title: Oral-systemic health during pregnancy: exploring prenatal and oral health providers' information, motivation and behavioral skills.
abstract: Pregnancy is identified as a sensitive period of increased risk for poor oral health among mothers and offspring. Subsequently, both medical and dental associations have re-endorsed consolidated, inter-professional guidelines promoting oral health during pregnancy. The objective was to explore prenatal and oral health providers' information, motivation and practice behaviors related to oral health during pregnancy. Twenty-two in-depth interviews were conducted with prenatal and oral health providers based on the Information-Motivation-Behavioral Skills Model. Data were analyzed using the constant comparative method in NVivo 10. Providers held variable knowledge with regards to identified oral-systemic connections and implications. Most providers were unaware of the guidelines; however, some oral health providers reported avoiding specific treatment behaviors during this period. Motivation to address oral-systemic health during pregnancy included: prevention; healthy pregnancy/birth outcomes; patient's complaint/question as cue to action; comprehensive, patient-centered, and family-centered care; ethical duty; and professional governing body. Oral health providers reported assessing, educating, and communicating with patients about oral health issues; whereas prenatal providers rarely addressed oral health but reported signing approval forms to receive such care. A few oral health providers highlighted lifecourse implications and the need for family-centered care when addressing poor oral health among pregnant patients. Findings suggest gaps in oral health prevention information and behaviors among prenatal and oral health providers. Future efforts should examine effective dissemination and implementation strategies that translate evidence-based guidelines into clinical practice, with the ultimate goal of improve oral-systemic health among women and their offspring across the lifecourse.
authors.affiliation: Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA, cvamos@health.usf.edu.
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: Vamos
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Walsh
authors.forename: Erika
authors.initials: E
authors.lastname: Thompson
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Daley
authors.forename: Linda
authors.initials: L
authors.lastname: Detman
authors.forename: Rita
authors.initials: R
authors.lastname: DeBate
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards; D003815:Dentists / Q000523:psychology / Q000592:standards; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009909:Oral Health; D011247:Pregnancy; D011295:Prenatal Care / Q000523:psychology / Q000592:standards; D055815:Young Adult