Attitudes of Dentists and Dental Students Regarding Perinatal Oral Healthcare

Megan K. Burns, D.D.S.* and Donna Kritz-Silverstein Ph.D.

University of California Los Angeles; University Of California San Diego
Background
Infant oral health begins before birth, with

Table 1. Sample Characteristics

__________________________________________________________________

Figure 1. Provide FMX

100 90 80 70 60 50 40 Students General Dentists

Results
Education about treatment during pregnancy averaged 2.5 hours for dentists and 4.0 hours for students; 52.9% of dentists, but only 8.3% of students, reported receiving no education on treatment of pregnant women

7comprehensive oral care for pregnant women Reduction of dental disease in pregnant women: Reduces transmission of bacteria to infants
Reduces likelihood of ECC

Characteristic
Gender Male Female No ed. on tx of pregnant patients

Students N %
68 65 51 49

Dentists N %
23 11 68 32

Previous studies report that: Dentists do not provide comprehensive dental

care during pregnancy More recent dental school graduates are more likely to counsel about vertical caries transmission

11 Mean(SD)

8 Range 23-46 ---0-20

18 Mean(SD) 56.3(11.0) 29.2(11.3) 2.5(4.3)

53 Range 28-72 7-47 0-20

30 20 10 0 Would not provide

P=0.02

P<0.0001

Dentists were more willing than students to provide FMX in all trimesters; however, 64% of both groups would not provide FMX in any trimester Students were more wiling than dentists to provide emergency treatment in all trimesters Dentists were more willing than students to provide routine restorative care and Sc/RP in the second trimester Compared to students, dentists were: More likely to believe in the safety of radiographs, emergency treatment and antibiotics during pregnancy Compared to dentists, students were: More likely to believe in the safety of Xylitol during pregnancy, efficacy of counseling about vertical transmission of bacteria, and that treatment of active dental disease will reduce ECC

Age Yrs since graduation # of hrs of ed. on tx of pregnant patients

27.9(3.8) ---4.0(3.7)

1st trimester

2nd trimester

3rd trimester

All trimesters

Figure 2. Emergency treatment

100 90 80 70 60 50 40 30 20
7

According to a 2010 CDA report:

Benefit of dental treatment for pregnant

Students

General Dentists

women far outweighs risks of non-treatment Prevention, diagnosis and treatment are safe Radiographs can be taken any time during pregnancy

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P<0.0001

No published studies have examined:

Dentists use of the 2010 CDA guidelines

Figure 5. Comparisons of students vs. dentists on knowledge and beliefs about peri-natal oral healthcare
Students Dentists 0 1 2 3 4 5 6

Beliefs and attitudes of dental students regarding care of pregnant patients

10 0 Would not provide 1st trimester 2nd trimester 3rd trimester All trimesters

OB/GYN consult required

Purpose
This study compares general dentists to fourth year dental students in California on beliefs and practices regarding perinatal oral healthcare

Routine restorative care

Figure 3. Routine restorative care

100 Students General Dentists P=.02 90 80

Radiographs

P=0.05

Limitations and Strengths

Limitations Small sample size of general dentists; may limit generalizability Strengths First to compare general dentists and dental students using current guidelines about treatment during pregnancy

Local anesthesia

70 60

Emergency tx

P=.07

50 40 30

Methods
Rx for Abx

Survey assessing perinatal oral healthcare Behavior Attitudes Knowledge Distributed to two 4th year dental school classes and dentists at three dental society meetings in the greater Los Angeles area 133 students and 34 dentists returned surveys

P=.06

20 10

Perio Exam

0 Would not provide 1st trimester 2nd trimester 3rd trimester All trimesters

Rx for Chlorhexidine

Figure 4. Scaling and root planing

100 Students General Dentists P<.0001 90 80 70 60 50 P<.0001 40 30 20 10 0 Would not provide 1st trimester 2nd trimester 3rd trimester All trimesters

Conclusions
Although the CDA has published guidelines regarding the safety of dental treatment in pregnant patients, neither dentists or dental students feel confident in safety of providing dental care throughout pregnancy Dental students knowledge of preventive care is more current than general dentists, although dentists are more willing to provide care throughout all trimesters More education about treating pregnant patients, and a greater dissemination of current guidelines, is needed

Xylitol products

P=0.0002

N2O

Data compared with: Chi-Square analysis Independent t-tests

Consult-vert transmission bacteria

Perio tx: pre-term labor

Dental tx--> reduce ECC

P=.0007