and Evaluation (COHORTE) Research Group, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research,University of Sydney, Locked Bag 7103, Liverpool, 1871, Australia.
| | - Hannah G Dahlen
- School of Nursing & Midwifery, Western Sydney University, Ingham Institute Applied Medical Research, Parramatta, 2150, Australia
| | - Jennifer Reath
- Peter Brennan Chair of General Practice, School of Medicine, Western Sydney University, Parramatta, 2150, Australia
| | - Shilpi Ajwani
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney, Sydney, 2010, Australia
| | - Sameer Bhole
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney, Sydney, 2010, Australia
| | - Andrew Korda
- Obstetrics and Gynaecology, School of Medicine, Western Sydney University, Parramatta, 2150, Australia
| | - Harrison Ng Chok
- Centre for Nursing Research and Practice Development, Western Sydney University, Nepean Blue Mountains Local Health District, Penrith, 2751, Australia
| | | | - Amy Villarosa
- COHORTE Research Group, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Liverpool, 1871, Australia
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, Ingham Institute Applied Medical Research, Sydney, 2060, Australia
| |
Collapse
|
13
|
Veale M, Ajwani S, Johnson M, Nash L, Patterson T, George A. The early childhood oral health program: a qualitative study of the perceptions of child and family health nurses in South Western Sydney, Australia. BMC Oral Health 2016; 16:56. [PMID: 27184569 PMCID: PMC4867529 DOI: 10.1186/s12903-016-0213-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 05/11/2016] [Indexed: 11/30/2022] Open
Abstract
Background Early childhood caries affects nearly half the population of Australian children aged 5 years and has the potential to negatively impact their growth and development. To address this issue, an Early Childhood Oral Health (ECOH) program, facilitated by Child and Family Health Nurses (CFHNs), commenced in 2007 in New South Wales, Australia. This study builds on the previous evaluation of the program. It aims to explore the perceptions of CFHNs regarding the implementation of the ECOH program in South Western Sydney and the challenges and barriers related to its sustainability. Methods A descriptive qualitative design was used in this study. Two focus groups were conducted with 22 CFHNs who were sampled from two Community Health Centres in South Western Sydney, Australia. Data were transcribed verbatim and thematic analysis was undertaken. Results Most CFHNs acknowledged the importance of early childhood oral health promotion and were providing education, oral assessments and referrals during child health checks. Many stressed the need for collaboration with other health professionals to help broaden the scope of the program. Some barriers to implementing the program included confusion regarding the correct referral process, limited feedback from dental services and the lack of oral health awareness among parents. Conclusion The study findings suggest that the ECOH program is being sustained and effectively implemented into practice by CFHNs. Improvement in the referral and feedback process as well as enhancing parental knowledge of the importance of infant and child oral health could further strengthen the effectiveness of the program. Expanding oral health education opportunities into general practice is advocated, while regular on-line training for CFHNs is preferred. Future research should include strategies to reduce non-attendances, and an assessment of the impact on the prevalence of childhood caries of the ECOH program. Electronic supplementary material The online version of this article (doi:10.1186/s12903-016-0213-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Maxine Veale
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
| | - Shilpi Ajwani
- Sydney Local Health District Oral Health Services/ Sydney Dental Hospital/ University of Sydney, Sydney, Australia
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University/Ingham Institute Applied Medical Research, Sydney, Australia
| | - Linda Nash
- Marrickville Community Oral Health Clinic, Sydney Local Health District Oral Health Services, Sydney, Australia
| | - Tiffany Patterson
- Centre for Applied Nursing Research, Western Sydney University/ South Western Sydney Local Health District/ Ingham Institute Applied Medical Research , Sydney, Australia
| | - Ajesh George
- Collaboration for Oral Health Outcomes, Research, Translation and Evaluation (COHORTE) Research Group/Western Sydney University/South Western Sydney Local Health District Oral Health Services/University of Sydney/Ingham Institute Applied Medical Research, Sydney, Australia.
| |
Collapse
|
14
|
Wagner Y, Heinrich-Weltzien R. Midwives' oral health recommendations for pregnant women, infants and young children: results of a nationwide survey in Germany. BMC Oral Health 2016; 16:36. [PMID: 26988101 PMCID: PMC4797163 DOI: 10.1186/s12903-016-0192-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 03/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies suggest that poor oral health during pregnancy can lead to perinatal complications, such as low birth weight and preterm delivery as well as poor oral health in children. Aim of this study was to assess the German midwives knowledge about oral health and preventive recommendations for pregnant women, infants and young children. METHODS The nationwide online-survey was conducted with use of a self-developed, pretested and validated standardized questionnaire. The German association of midwives (Deutscher Hebammenverband e.V.) informed their members about the survey through email, newsletter, website and association journal (Hebammenforum) (n = 7.500). Data were analyzed using descriptive statistics. RESULTS Response rate was 12.6 % (mean age 42.9 ± 9.3 years). The majority of midwives advised pregnant women about periodontal diseases (78.6 %). Of the midwives, 8.4 % mentioned the possible associations between periodontal diseases and perinatal complications. In general, half of the midwives (53.5 %) recommended a dental visit during pregnancy. A total of 65.5 % of midwives advised parents about early childhood caries. The majority of midwives recommended that oral hygiene starts with eruption of the first tooth (60.4 %) and the first dental visit of the child should be at age 2 or 3 years (51.6 %). Midwives recommendations regarding the implementation of oral hygiene and the referral to a dentist during pregnancy and childhood were highly variable. CONCLUSIONS To increase oral awareness and to improve the oral health knowledge among midwives and all other health-care professionals, uniform guidelines should be developed in Germany. TRIAL REGISTRATION German Clinical Trial Register DRKS00008021.
Collapse
Affiliation(s)
- Yvonne Wagner
- Department of Preventive Dentistry and Pediatric Dentistry, Jena University Hospital, Bachstr. 18, 07743 Jena, Germany
| | - Roswitha Heinrich-Weltzien
- Department of Preventive Dentistry and Pediatric Dentistry, Jena University Hospital, Bachstr. 18, 07743 Jena, Germany
| |
Collapse
|
15
|
George A, Lang G, Johnson M, Ridge A, de Silva AM, Ajwani S, Bhole S, Blinkhorn A, Dahlen HG, Ellis S, Yeo A, Langdon R, Carpenter L, Heilbrunn-Lang A. The evaluation of an oral health education program for midwives in Australia. Women Birth 2015; 29:208-13. [PMID: 26552339 DOI: 10.1016/j.wombi.2015.10.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 09/29/2015] [Accepted: 10/08/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Antenatal care providers are now recommended to promote oral health during pregnancy and provide dental referrals. However, midwives in Australia are not trained to undertake this role. To address this shortcoming, an online evidence based midwifery initiated oral health (MIOH) education program was systematically developed as a professional development activity. AIM This study aimed to evaluate the effectiveness of the program in improving the oral health knowledge of midwives and assess their confidence to promote maternal oral health post training. METHODS The program was evaluated using a pre-post test design involving 50 midwives purposively recruited from two states in Australia. The pre-post questionnaire contained 24 knowledge items previously pilot tested as well as items exploring confidence in promoting oral health and perceptions of the program. FINDINGS The results showed a significant improvement in the oral health knowledge (↑21.5%, p<0.001) of midwives after completion of the program. The greatest improvement in knowledge occurred in key areas vital in promoting maternal oral health namely the high prevalence of dental problems and its impact on birth and infant outcomes. The majority also reported being confident in introducing oral health into antenatal care (82%) and referring women to dental services (77.6%) after undertaking the education program. CONCLUSION The MIOH education program is a useful resource to equip midwives with the necessary knowledge and skills to promote oral health during pregnancy. The program is accessible and acceptable to midwives and can potentially be transferable to other antenatal care providers.
Collapse
Affiliation(s)
- Ajesh George
- Collaboration for Oral Health Outcomes, Research, Translation and Evaluation (COHORTE) Research Group, Western Sydney University/South Western Sydney Local Health District/University of Sydney/Centre for Applied Nursing Research/Ingham Institute Applied Medical Research, Liverpool 1871, Australia.
| | - Gillian Lang
- Healthy Families, Healthy Smiles, Dental Health Services Victoria, Melbourne 3053, Australia
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, Sydney 2060, Australia
| | - Allison Ridge
- Healthy Families, Healthy Smiles, Dental Health Services Victoria, Melbourne 3053, Australia
| | - Andrea M de Silva
- Dental Health Services Victoria, and Melbourne Dental School, University of Melbourne, 3053, Australia
| | - Shilpi Ajwani
- Sydney Local Health District Oral Health Services/Sydney Dental Hospital/University of Sydney, 2010, Australia
| | - Sameer Bhole
- Sydney Local Health District Oral Health Services/Sydney Dental Hospital/University of Sydney, 2010, Australia
| | | | - Hannah G Dahlen
- School of Nursing & Midwifery, Western Sydney University/Ingham Institute Applied Medical Research, Parramatta 2150, Australia
| | - Sharon Ellis
- Camden and Campbelltown Hospitals, South Western Sydney Local Health District, 2170, Australia
| | - Anthony Yeo
- Centre for Applied Nursing Research, Western Sydney University, Liverpool 1871, Australia
| | - Rachel Langdon
- Centre for Applied Nursing Research, Western Sydney University/South Western Sydney Local Health District/Ingham Institute Applied Medical Research, Liverpool 1871, Australia
| | - Lauren Carpenter
- Dental Health Services Victoria and The Jack Brockhoff Child Health and Wellbeing Program, Melbourne 3053, Australia
| | - Adina Heilbrunn-Lang
- Centre for Applied Oral Health Research, Dental Health Services Victoria, Melbourne 3053, Australia
| |
Collapse
|
16
|
Heilbrunn-Lang AY, de Silva AM, Lang G, George A, Ridge A, Johnson M, Bhole S, Gilmour C. Midwives' perspectives of their ability to promote the oral health of pregnant women in Victoria, Australia. BMC Pregnancy Childbirth 2015; 15:110. [PMID: 25943399 PMCID: PMC4490712 DOI: 10.1186/s12884-015-0536-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 04/17/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Midwives have a potential role in promoting the oral health of pregnant women although they have little formal training in this area. The aim of this study was to explore the perspectives of midwives in Victoria towards incorporating oral health promotion into their antenatal practice after undergoing training through the Midwifery Initiated Oral Health (MIOH) online education program. METHODS A purposive sample of thirty-nine midwives from maternity services across Victoria, Australia were invited to participate in an online MIOH education program in October 2012. The program included three self-paced modules covering oral health screening, referral processes, and theoretical and practical skill assessments. A mixed methods design was used to capture midwives perspectives. Evaluation questionnaires, completed pre- and post-training, captured knowledge and confidence (confidence likert scale), and also included five opened-ended questions post-training. Open-ended questions, feedback forms and unsolicited emails formed the data for qualitative analysis. Data were analysed using content and thematic analysis and descriptive statistics. RESULTS Thirty-three midwives completed the MIOH education program and demonstrated a significant increase (51.5%) in their confidence to promote oral health. All participants viewed the program as suitable, acceptable and useful for their practice and were happy to recommend the course to other Victorian midwives. Participants indicated that it would be feasible to incorporate oral health into the first antenatal booking visit and recognised that oral health promotion was within their scope of practice. CONCLUSIONS This study has shown that the MIOH education program is a valued resource that can assist midwives to increase their confidence and skills to incorporate oral health promotion into their practice. A key barrier identified was time constraints during antenatal care booking visits. However, it is evident that with relevant training it would be feasible and acceptable for Victorian midwives to incorporate oral health promotion within their practice. The current engagement with midwives in Victoria and other parts of Australia provides an opportunity to continue to explore and define the role of antenatal health care professionals in oral health promotion at a state and national level.
Collapse
Affiliation(s)
- Adina Y Heilbrunn-Lang
- Centre for Applied Oral Health Research, Dental Health Services Victoria, Melbourne, Australia.
| | - Andrea M de Silva
- Centre for Applied Oral Health Research, Dental Health Services Victoria, Melbourne, Australia.
| | - Gillian Lang
- Health Promotion, Dental Health Services Victoria, Melbourne, Australia.
| | - Ajesh George
- Centre for Applied Nursing Research, University of Western Sydney/ South Western Sydney Local Health District, Sydney, Australia. .,Ingham Institute Applied Medical Research, Sydney, Australia. .,Faculty of Dentistry, University of Sydney, Sydney, Australia.
| | - Allison Ridge
- Health Promotion, Dental Health Services Victoria, Melbourne, Australia.
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, Sydney, Australia.
| | - Sameer Bhole
- Faculty of Dentistry, University of Sydney, Sydney, Australia. .,Sydney Local Health District Oral Health Services and Sydney Dental Hospital, Sydney, Australia.
| | - Carole Gilmour
- Australian College of Midwifery Victorian Branch, Melbourne, Australia. .,Monash University, Melbourne, Australia.
| |
Collapse
|
17
|
Johnson M, George A, Dahlen H, Ajwani S, Bhole S, Blinkhorn A, Ellis S, Yeo A. The midwifery initiated oral health-dental service protocol: an intervention to improve oral health outcomes for pregnant women. BMC Oral Health 2015; 15:2. [PMID: 25588410 PMCID: PMC4324677 DOI: 10.1186/1472-6831-15-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 01/05/2015] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Evidence is emerging that women's poor oral health and health practices during pregnancy are associated with poor oral health in their children and potentially an increased risk of pre-term or low-birth weight infants. METHODS/DESIGN The Midwifery Initiated Oral Health-Dental Service (MIOH-DS) trial is a three arm multicentre randomised controlled trial which will recruit women from three metropolitan hospitals aimed at improving women's oral health and service access and indirectly reducing perinatal morbidity. All three arms of the trial will deliver oral health promotion material, although a midwife oral assessment and referral to private/public/health fund dental services pathway (Intervention Group 1) and the midwife oral assessment and referral to local free public dental services pathway (Intervention Group 2) will be compared to the control group of oral health promotional material only. Midwives will undergo specific oral health education and competency testing to undertake this novel intervention. DISCUSSION This efficacy trial will promote a new partnership between midwives and dentists focused on enhancing the oral health of women and their infants. Should the intervention be found effective, this intervention, with existing on-line educational program for midwives, can be easily transferred into practice for large metropolitan health services within and beyond Australia. Further cost-benefit analysis is proposed to inform national health policy. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12612001271897.
Collapse
Affiliation(s)
- Maree Johnson
- />Faculty of Health Sciences, Australian Catholic University, Ingham Institute Applied Medical Research, Sydney, Australia
| | - Ajesh George
- />Centre for Applied Nursing Research, University of Western Sydney/ South Western Sydney Local Health District, University of Sydney, Ingham Institute Applied Medical Research, Liverpool BC, Locked Bag 7103, Sydney, NSW 1871 Australia
| | - Hannah Dahlen
- />School of Nursing & Midwifery, University of Western Sydney, Ingham Institute Applied Medical Research, Sydney, Australia
| | - Shilpi Ajwani
- />Sydney Local Health District Oral Health Services and Sydney Dental Hospital, Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Sameer Bhole
- />Sydney Local Health District Oral Health Services and Sydney Dental Hospital, Faculty of Dentistry, University of Sydney, Sydney, Australia
| | | | - Sharon Ellis
- />Camden and Campbelltown Hospitals, South Western Sydney Local Health District, Sydney, Australia
| | - Anthony Yeo
- />Centre for Applied Nursing Research, University of Western Sydney, Sydney, Australia
| |
Collapse
|
18
|
Phelan C, Wright C. Response to Arora et al.: a qualitative evaluation of the view of Child and Family Health Nurses on the early childhood oral health education materials in New South Wales, Australia. Health Promot J Austr 2013; 24:78-9. [PMID: 23575596 DOI: 10.1071/he12914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 11/02/2012] [Indexed: 11/23/2022] Open
|
19
|
George A, Shamim S, Johnson M, Dahlen H, Ajwani S, Bhole S, Yeo AE. How do dental and prenatal care practitioners perceive dental care during pregnancy? Current evidence and implications. Birth 2012; 39:238-47. [PMID: 23281906 DOI: 10.1111/j.1523-536x.2012.00553.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Poor maternal oral health may be associated with adverse pregnancy and infant outcomes. However, women seldom seek dental care during pregnancy, and misconceptions by prenatal care practitioners about oral health care during pregnancy may contribute to the problem. The aim of this study was to review current knowledge, attitudes, and behavior of dental and prenatal care practitioners about oral health care during pregnancy. METHODS This review examined all studies published in English that explored the knowledge, attitude, behavior, and barriers faced by dentists, general practitioners, midwives, and obstetricians/gynecologists with respect to oral health care during pregnancy. RESULTS Despite acknowledging the importance of maternal oral health, many dentists are uncertain about the safety of dental procedures and are hesitant in treating pregnant women. General practitioners and midwives are poorly informed about the impact of poor maternal oral health and rarely initiate this topic during prenatal care. Many general practitioners also believe that dental procedures are unsafe during pregnancy. Obstetricians/gynecologists are well informed about perinatal oral health and are supportive of dental procedures, but because of lack of training in this area and competing health demands they seldom focus on oral health care during their prenatal care. CONCLUSION No real consensus exists among dentists and prenatal care practitioners with respect to oral health care during pregnancy. This issue poses a significant deterrent for pregnant women seeking dental care. Practice guidelines in perinatal oral health are needed for health professionals to emphasize this important aspect of prenatal care.
Collapse
Affiliation(s)
- Ajesh George
- Centre for Applied Nursing Research (CANR), South Western Sydney Local Health District (SWSLHD)/University of Western Sydney, Sydney, New South Wales, Australia
| | | | | | | | | | | | | |
Collapse
|