Gupta Sujaya, Shrestha Barsha, Gupta Neha, Tuladhar Anik, Kc Sushil, Dhami Bhageshwar
Department of Periodontics, Kantipur Dental College, Basundhara, Kathmandu, Nepal.
Barah Dental Clinic, Dharan, Nepal.
JNMA J Nepal Med Assoc. 2018 Mar-Apr;56(210):565-571.
Periodontal disease and caries are the most common causes of tooth loss worldwide. Studies have demonstrated strong association between periodontitis and adverse pregnancy outcomes. Medical doctors, who are the primary healthcare providers, seldom advise women to seek dental care during pregnancy. This study was undertaken to explore the knowledge, attitudes and behaviours of medical doctors towards oral health and to identify the barriers of prenatal periodontal healthcare in their practices and its possible implications on pregnancy outcomes.
Total 377 doctors filled the questionnaire. The data collected through personal contacts, social networking, emails, online forms and networking at conferences were analysed using Statistical Package for the Social Sciences 20 software program and presented in tables, charts and diagrams.
Out of 263 (69.8%) male and 114 (30.2%) female doctors enrolled in the study, only 52 (13.8%) had received education or training on oral care during pregnancy. Among them 299 (79.3%) agreed that there is possible link between health of teeth-gums and pregnancy. Approximately 105 (27.9%) encountered patients with oral/periodontal problem every week but only 108 (28.6%) "always" advised their patient for regular dental check-ups. Similarly, 358 (95%) agreed that there is need for universal guidelines however, 133 (35.3%) thought there was insufficient time to advise patients on oral health during check-ups.
There is need for training on 'oral healthcare during pregnancy' for medical doctors. Developing universal guidelines for oral healthcare in pregnant women for all health professionals would be another important step. An adequate referral system to oral healthcare providers and biannual check-ups is recommended for both general patient as well as pregnant women for preventing adverse situations related to oral and specifically periodontal diseases.
牙周病和龋齿是全球范围内牙齿缺失的最常见原因。研究表明，牙周炎与不良妊娠结局之间存在密切关联。作为主要医疗服务提供者的医生，很少建议女性在孕期寻求牙科护理。本研究旨在探讨医生对口腔健康的知识、态度和行为，并确定其临床实践中产前牙周保健的障碍及其对妊娠结局可能产生的影响。
共有377名医生填写了问卷。通过个人联系、社交网络、电子邮件、在线表格以及会议网络收集的数据，使用社会科学统计软件包20软件程序进行分析，并以表格、图表和示意图的形式呈现。
参与该研究的263名（69.8%）男性医生和114名（30.2%）女性医生中，只有52名（13.8%）接受过孕期口腔护理的教育或培训。其中，299名（79.3%）同意牙齿-牙龈健康与妊娠之间可能存在联系。大约105名（27.9%）医生每周都会遇到有口腔/牙周问题的患者，但只有108名（28.6%）“总是”建议患者进行定期牙科检查。同样，358名（95%）医生同意需要通用指南，然而，133名（35.3%）医生认为在检查期间没有足够的时间向患者提供口腔健康建议。
需要为医生开展“孕期口腔保健”培训。为所有卫生专业人员制定针对孕妇的通用口腔保健指南将是另一重要举措。建议为普通患者以及孕妇建立一个完善的转介至口腔保健提供者的系统，并每半年进行一次检查，以预防与口腔尤其是牙周疾病相关的不良情况。
