Oral-Systemic Health During Pregnancy: Exploring Prenatal and Oral Health Providers’ Information, Motivation and Behavioral Skills

Pregnancy is identified as a sensitive period of increased risk for poor oral health among mothers and offspring. Subsequently, both medical and dental associations have re-endorsed consolidated, inter-professional guidelines promoting oral health during pregnancy. The objective was to explore prenatal and oral health providers’ information, motivation and practice behaviors related to oral health during pregnancy. Twenty-two in-depth interviews were conducted with prenatal and oral health providers based on the Information-Motivation-Behavioral Skills Model. Data were analyzed using the constant comparative method in NVivo 10. Providers held variable knowledge with regards to identified oral-systemic connections and implications. Most providers were unaware of the guidelines; however, some oral health providers reported avoiding specific treatment behaviors during this period. Motivation to address oral-systemic health during pregnancy included: prevention; healthy pregnancy/birth outcomes; patient’s complaint/question as cue to action; comprehensive, patient-centered, and family-centered care; ethical duty; and professional governing body. Oral health providers reported assessing, educating, and communicating with patients about oral health issues; whereas prenatal providers rarely addressed oral health but reported signing approval forms to receive such care. A few oral health providers highlighted lifecourse implications and the need for family-centered care when addressing poor oral health among pregnant patients. Findings suggest gaps in oral health prevention information and behaviors among prenatal and oral health providers. Future efforts should examine effective dissemination and implementation strategies that translate evidence-based guidelines into clinical practice, with the ultimate goal of improve oral-systemic health among women and their offspring across the lifecourse.

This is a preview of subscription content, access via your institution.

Access optionsBuy single article

Instant access to the full article PDF.

39,95 €

Price includes VAT (India)

dataLayer.push({"ecommerce":{"currency":"EUR","impressions":[{"name":"Oral-Systemic Health During Pregnancy: Exploring Prenatal and Oral Health Providers’ Information, Motivation and Behavioral Skills","id":"1573-6628","price":39.95,"brand":"Springer US","category":"Medicine & Public Health","variant":"ppv-article","quantity":1}]}});

Rent this article via DeepDyve.

function deepDyveResponse(data) { if (data.status === 'ok') { [].slice.call(document.querySelectorAll('.c-box.buybox__rent-article')).forEach(function (article) { article.style.display = 'flex' var link = article.querySelector('.deepdyve-link') if (link) { link.setAttribute('href', data.url) } }) } } var script = document.createElement('script') script.src = '//www.deepdyve.com/rental-link?docId=10.1007/s10995-014-1632-7&journal=1573-6628&fieldName=journal_doi&affiliateId=springer&format=jsonp&callback=deepDyveResponse' document.body.appendChild(script)

Learn more about Institutional subscriptions

.sprcom-buybox-articleSidebar{box-shadow: 0px 0px 5px rgba(51,51,51,0.101);display: flex;flex-wrap: wrap;font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;text-align: center; } .sprcom-buybox-articleSidebar *{box-sizing: border-box;line-height: calc(100% + 4px);margin: 0px; } .sprcom-buybox-articleSidebar > *{display: flex;flex-basis: 240px;flex-direction: column;flex-grow: 1;flex-shrink: 1;margin: 0.5px; } .sprcom-buybox-articleSidebar > *{box-shadow: 0 0 0 1px rgba(204,204,204,0.494); } .sprcom-buybox-articleSidebar .c-box__body{display: flex;flex-direction: column-reverse;flex-grow: 1;justify-content: space-between;padding: 6%; } .sprcom-buybox-articleSidebar .c-box__body .buybox__buy{display: flex;flex-direction: column-reverse; } .sprcom-buybox-articleSidebar p{color: #333;font-size: 15px; } .sprcom-buybox-articleSidebar .buybox__price{font-size: 24px;font-weight: 500;line-height: calc(100% + 8px);margin: 20px 0;order: 1; } .sprcom-buybox-articleSidebar form{order: 1; } .sprcom-buybox-articleSidebar .buybox__price-info{margin-bottom: 20px; } .sprcom-buybox-articleSidebar .c-box__heading{background-color: #f0f0f0;color: #333;font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen-Sans, Ubuntu, Cantarell, 'Helvetica Neue', sans-serif;font-size: 16px;margin: 0px;padding: 10px 12px;text-align: center; } .sprcom-buybox-articleSidebar .c-box__button{background-color: #3365A4;border: 1px solid transparent;border-radius: 2px;color: #fff;cursor: pointer;display: inline-block;font-family: inherit;font-size: 16px;max-width: 222px;padding: 10px 12px;text-decoration: none;width: 100%; } .sprcom-buybox-articleSidebar h3{clip: rect(1px, 1px, 1px, 1px);height: 1px;overflow: hidden;position: absolute;width: 1px; } .sprcom-buybox-articleSidebar h2{flex-basis: 100%;margin-bottom: 16px;text-align: left; } .sprcom-buybox-articleSidebar .buybox__institutional-sub, .buybox__rent-article .c-box__body{flex-direction: row; } .sprcom-buybox-articleSidebar .buybox__institutional-sub, .buybox__rent-article .buybox__info{text-align: left; } .sprcom-buybox-articleSidebar .buybox__institutional-sub{background-color: #f0f0f0; } .sprcom-buybox-articleSidebar .visually-hidden{clip: rect(1px, 1px, 1px, 1px);height: 1px;overflow: hidden;position: absolute;width: 1px; } .sprcom-buybox-articleSidebar style{display: none; } ;(function () { var timestamp = Date.now() document.write('') var head = document.getElementsByTagName("head")[0] var script = document.createElement("script") script.type = "text/javascript" script.src = "https://buy.springer.com/assets/js/buybox-bundle-abe5f44a67.js" script.id = "ecommerce-scripts-" + timestamp head.appendChild(script) var buybox = document.querySelector("[data-id=id_"+ timestamp +"]").parentNode ;[].slice.call(buybox.querySelectorAll(".buying-option")).forEach(init) function init(buyingOption, index) { var form = buyingOption.querySelector("form") if (form) { var formAction = form.getAttribute("action") document.querySelector("#ecommerce-scripts-" + timestamp).addEventListener("load", bindModal(form, formAction, timestamp, index), false) } } function bindModal(form, formAction, timestamp, index) { var weHasBrowserSupport = window.fetch && Array.from return function() { console.log("ecommerce-scripts loaded, attempting to init modal …") var Buybox = EcommScripts ? EcommScripts.Buybox : null var Modal = EcommScripts ? EcommScripts.Modal : null if (weHasBrowserSupport && Buybox && Modal) { var modalID = "ecomm-modal_" + timestamp + "_" + index var modal = new Modal(modalID) modal.domEl.addEventListener("close", close) function close() { form.querySelector("button[type=submit]").focus() } var cartURL = "/cart" var cartModalURL = "/cart?messageOnly=1" form.setAttribute( "action", formAction.replace(cartURL, cartModalURL) ) var formSubmit = Buybox.interceptFormSubmit( Buybox.fetchFormAction(window.fetch), Buybox.triggerModalAfterAddToCartSuccess(modal), function() { form.removeEventListener("submit", formSubmit, false) form.setAttribute( "action", formAction.replace(cartModalURL, cartURL) ) form.submit() } ) form.addEventListener("submit", formSubmit, false) document.body.appendChild(modal.domEl) } else { console.log("binding failed:", weHasBrowserSupport, EcommScripts) } } } })() References

Barnett, M. L. (2006). The oral-systemic disease connection. An update for the practicing dentist. Journal of the American Dental Association, 137(S2), 5S–6S.

Article PubMed Google Scholar

Nicolau, B., Thomson, W. M., Steele, J. G., & Allison, P. J. (2007). Life-course epidemiology: Concepts and theoretical models and its relevance to chronic oral conditions. Community Dentistry and Oral Epidemiology, 35(4), 241–249.

Article CAS PubMed Google Scholar

Lieff, S., Boggess, K. A., Murtha, A. P., Jared, H., Madianos, P. N., Moss, K., et al. (2004). The oral conditions and pregnancy study: Periodontal status of a cohort of pregnant women. Journal of Periodontology, 75(1), 116–126.

Article PubMed Google Scholar

Lachat, M. F., Solnik, A. L., Nana, A. D., & Citron, T. L. (2011). Periodontal disease in pregnancy: Review of the evidence and prevention strategies. The Journal of Perinatal & Neonatal Nursing, 25(4), 312–319.

Article Google Scholar

Kloetzel, M. K., Huebner, C. E., & Milgrom, P. (2011). Referrals for dental care during pregnancy. Journal of Midwifery & Women’s Health, 56(2), 110–117.

Article Google Scholar

U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, Office of Research on Women’s Health. Moving into the future with new dimensions and strategies: A vision for 2020 for women’s health research, volume II—Regional scientific reports. Bethesda, MD: National Institutes of Health, 2010 Contract No.: 10-7606-B.

Xiong, X., Buekens, P., Fraser, W., Beck, J., & Offenbacher, S. (2006). Periodontal disease and adverse pregnancy outcomes: A systematic review. BJOG, 113(2), 135–143.

Article CAS PubMed Google Scholar

Boggess, K. A., Lieff, S., Murtha, A. P., Moss, K., Beck, J., & Offenbacher, S. (2003). Maternal, periodontal disease is associated with an increased risk for preeclampsia. Obstetrics and Gynecology, 101(2), 227–231.

Article PubMed Google Scholar

Moore, S., Ide, M., Coward, P. Y., Randhawa, M., Borkowska, E., Baylis, R., et al. (2004). A prospective study to investigate the relationship between periodontal disease and adverse pregnancy outcome. British Dental Journal, 197(5), 251–258.

Article CAS PubMed Google Scholar

Offenbacher, S., Lieff, S., Boggess, K. A., Murtha, A. P., Madianos, P. N., Champagne, C. M., et al. (2001). Maternal periodontitis and prematurity. Part I: Obstetric outcome of prematurity and growth restriction. Annals of Periodontology, 6(1), 164–174.

Article CAS PubMed Google Scholar

Xiong, X., Buekens, P., Vastardis, S., & Pridjian, G. (2006). Periodontal disease and gestational diabetes mellitus. American Journal of Obstetrics and Gynecology, 195(4), 1086–1089.

Article PubMed Google Scholar

Polyzos, N. P., Polyzos, I. P., Mauri, D., Tzioras, S., Tsappi, M., Cortinovis, I., et al. (2009). Effect of periodontal disease treatment during pregnancy on preterm birth incidence: A metaanalysis of randomized trials. American Journal of Obstetrics and Gynecology, 200(3), 225–232.

Article PubMed Google Scholar

Michalowicz, B. S., Hodges, J. S., DiAngelis, A. J., Lupo, V. R., Novak, M. J., Ferguson, J. E., et al. (2006). Treatment of periodontal disease and the risk of preterm birth. New England Journal of Medicine, 355(18), 1885–1894.

Article CAS PubMed Google Scholar

Sanz M, Kornman K, Working group 3 of the Joint EFP/AAP Workshop. Periodontitis and adverse pregnancy outcomes: Consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. Journal of Clinical Periodontology. 2013; 84(4 Suppl):S164–S9.

Madianos, P. N., Bobetsis, Y. A., & Offenbacher, S. (2013). Adverse pregnancy outcomes (APOs) and periodontal disease: Pathogenic mechanisms. Journal of Clinical Periodontology, 84(4 Suppl), S170–S180.

Google Scholar

Castañeda, H., Carrion, I. V., Kline, N., & Tyson, D. M. (2010). False hope: Effects of social class and health policy on oral health inequalities for migrant farmworker families. Social Science and Medicine, 71(11), 2028–2037.

Article PubMed Google Scholar

Boggess, K. A., & Edelstein, B. L. (2006). Oral health in women during preconception and pregnancy: Implications for birth outcomes and infant oral health. Maternal and Child Health Journal, 10(5 Suppl), S169–S174.

Article PubMed Google Scholar

American Academy of Periodontics. (2011). Policy on early childhood caries (ECC): Classifications, consequences, and preventive strategies. Pediatric Dentistry, 34(6), 50–52.

Google Scholar

Task Force on Periodontal Treatment of Pregnant Women, American Academy of Periodontology. (2004). American Academy of Periodontology statement regarding periodontal management of the pregnant patient. Journal of Periodontology, 75(3), 495.

Council on Clinical Affairs. (2011). Guideline on perinatal oral health care. American Academy of Pediatric Dentistry: Reference Manual, 33(6), 11–12.

Google Scholar

American Dental Association. (2011). Oral health during pregnancy. Journal of the American Dental Association, 142(5), 574.

Article Google Scholar

American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. (2007). Guidelines for perinatal care (6th ed., pp. 123–124). Washington, DC: American College of Obstetricians and Gynecologists; Elk Grove Village, IL: American Academy of Pediatrics.

Hwang, S., Smith, V., McCormick, M., & Barfield, W. (2011). Racial/ethnic disparities in maternal oral health experiences in 10 states, pregnancy risk assessment monitoring system, 2004–2006. Maternal and Child Health Journal, 15(6), 722–729.

Article PubMed Google Scholar

Morgan, M., Crall, J., Goldenberg, R., & Schulkin, J. (2009). Oral health during pregnancy. Journal of Maternal-Fetal and Neonatal Medicine, 22(9), 733–739.

Article CAS PubMed Google Scholar

Strafford, K. E., Shellhaas, C., & Hade, E. M. (2008). Provider and patient perceptions about dental care during pregnancy. Journal of Maternal-Fetal and Neonatal Medicine, 21(1), 63–71.

Article PubMed Google Scholar

Wilder, R., Robinson, C., Jared, H. L., Lieff, S., & Boggess, K. (2007). Obstetricians’ knowledge and practice behaviors concerning periodontal health and preterm delivery and low birth weight. Journal Dental Hygiene, 81(4), 81.

Google Scholar

Huebner, C. E., Milgrom, P., Conrad, D., & Lee, R. S. (2009). Providing dental care to pregnant patients: a survey of Oregon general dentists. Journal of the American Dental Association, 140(2), 211–222.

Article PubMed Google Scholar

Pina, P., & Douglass, J. (2011). Practices and opinions of Connecticut general dentists regarding dental treatment during pregnancy. General Dentistry, 59(1), e25–e31.

PubMed Google Scholar

Oral Health Care During Pregnancy Expert Workgroup. (2012). Oral health care during pregnancy: A national consensus statement—Summary of an Expert Workgroup Meeting. Washington, DC: National Maternal and Child Oral Health Resource Center.

Google Scholar

Fisher, J., & Fisher, W. (2002). The Information-Motivation-Behavioral Skills Model. In R. DiClemente, R. Crosby, & M. Kegler (Eds.), Emerging theories in health promotion practice and research: Strategies for improving public health. San Francisco, CA: Wiley.

Google Scholar

QSR (Version 10) [Computer software]. International Pty Ltd. NVivo. 2012.

Glaser, B. G. (1965). The constant comparative method of qualitative analysis. Social Problems, 12(4), 436–445.

Article Google Scholar

George, A., Shamim, S., Johnson, M., Ajwani, S., Bhole, S., Blinkhorn, A., et al. (2011). Periodontal treatment during pregnancy and birth outcomes: A meta-analysis of randomised trials. International Journal of Evidence‐Based Healthcare, 9(2), 122–147.

Article PubMed Google Scholar

Jiang, H., Xiong, X., Su, Y., Zhang, Y., Wu, H., Jiang, Z., et al. (2013). A randomized controlled trial of pre-conception treatment for periodontal disease to improve periodontal status during pregnancy and birth outcomes. BMC Pregnancy and Childbirth, 13, 228.

Article PubMed Central PubMed Google Scholar

Institute of Medicine. (2011). Advancing oral health in America. Washington, D.C.: The National Academies Press.

Google Scholar

Abernethy, A. P., Herndon, J. E., Wheeler, J. L., Patwardhan, M., Shaw, H., Lyerly, H. K., et al. (2008). Improving health care efficiency and quality using tablet personal computers to collect research-quality, patient-reported data. Health Services Research, 43(6), 1975–1991.

Article PubMed Central PubMed Google Scholar

Wofford, J. L., Smith, E. D., & Miller, D. P. (2005). The multimedia computer for office-based patient education: A systematic review. Patient Education and Counseling, 59(2), 148–157.

Article PubMed Google Scholar

Lewis, D. (1999). Computer-based approaches to patient education: A review of the literature. Journal of the American Medical Informatics Association, 6(4), 272–282.

Article PubMed Central CAS PubMed Google Scholar

Richter, J. G., Becker, A., Koch, T., Nixdorf, M., Willers, R., Monser, R., et al. (2008). Self-assessments of patients via Tablet PC in routine patient care: Comparison with standardised paper questionnaires. Annals of the Rheumatic Diseases, 67(12), 1739–1741.

Article CAS PubMed Google Scholar

Ratzan SC, Parker RM. Introduction. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services2000 Contract No.: CBM 2000-1.

Vamos, C. A. (2011). Applying a health literacy lens to preventative children’s oral health programming. Umwelt und Gesundheit, 4, 30–34.

Google Scholar

Download references

Author informationAuthors and Affiliations

Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA

Cheryl A. Vamos, Margaret L. Walsh, Erika Thompson, Ellen M. Daley, Linda Detman & Rita DeBate

AuthorsCheryl A. VamosView author publications

You can also search for this author in PubMed Google Scholar

Margaret L. WalshView author publications

You can also search for this author in PubMed Google Scholar

Erika ThompsonView author publications

You can also search for this author in PubMed Google Scholar

Ellen M. DaleyView author publications

You can also search for this author in PubMed Google Scholar

Linda DetmanView author publications

You can also search for this author in PubMed Google Scholar

Rita DeBateView author publications

You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cheryl A. Vamos.

Rights and permissions

Reprints and Permissions

About this articleCite this article

Vamos, C.A., Walsh, M.L., Thompson, E. et al. Oral-Systemic Health During Pregnancy: Exploring Prenatal and Oral Health Providers’ Information, Motivation and Behavioral Skills. Matern Child Health J 19, 1263–1275 (2015). https://doi.org/10.1007/s10995-014-1632-7

Download citation

Published: 04 November 2014

Issue Date: June 2015

DOI: https://doi.org/10.1007/s10995-014-1632-7