Adams Sally H, Gregorich Steven E, Rising Sharon S, Hutchison Margaret, Chung Lisa H
J Midwifery Womens Health. 2017 Jul;62(4):463-469. doi: 10.1111/jmwh.12613. Epub 2017 Jul 7.
National and professional organizations recommend oral health promotion in prenatal care to improve women's oral health. However, few prenatal programs include education about oral health promotion. The objective of this study was to determine if women receiving a brief, low-cost, and sustainable educational intervention entitled CenteringPregnancy Oral Health Promotion had clinically improved oral health compared to women receiving standard CenteringPregnancy care.
Women attending CenteringPregnancy, a group prenatal care model, at 4 health centers in the San Francisco Bay Area, participated in this nonrandomized controlled pilot study in 2010 to 2011. The intervention arm received the CenteringPregnancy Oral Health Promotion intervention consisting of two 15-minute skills-based educational modules addressing maternal and infant oral health, each module presented in a separate CenteringPregnancy prenatal care session. The present analysis focused on the maternal module that included facilitated discussions and skills-building activities including proper tooth brushing. The control arm received standard CenteringPregnancy prenatal care. Dental examinations and questionnaires were administered prior to and approximately 9 weeks postintervention. Primary outcomes included the Plaque Index, percent bleeding on probing, and percent of gingival pocket depths 4 mm or greater. Secondary outcomes were self-reported oral health knowledge, attitudes (importance and self-efficacy), and behaviors (tooth brushing and flossing). Regression models tested whether pre to post changes in outcomes differed between the intervention versus the control arms.
One hundred and one women participated in the study; 49 were in the intervention arm, and 52 were in the control arm. The control and intervention arms did not vary significantly at baseline. Significant pre to post differences were noted between the arms with significant improvements in the intervention arm for the Plaque Index, bleeding on probing, and pocket depths 4 mm or greater.
Providing brief oral health education and skills-building activities within prenatal care may be effective in improving women's oral health during pregnancy. These findings provide support for developing a full-scale randomized clinical trial of the CenteringPregnancy Oral Health Promotion intervention.
国家和专业组织建议在产前护理中促进口腔健康，以改善女性的口腔健康状况。然而，很少有产前项目包含口腔健康促进方面的教育内容。本研究的目的是确定与接受标准孕期中心护理的女性相比，接受一项名为“孕期中心口腔健康促进”的简短、低成本且可持续的教育干预的女性，其口腔健康状况在临床上是否有所改善。
2010年至2011年期间，在旧金山湾区的4个健康中心参加孕期中心（一种小组产前护理模式）的女性参与了这项非随机对照试验性研究。干预组接受了“孕期中心口腔健康促进”干预，该干预包括两个15分钟的基于技能的教育模块，分别涉及母婴口腔健康，每个模块在单独的孕期中心产前护理课程中呈现。本分析聚焦于包含促进讨论和技能培养活动（包括正确刷牙）的母亲模块。对照组接受标准的孕期中心产前护理。在干预前及干预后约9周进行牙科检查和问卷调查。主要结局包括菌斑指数、探诊出血百分比以及牙龈袋深度≥4mm的百分比。次要结局为自我报告的口腔健康知识、态度（重要性和自我效能感）以及行为（刷牙和使用牙线）。回归模型检验了干预组与对照组在结局指标干预前后的变化是否存在差异。
101名女性参与了该研究；49名在干预组，52名在对照组。两组在基线时无显著差异。两组之间干预前后存在显著差异，干预组在菌斑指数、探诊出血以及牙龈袋深度≥4mm方面有显著改善。
在产前护理中提供简短的口腔健康教育和技能培养活动可能对改善孕期女性的口腔健康有效。这些发现为开展“孕期中心口腔健康促进”干预的全面随机临床试验提供了支持。
