Joy U. Ifesanya, Adeleke O. Ifesanya, Michael C. Asuzu, and Gbemisola A. Oke
Abstract
Background and objectives: The need to attain and maintain good oral hygiene among pregnant women cannot be over emphasized as periodontal diseases in pregnancy have been linked with poor pregnancy outcomes. This study assessed the variables that affect oral hygiene status among pregnant women in a south-western Nigerian locality.
Methodology: Four hundred and five pregnant Nigerian women were assessed for their oral hygiene status using the Oral Hygiene Index-Simplified. Demographic and pregnancy statistics were also obtained and the relationships between these and oral hygiene status were determined.
Results: The mean age was 25.35 ± 5.02 years. Most of the women (96.0%) had never visited a dentist or any other oral health care provider and only 12.5% of those who had been attended by dental care givers have ever had professional dental cleaning. The oral hygiene status appeared to worsen as parity increased (p=0.047) while the use of the toothbrush and paste was associated with good oral hygiene (p=0.007). Higher education was associated with use of the tooth brush and paste (p=0.046) and good oral hygiene (p= 0.001).
Conclusion: The positive effect of education on oral hygiene practices is highlighted in this study. However there is still need for proper health enlightenment in this population with regards to use of the available oral health care facilities.
Keywords: Oral hygiene, Pregnancy, Nigeria.
Correspondence:
Dr. Joy U. Ifesanya
Department of Child Oral Health
University College Hospital,
Ibadan
E-mail: joyifesanya@yahoo.co.uk
Telephone: +2348055623129
Introduction
Previous reports have documented a high prevalence of gingivitis among pregnant women.1,2 Some of these reports have associated the occurrence of periodontal diseases in pregnant women with an increased risk for poor pregnancy outcome.3,4 Physiologic changes such as pregnancy alter women’s body response to external stimuli. In the mouth, the greatest effect of pregnancy is seen in the gums. The main cause of gingivitis both in the pregnant and non- pregnant state is dental plaque, a soft creamy film which is adherent to the teeth and houses the majority of between 300 to 500 different bacterial species found in the mouth.5 The higher concentration of oestrogen and progesterone during pregnancy especially in the presence of plaque have been implicated in the pathophysiology of pregnancy gingivitis. Plaque starts building up immediately after tooth-brushing6, thus, daily oral cleansing helps to keep this biofilm under control5 and enhance good oral hygiene.
The possibility that many women go through their pregnancies without giving consideration to their oral health status while they are bombarded with health talks on other aspects of health at every ante-natal visit leaves much to be desired7. Reports have shown that women are more likely to use dental services in pregnancy if they were married, educated, had dental insurance, previously used dental services when not pregnant, or had knowledge about the possible connection between oral health and pregnancy outcome8. The purpose of this study was to explore the factors determining good oral hygiene among pregnant women in a South- western Nigerian locality.
METHODOLOGY
Ethical approval was obtained from the State Ethical Review Board. Interviewer-administered questionnaires were used to obtain demographic data, pregnancy and social history, oral hygiene practices and history of professional dental care from pregnant women who were consecutive attendees at two primary health care ante-natal clinics in a local government area within a municipality in south western Nigeria over a period of six (6) weeks. Each woman had an intra-oral examination with a mirror and periodontal probe which was conducted by the first author, under natural light with particular attention to their oral hygiene and gingival health status. The Oral Hygiene Index (Simplified) of Green and Vermillion (1960) was used as a measure of oral hygiene, while the Gingival Index of Löe and Silness (1963)y was used as a measure of gingival health. The data obtained were entered into a computer spread sheet and analyzed using the Statistical Package for Social sciences (SPSS) version 17. Frequency tables and measures of central tendency were generated and statistical relationships were obtained using the Chi-square test. Binary logistic regression analysis was carried out on variables that had statistically significant effect on the oral hygiene status of the women to determine which specific groups were significant predictors of good oral hygiene.