Promoting oral health in pregnant women through midwifery practice : an innovative approach

Introduction: Pregnant women are prone to dental problems which can contribute to adverse perinatal outcomes. Unfortunately only a third of Australian women consult a dentist during pregnancy with the main barriers being lack of dental awareness, high dental costs and limited emphasis on oral health during antenatal care. To address this issue a unique midwifery initiated oral health dental service (MIOH-DS) program was developed to promote maternal oral health. The program involved training midwives to provide oral health education/assessment and referrals during early pregnancy and offering priority dental referral pathways. The aim of the study was to pilot test the effectiveness of the MIOH-DS program in improving the uptake of dental services, quality of life and oral health knowledge among pregnant women. Method: The program was piloted using a randomised controlled trial. 300 pregnant women were recruited from a metropolitan hospital in South-Western Sydney and allocated into three groups. The control group received no intervention; Group one received the midwifery intervention (MIOH); and Group 2 received the midwifery and a dental intervention (MIOHDS). All participants received an educational brochure. Pre and post questionnaires were completed by participants at recruitment (12-20 weeks) and follow up (28-42 weeks). Results: 150 women were followed up until birth. No significant differences were found at baseline between groups. Pre/post data showed a 50% improvement in uptake of dental services in Group 2 compared to Group 1 and control (75% vs. 20% vs. 19%). Quality of life significantly improved in group 1 & 2 while oral health knowledge improved (P<0.05) among all 3 groups with the most improvement observed in Group 2. Conclusion: The findings suggest that the MIOH-DS program is effective in promoting oral health and wellbeing among pregnant women. Further testing of the program is currently underway using a larger NHMRC multicentre trial.