Knowledge, attitude and barriers to maternal oral health among expectant mothers at a tertiary hospital in Western Kenya

Abstract

Background Pregnant women are more susceptible to oral health conditions such as gingivitis due to hormonal changes, frequent vomiting, changes in dietary habits as well as changes in their immunity. In addition, lack of information on oral healthcare during pregnancy may contribute to poor oral health seeking behaviour and increased oral disease burden among expectant mothers. This study assessed the knowledge, attitude and barriers to maternal oral healthcare among pregnant women seeking health services at a referral hospital in Western Kenya. The study employed a cross-sectional descriptive study design. Methods: A cross-sectional descriptive study was conducted with 379 participants. A total of 309 pregnant women were selected using systematic sampling technique. A census approach was used to recruit 70 nurse-midwives working at the maternal and child health units. The functionalist theory and health belief model were used to generate the conceptual framework for this study. Interviewer administered structured questionnaire were employed for pregnant women and self-administered questionnaires were used in the case of nurse-midwives. Descriptive results were presented in frequency tables, bar charts and pie charts as appropriate. Ordered logistic regressions were conducted to respectively ascertain the predictors of and differences in pregnant mothers’ and nurse-midwives’ knowledge and perceived barriers to maternal oral health. A p value <.05 at 95% confidence level was considered significant. Results A total of 309 pregnant women participated, with a mean age of participants was 28±5 years and a mean parity of 2±1. Almost half 132 (42.7%) of all the participants reported to have some oral disorder such as bleeding gums, sensitive teeth, tooth ache or tooth decay. Only 30 (9.7%) had visited a dentist in the previous 12 months. Majority 266 (86%) had a low level of oral health knowledge by agreeing to the statement that it is normal to have a bleeding gums during pregnancy while 266 (86%) were of the view that dental extraction is unsafe during pregnancy. Women who had basic or secondary education demonstrated poorer knowledge (Coef. =-0.736, p=0.016) and attitude (Coef. =-0.453, p=0.54) compared to women who had tertiary education. Conclusion The greatest barriers to oral healthcare among these expectant mothers was lack of relevant information or oral health 256(83%) and high cost of dental treatment 232(75%). Other perceived barriers included lack of money for transportation and long distance to the nearest health facility.