Dental care for pregnant women

There is growing interest in dental care for pregnant women. One reason is that hormonal changes during pregnancy increase the risk for oral and dental problems; a second is the possible association between maternal periodontal infection and premature birth. Objectives: This study examined dentists' attitudes, knowledge, and practices in providing care to pregnant women. Methods: The method was a mail-out survey to all general dentists in one Western state. Questions assessed attitudes, knowledge and practices regarding anticipatory guidance, preventive care, routine and emergency treatment, and pain management. Results: The response rate was 55.2% (n = 829). Respondents' average age was 47 years; 81% were men. Time since graduation from dental school was: <10 years (31.5%), 11-20 years (19.2%), and > 20 years (45.6%). Relatively few (37.2%) reported having attended CDE on the care of pregnant women. While most (91.7%) agreed dental treatment should be part of prenatal care, only 77.2% felt they had the skills to counsel pregnant women and 66.6% reported they had time to add counseling to their practices. Most (> 95%) knew that scaling and root planning, single x-rays, and tooth extractions are appropriate to provide to pregnant women. Areas of misinformation included use of full-mouth x-rays, nitrous oxide, and acetaminophen. For instance, over half (54.0%) reported full-mouth surveys were never appropriate. Two safety concerns were identified. More than one-quarter (28.3%) were incorrect in recommending aspirin to pregnant women and 57.1% did not know to avoid using a long-acting anesthetic in the course of treating a dental emergency. Years since graduation or receipt of relevant CDE were not strongly related to knowledge or practice. Conclusions: Each year more than 6 million U.S. women become pregnant. Dental school curricula and CDE should be revised to ensure dental services provided to pregnant women are timely, effective, and safe.