title: Midwives' oral health recommendations for pregnant women, infants and young children: results of a nationwide survey in Germany.
abstract: BACKGROUND
  Studies suggest that poor oral health during pregnancy can lead to perinatal complications, such as low birth weight and preterm delivery as well as poor oral health in children. Aim of this study was to assess the German midwives knowledge about oral health and preventive recommendations for pregnant women, infants and young children.
  
  
  METHODS
  The nationwide online-survey was conducted with use of a self-developed, pretested and validated standardized questionnaire. The German association of midwives (Deutscher Hebammenverband e.V.) informed their members about the survey through email, newsletter, website and association journal (Hebammenforum) (n = 7.500). Data were analyzed using descriptive statistics.
  
  
  RESULTS
  Response rate was 12.6 % (mean age 42.9 ± 9.3 years). The majority of midwives advised pregnant women about periodontal diseases (78.6 %). Of the midwives, 8.4 % mentioned the possible associations between periodontal diseases and perinatal complications. In general, half of the midwives (53.5 %) recommended a dental visit during pregnancy. A total of 65.5 % of midwives advised parents about early childhood caries. The majority of midwives recommended that oral hygiene starts with eruption of the first tooth (60.4 %) and the first dental visit of the child should be at age 2 or 3 years (51.6 %). Midwives recommendations regarding the implementation of oral hygiene and the referral to a dentist during pregnancy and childhood were highly variable.
  
  
  CONCLUSIONS
  To increase oral awareness and to improve the oral health knowledge among midwives and all other health-care professionals, uniform guidelines should be developed in Germany.
  
  
  BACKGROUND
  German Clinical Trial Register DRKS00008021.
authors.affiliation: Department of Preventive Dentistry and Pediatric Dentistry, Jena University Hospital, Bachstr. 18, 07743, Jena, Germany. Yvonne.Wagner@med.uni-jena.de.
authors.forename: Yvonne
authors.identifier: http://orcid.org/0000-0002-1184-2006
authors.initials: Y
authors.lastname: Wagner
authors.affiliation: Department of Preventive Dentistry and Pediatric Dentistry, Jena University Hospital, Bachstr. 18, 07743, Jena, Germany.
authors.forename: Roswitha
authors.initials: R
authors.lastname: Heinrich-Weltzien
mesh_terms: D000328:Adult; D002675:Child, Preschool; D005260:Female; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D008880:Midwifery; D009909:Oral Health; D011247:Pregnancy; D011795:Surveys and Questionnaires
keywords: Oral health; Prevention; Tooth brushing