Dentists' perceptions of barriers to providing dental care to pregnant women.
OBJECTIVE
The purpose of the study was to understand US dentists' attitudes, knowledge, and practices regarding dental care for pregnant women and to determine the impact of recent papers on oral health and pregnancy and guidelines disseminated widely.


METHODS
In 2006 and 2007, the investigators conducted a mailed survey of all 1,604 general dentists in Oregon; 55.2% responded). Structural equation modeling was used to estimate associations between dentists' attitudes toward providing care to pregnant women, dentists' knowledge about the safety of dental procedures, and dentists' current practice patterns.


RESULTS
Dentist's perceived barriers have the strongest direct effect on current practice and might be the most important factor deterring dentists from providing care to pregnant patients. Five attitudes (perceived barriers) were associated with providing less dental services: time, economic, skills, dental staff resistance, and peer pressure. The final model shows a good fit with a chi-square of 38.286 (p = .12; n = 772; df = 52) and a Bentler-Bonett normed fit index of .98 and a comparative fit index of .993. The root mean square error of approximation is .02.


CONCLUSIONS
Findings suggest that attitudes are significant determinants of accurate knowledge and current practice. Multidimensional approaches are needed to increase access to dental care and protect the oral health of women during pregnancy. Despite current clinical recommendations to deliver all necessary care to pregnant patients during the first, second, and third trimesters, dentists' knowledge of the appropriateness of procedures continues to lag the state of the art in dental science.
Lee
Rosanna Shuk-Yin
RS
Department of Dental Public Health Sciences, University of Washington, Seattle, Washington 98195-7475, USA.
Milgrom
Peter
P
Huebner
Colleen E
CE
Conrad
Douglas A
DA
D000328:Adult; D001291:Attitude of Health Personnel; D003144:Communication Barriers; D003729:Dental Care / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000517:prevention & control*; D009909:Oral Health; D009922:Oregon; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000379:methods; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D011295:Prenatal Care / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
J Womens Health (Larchmt). 2005 Dec;14(10):880-2
16372888
Med J Aust. 2004 Mar 15;180(S6):S57-60
15012583
J Public Health Dent. 2002 Summer;62(3):140-7
12180041
Am J Obstet Gynecol. 2007 Feb;196(2):135.e1-7
17306654
Matern Child Health J. 1999 Dec;3(4):199-209
10791360
J Dent Child (Chic). 2009 Jan-Apr;76(1):46-52
19341579
J Public Health Dent. 2008 Summer;68(3):170-3
18843805
Lancet. 2003 Oct 11;362(9391):1225-30
14568747
Public Health Rep. 2000 Sep-Oct;115(5):448-59
11236017
Am J Public Health. 2004 May;94(5):765-71
15117698
Northwest Dent. 1996 Nov-Dec;75(6):23-8
9487880
MMWR Surveill Summ. 2007 Dec 14;56(10):1-35
18075488
J Periodontol. 2009 Jun;80(6):878-83
19485816
J Am Dent Assoc. 2005 Sep;136(9):1257-63
16196230
J Am Dent Assoc. 2001 Jul;132(7):875-80
11480640
J Am Dent Assoc. 2001 Jul;132(7):1009-16
11480627
J Am Dent Assoc. 2010 Jun;141(6):688-95
20516101
J Matern Fetal Neonatal Med. 2009 Sep;22(9):733-9
19488943
Psychol Methods. 2002 Mar;7(1):64-82
11928891
MMWR Recomm Rep. 2001 Aug 17;50(RR-14):1-42
11521913
J Am Dent Assoc. 2009 Feb;140(2):211-22
19188418
J Matern Fetal Neonatal Med. 2008 Jan;21(1):63-71
18175246