Oral-systemic health during pregnancy: Exploring prenatal and oral health providers' information, motivation and behavioral skills

Background: Poor oral health during pregnancy is a significant public health issue because of its prevalence, impact on women’s and their future children’s oral health, and evidence suggesting oral-systemic links with adverse pregnancy and birth outcomes and chronic health conditions across the lifecourse. Subsequently, both medical and dental associations have endorsed inter-professional guidelines promoting prenatal oral health. The objective was to explore providers’ information, motivation and practice behaviors related to oral health during pregnancy.

Methods: Twenty-two in-depth interviews were conducted with prenatal (PPs) and oral health providers (OHPs) based on the Information-Motivation-Behavioral Skills Model. Data were analyzed using the constant comparative method in NVivo 10.

Results: Providers held variable knowledge with regards to identified oral-systemic connections and implications. Most providers were unaware of the guidelines; however, some OHPs reported avoiding specific treatment behaviors during this period. Motivation to address prenatal oral-systemic health included: prevention; healthy pregnancy/birth outcomes; patient’s complaint/question as cue to action; comprehensive care; ethical duty; and professional boards. OHPs reported assessing, educating, and communicating with patients about oral health issues; whereas PPs rarely addressed oral health but reported signing approval forms for patients to receive care from OHPs. OHPs often highlighted lifecourse implications and the need for family-centered care when addressing oral health among pregnant patients.

Conclusions: Findings suggest gaps in oral health prevention information and behaviors among providers. Future efforts should examine effective dissemination and implementation strategies that translate evidence-based guidelines into clinical practice, with the ultimate goal of improving oral-systemic health among women and their offspring.