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Dental Care During Pregnancy Oregon 2000

Dental Care During Pregnancy Oregon 2000. Kathy R. Phipps, DrPH (1) Kenneth D. Rosenberg, MD, MPH (2) Alfredo P. Sandoval, MS, MBA (2) (1) Association of State & Territorial Dental Directors (2) Oregon Department of Human Services

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Dental Care During Pregnancy Oregon 2000

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  1. Dental Care During PregnancyOregon 2000 Kathy R. Phipps, DrPH (1) Kenneth D. Rosenberg, MD, MPH (2) Alfredo P. Sandoval, MS, MBA (2) (1) Association of State & Territorial Dental Directors (2) Oregon Department of Human Services American Public Health Association, 131st Annual Meeting, November 19, 2003, San Francisco

  2. Background • A tooth for every pregnancy • Pregnancy & oral health • pregnancy gingivitis, pyogenic granuloma • Recent focus on • pregnancy & birth outcomes • transmission of mutans streptococci

  3. Background • Little known about • oral health of pregnant women • use of dental services during pregnancy • Purpose of project • existing surveillance system - PRAMS • obtain state-level population-based data

  4. What is PRAMS? • Pregnancy Risk Assessment Monitoring System • Collects state-specific information on • maternal attitudes and experiences • Improve the health of mothers and infants

  5. Oregon PRAMS • Began in 1998 • Technical assistance from CDC • not part of the CDC system until 2003 • Majority of data is from 2000 • combined data set from 2000 and 2001

  6. Participating States - 2003 31 states plus New York City www.cdc.gov/reproductivehealth/pramstates.htm

  7. Methods - Oregon PRAMS 2000 • Stratified random sample • 2,950 mothers with a recent live birth • Oral health questions • needed to see a dentist for a problem • went to a dentist • healthcare provider talked with them about the importance of seeing a dentist

  8. Demographic Information • Overall response rate 73% • Mothers age • < 20 years 11.4% • 20-34 years 78.1% • > 35 years 10.5% • Mothers race/ethnicity • White 75.1% • Hispanic 16.2% • Other 8.6%

  9. Demographic Information • Maternal Education • < 12 years 18.1% • At least 12 years 79.5% • Unknown 2.4% • Marital status • Unmarried/divorced/annulled 28.4% • Married or separated 71.6%

  10. Demographics & Lifestyle • Family Income • < $15,000 23.7% • $15,000 - $29,999 26.0% • $30,000 - $49,999 23.6% • > $50,000 26.7% • Smoked during pregnancy 16.0% • Alcohol in 3rd trimester 9.3%

  11. Prenatal Care & Birth Outcomes • Prenatal care in 1st trimester 81.8% • Normal birth weight 95.2% • Payor for labor and delivery • Private insurance 62.7% • Public insurance 32.1% • No insurance/other 5.2%

  12. During your pregnancy... Question % No % Yes A healthcare worker talked with me about: a. the importance of seeing a dentist b. how to care for my teeth/gums 69 61 31 39 I needed to see a dentist for a problem 72 28 I went to a dentist or dental clinic 57 43 I had my teeth cleaned in the last year 53 47

  13. During your prenatal visits, did a health care worker talk with you about ...

  14. Needed to see a dentist ... Needed to see a dentist because of a problem 28% of women Went to dentist 60% Did NOT go to dentist 40% 11% of all women

  15. Did NOT go to dentist ... Among women who said they needed care, those most likely NOT to see a dentist: Univariate OR (95% CI) Multivariate OR (95% CI) Income < $30,000 2.04 1.25 - 3.33 1.96 1.19-3.22 Hispanic 1.63 1.13-2.35 1.42 0.95-2.13 PRAMS 2000 and 2001 Combined

  16. Oregon (2000) Compared to Other States (1998) Gaffield ML, et al. JADA 2001;132:1009-16.

  17. How long has it been since you had your teeth cleaned by a dentist or hygienist?

  18. Did NOT Have Teeth Cleaned in Last Year Odds Ratio 95% CI Multivariate Analysis WIC Enrollment 1.69 1.28-2.22 Hispanic 1.96 1.47-2.63 Late/No Prenatal Care 1.69 1.22-2.38 Smoked in 1st Trimester 1.85 1.35-2.56 PRAMS 2000 and 2001 Combined

  19. Had Teeth Cleaned in Last Year

  20. Summary • Many pregnant women do not seek dental care even if they have a problem • Healthcare workers are not talking to women about oral health • Low-income and Hispanic women are less likely to seek dental care

  21. Potential Recommendations • Educate health care workers • Educate pregnant women • Target high risk women • Develop a referral network • Medicaid dental for pregnant women • Oral health questions in PRAMS THE END

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