Periodontal Health Knowledge and Awareness in Pregnancies

periodontic Health Knowledge and knowingness in Pregnancies agnomen Periodontal Health cognition and aw areness among gravid females in Bangalore, India cosmopolitanisationThere is plenty of grounds in the literature suggesting an association mingled with periodontal diseases, gestation period and point preterm low nascency weight deliveries. The correlation has been expanded from periodontitis and preterm giving return to various forms of periodontal infections and adverse maternity eruptcome, preterm birth, low birthweight, stillbirth, miscarriage, intrauterine return retardation and pre-eclampsia.Aims and ObjectiveThe direct of this contract was to pass judgment the cognisance regarding periodontal wellness among heavy(predicate) females in Bangalore, India.Materials and mode Three hundred big(predicate) female patients who visited the OPD of Gynaecology Department of governing body Hospital, K.R. Puram, Bangalore was evaluated for viva voce hygiene status . Awareness of the alliance between unscripted wellness and pregnancy, demographics, verbal examination wellness association, viva voce hygiene, and dental visits during pregnancy and their willingness for handling was surveyed by self administered questionnaire from the patients who were willing to participate in the theme. The data were collected, summarized and statistically analyzed.Results Awareness among great(predicate) women was found to be statistically non signifi sightt (p cherish 0.05) disregardless of the age and preceptal qualifications (p value 0.05).Conclusion Knowledge and awareness regarding periodontal disease, and its tack on the pregnancy and birth way out are limited.Key words- Pregnancy, Awareness, Periodontal HealthINTRODUCTIONWomens life cycle changes imparts unique challenges to the oral exam examination health complaint profession. Hormonal influences associated with the reproductive process alter periodontal and oral tissue responses to local instruments creating diagnostic and therapeutic dilemmas. It is imperative, therefore, that clinician recognize, customize and interchange periodontal therapy, consort to an individual female and the stage of her life cycle.1 by from the underlying systemic diseases, ceratin physiological condition can too aggravate the underlying gingival status, especially when the oral hyagiene is inadequate. Pregnancy beingness one of these conditions, is a time when the patient whitethorn experience the most(prenominal) profound physiologic and psychological changes in her life. There is plenty of evidence in the literature suggesting an association between periodontal diseases, pregnancy and even preterm low birth weight deliveries. The link between periodontal infections and preterm birth has been one of the frontiers in dental research. The correlation has been expanded from periodontitis and preterm birth to various forms of periodontal infections and adverse pregnancy outcome , preterm birth, low birthweight, stillbirth, miscarriage, intrauterine growth retardation and pre-eclampsia.2,3,4Pregnancy houses an ideal opportunity to improve womens health practices. Prenatal care entails regular and frequent medical visits, so that women are or can be motivated to improve their health for the realise of the developing fetus. Since maternal oral flora and oral hygiene practices are predictors of the oral flora and oralhealth of infants and youngsterren, a with child(predicate) womans knowledge and actions concerning her oral health are critical to the oral health of her child or children and may be a key to puerility pit prevention.Certain oral disease, such as periodontitis or periodontal infection, gingivitis or even caries can affect and influence not only the Maternal oral health but also the oral health of her child. Targeting pregnant women to increase their oral health knowledge may improve their oral health and, thus, the oral health of their child ren. Maternal oral flora and oral health are one of the greatest predictors of childhood oral flora and oral health.1,2The interaction between oral and systemic health has long been of interest. It has been shown that pregnant womenhave a higher incidence of gingival inflammation compared to non-pregnant women2,3,4 According to literature in pregnant women the incidence of gingival inflammation observed from 36% to 100 %3,5 These vascular and Hormonal changes can lead to exagge browsed immune respone of gingival towards bacterial plaque. 6,7Good oral hygiene practices, however, can minimize gingival disease during pregnancy.2,7Two case sway studies 8,9 and cohort studies 10,11,12showed that periodontal disease could be an independent riskiness factor for pre-term birth and low birthweight after adjusting for several known risk factors. 2In fact, treatment of periodontal disease has been shown to reduce pre-term birth. 12,13Other studies have shown additional associations between pe riodontal diseaseand pregnancy, such as increased risk for development of preeclampsia during pregnancy.14The purpose of the present analyse was to appreciate the awareness regarding periodontal health among pregnant females in Bangalore. The results obtained would serve asbaseline information for planning an oral health education program aimed at improving the oralhealth of pregnant women receiving care in the hospital.Specifically, it would trace areas of deficiency in thewomens knowledge and this would be helpful informulating the capability of the oral health messages.MATERIALS AND METHODThe presentcross sectional guinea pig was conducted in the Gynaecology Department of judicature Hospital, K.R. Puram, Bangalore during June to August 2011.The minimum sample size of it wascomputed using the formula n= z2pq/d2 where p (theprevalence of women with good knowledge) was set at40%. Thus the computed minimum sample size was 271 subjects. This was increased by 10% to 300subjects t o accommodate attrition. Hence, three hundred pregnant females who visited the OPD of Gynaecology Department of Government Hospital, K.R. Puram, Bangalorewere taken instudy design using guile little random sampling. The subjects were informed around the purpose of the study and only those who gave written voluntary consent were taken into the study. Also, ethical approval was obtained from the institutional brush up board and permission from the head of Government Hospital was also obtained.The questionnaire wasdeveloped and pre-tested on 25 pregnant women toallow for refinement of the questions in order tofacilitate answering(Table 1). Questionnaires wereadministered to all respond pregnantwomen who attended the antenatal clinic during thestudy period.The questionnaire contained two segments. The first part contained inquiries on the players sociodemographic qualities, for example, age, occupation, monthly income and educational status.The second part contained fifteen question s pertaining to thespians awareness regarding knowledge of relationship between oral health and pregnancy, knowledge about oral health, knowledge about oral hygiene, dental appointment during pregnancy, advice regarding necessity of dental health in pregnancy, presence of exhaust gums and whether any of the possible actions were taken to treat or reduce the gingival problems along with their compliance for the treatment.Each question answered Yes was given a produce of 1 while for No, score 0 was given. Thus, the maximum achievablescore was 15 with a higher score indicating a high level of awareness. Individuals with lots of 11 and to a higher placewere graded as having high awareness, those having scores from 6 to 10 were having total awareness while those with scores 5 or less were having low awareness. Awareness of periodontal health, according to age and educational qualifications of the pregnant females was also considered in the study.The results obtained from the period ontal health awareness questionnaire were compiled and subjected to statistical analysis using SPSS version 19.0. Descriptive statistics were reported as well as cross-tabulations by age, parity, education and occupation. For the purpose of analysis thelevel of education was categorized as low (primaryeducation only), middle (secondary education) andtertiary (post secondary education).Inference on the cross-tabulations were performed, using chi-square tests to test for general association. A probability value of RESULTSSociodemographic features of study participantsThe mean age of our studypopulation was 24.97+4.343years (range 1835 years)with the majority of the study population in the 18-25 (59.3%) and 26-30 (33%) years gray-haired categories. Over half (53.7%) of the respondents wereprimigravida while the remaining women had between1 and 5 children. Out of the come study population, 2.3% had primaryschool education, 10.7% secondary schooleducation, 33.3% attained post secondar y educationand 53.7% attended university (Table 2). some of the study participants were unemployed(78.3%), followed by employee (21.7%) (Table 2).On theutilization of dental work, 285 (62.9%) respondentsreported ever visiting a dental facility.The mean of questions answered correct by the subject was 4.53 +1.814 with a range of 1 8.Majority, i.e. 60 per centum subjects had low awareness and only 40 percent with average awareness and 0 percent with high awareness (Table 3). The results of awareness among pregnant women came out to be statistically non significant (p value 0.05) irrespective of the age.The results of awareness among pregnant women came out to be statistically non significant (p value 0.05) irrespective of educational qualifications.DISCUSSIONIt is worth sayin that good oral health in pregnancy is very important factor, as recent trends showed that the poor oral health can lead to unfavourable pregnancy results. This is important in context of developing countri es like india, where high mortality rate present.Most of the common oral diseases present during pregnancy (i.e. periodontal disease) are preventable only by using simplest measures like regular flossing and tooth brushing.A persons knowledge, attitude and oral health would influence and generate such imperative behaviour which is the ultimate result of persons awareness.15 Thus, this study wasdesigned to provide a view of periodontal awareness among pregnant females in Bangalore.The present study showed low awareness(60%) among majority of the study population followed by average awareness among rest 40% of the participants. The results of the present study were similar to study conducted by HA Alwaeli SH Al-Jundi (2005)16who reason out that knowledge and awareness for pregnant women about their teeth and gingival condition is generally poor. Pregnant women need sinless information about their teeth and oral health. Simple educational condom programmes on oral self-care and dise ase prevention before and during pregnancy should be provided to improve oral health.Another similar kind of study was conducted by Kim A. Boggess Diana M. Urlaub, Merry-K Moos etal (2011)1and concluded that pregnant women have some oral health knowledge, which varied according to maternal race or ethnicity. Their beliefs varied according to their education levels. Including oral health education as a part of prenatal care may improve knowledge regarding the importance of oral health among compromising pregnant women, thereby, improving their oral health and that of their children.The awareness among pregnant women came out to be low below 25 years of age.The awareness among pregnant women came out to be average above 25 years of age.When the results were compared of above and below 25 years of age the awareness came out to be nonsignificant with average awareness among above 25 years of age.This study is not without limitations. Onelimitation is its reliance on self-reported data, which isoften subject to biases inherent to questions being askedsuch as recall bias. Nonetheless, the results wouldserve as a veritable tool for designing and specifyingappropriate oral health education messages forpregnant women receiving antenatal care.CONCLUSIONA majority of the pregnant women has good knowledge and information about general health however, their knowledge and awareness regarding periodontal disease, and its effect on the pregnancy and birth outcome is limited. Most pregnant women need more information about oral health, and prevention of gingival and periodontal diseases. Longitudinal studies are needed to assess the long-term effect of oral health education programs in maternalism care centers on dental health knowledge and behavior of pregnant women. Further studies are needed to determine if there is a noticeable correlation between periodontal disease and premature labor and whether periodontal therapy or prevention can reduce the risk of premature labor . Studies to assess the role of dental hygienists in designing and promoting information regarding periodontal health awareness and practices among pregnant women in maternity care centers.REFERENCESBoggess KA, Urlaub DM, Moos MK, Polinkovsky M, El-Khorazaty J, Lorenz C. Knowledge and beliefs regarding oral health among pregnant women. J Am DentAssoc. 2011142(11)1275-82.Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta odontol scand. 196321533-51Jensen J, Lilijmack W, Bloomquist C. The effect of female sex hormones on subgingival plaque. J Periodontol198152 599602.Nuamah I, Annan BD. Periodontal status and oral hygiene practices of pregnant and non-pregnant women. eastern Afr Med J. 199875712-4.Ferris GM. Alteration in female sex hormones their effect on oral tissues anddental treatment. Compendium. 1993 141558-64.Zachariasen RD. The effect of elevated ovarian hormones on periodontal healthoral contraceptives and pregnancy. Women Health. 19932021- 30.Raber-Durlacher JE, van Steenbergen TJ, Van der Velden U, de Graaff J,Abraham-Inpijn L. Experimental gingivitis during pregnancy and post-partumclinical, endocrinological, and microbiological aspects. J Clin Periodontol. 199421549-58.Offenbacher S, Katz V, Fetik G, Collins J, Boyd D, Maynor G, et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 1996 67 11031113.Dasanayake A. Poor periodontal health of the pregnant woman as a risk factor for low birth weight. Ann Periodontol 1998 3 206212.Jeffcoat MK, Geurs NC, Reddy MS, Cliver SP, Goldenberg RL, Hauth JC.Periodontal infection and preterm birth results of a prospective study. J AmDent Assoc. 2001132875-80.Offenbacher S, Leiff S, Boggess KA, Murtha AP, Madianos PN, Champagne CM, etal. Maternal periodontitis and prematurity. start up 1 Obstetric outcome of prematurity and growth restriction. Ann Periodontol 2001 6 164174.Lopez NJ, metalworker P, Gutierrez J. Periodontal therapy may red uce the risk of preterm low birthweight in women with periodontal disease. J Periodontol 2002 73 911924.Jeffcoat MK, Hauth JC, Geurs NC, Reddy MS, Cliver SP, Hodgkins PM, etal. Periodontal disease and preterm birth result of a pilot intervention study. J Periodontol 200374 12141218.Boggess KA, Lieff S, Murtha AP, Moss K, Beck J, Offenbacher S. Maternalperiodontal disease is associated with an increased risk for preeclampsia. ObstetGynecol. 2003101227-31.Al Habashneh R, Guthmiller JM, Levy S, Johnson GK, Squier C, Dawson DV, FangQ. Factors related to utilization of dental services during pregnancy. J ClinPeriodontol. 200532815-21.Alwaeli HA, Al-Jundi SH. Periodontal disease awareness among pregnant womenand its relationship with socio-demographic variables. Int J Dent Hyg. 2005374-82.TABLE 1 Questionnaire used for the studyTable 2 Socio-demographic characteristics of study populationTable 3 section awareness among study population regarding periodontal health