Oral Health in Pregnancy

During pregnancy, women are at a higher risk of oral diseases, and this can significantly impact on the health and wellbeing of the mother and baby. Unfortunately, many pregnant women are unaware of the implications of poor oral health, with only a third of pregnant women seeking dental care during pregnancy, even when they have oral health problems.

To address this, new guidelines recommend that antenatal care providers play an active role in promoting maternal oral health to pregnant women. Midwives see and advise the majority of pregnant women in Australia and are therefore in an excellent position to promote oral health. However, unlike other developed countries, the role of midwives in offering dental advice to pregnant women has not been clearly defined in Australia.The aim of this study is to develop a unique midwifery initiated oral health (MIOH) program to promote perinatal oral health. The MIOH program incorporates oral health guidelines into normal midwifery practice, providing appropriate pathways of referral for pregnant women to receive prompt dental treatment.

The program has been developed over the following eight (8) phases:

Phase 1: Systematic review and the development of MIOH guidelines

Phase 2: Perceptions of the MIOH program from midwives and pregnant women

Phase 3: Designing of the MIOH education program and evidence based resources for midwives

Phase 4: Oral health education, training and assessment of midwives

Phase 5: Piloting of the MIOH program

Phase 6: Multicentre trial of the MIOH Program

Phase 7: Process evaluation

Phase 8: Economic evaluation

Funding is gratefully acknowledged from:

• The National Medical and Health Research Council, Australia

• New South Wales Health

• The Australian Dental Association (NSW)

Project team:

• Assoc Prof. Ajesh George – Western Sydney University, SWSLHD, University of Sydney, Ingham Institute

• Prof Maree Johnson – Australian Catholic University, Ingham Institute

• Prof Hannah Dahlen – Western Sydney University

• Dr Shilpi Ajwani – SLHD Oral health services, Sydney Dental Hospital, University of Sydney

• Clinical Associate Prof Sameer Bhole – SLHD Oral health services, Sydney Dental Hospital, University of Sydney

• Prof Anthony Blinkhorn – University of Sydney

• Sharon Ellis – Campbelltown Hospital SWSLHD

• Dr Anthony Yeo – Western Sydney University

• Adjunct Assoc Prof Ravi Srinivas – SWSLHD Oral Health Services, Western Sydney University

• Dr Albert Yaacoub – NBMLHD Oral Health Services

Oral diseases are among the most common health problems experienced by Australians, with pregnant women being particularly at risk. As poor oral health during pregnancy can have a significant impact on the health and wellbeing of the mother and the child, guidelines recommend that antenatal care providers play an active role in promoting maternal oral health to pregnant women. Midwives are in an ideal position to fill this role, as they see and advise the majority of pregnant women in Australia. However there is currently no formal education or training regarding maternal oral health available to undergraduate midwifery students in Australia.
To address this, we plan to implement and evaluate Australia’s first oral health education program for undergraduate Bachelor of Midwifery students at the Western Sydney University. Having this initial education will help equip graduating midwives with the necessary knowledge and confidence to promote maternal oral health and will complement the existing MIOH CPD program.In-kind support is gratefully acknowledged from:

• Western Sydney University

Project team:

• Assoc Prof. Ajesh George – Western Sydney University, SWSLHD, University of Sydney, Ingham Institute

• Dr. Margaret Duff

• Prof Hannah Dahlen – Western Sydney University

• Prof Virginia Schmeid – Western Sydney University

• Dr Elaine Burns

• Dr Holly Priddis

Despite the importance of oral health care during pregnancy, pregnant women rarely seek dental care during pregnancy. This low uptake of dental services has mainly been attributed to various barriers experienced by pregnant women such as cost, lack of awareness and misconceptions. Yet, new research reveals that there are significant provider barriers that further exacerbate this problem, including a lack of clear consensus among dentists and antenatal care providers regarding perinatal oral health care, and a lack of emphasis being placed on oral health within maternity care in Australia. It is therefore vital that practice guidelines in perinatal oral health be developed for all dental and prenatal care providers in Australia. Such guidelines will help alleviate any concerns health professionals may have and ensure pregnant women receive a consistent message about the importance or oral health.
The aim of this study is to develop, implement and evaluate perinatal oral health (PERIOH) guidelines for antenatal (midwives/general practitioners/obstetricians) and dental care providers in Australia

Phase 1: Forming a multidisciplinary advisory committee for the development of the guidelines

Phase 2: Conducting pilot work for developing the guidelines

Phase 3: Developing the guidelines

Phase 4: Achieving consensus through consultation

Phase 5: Dissemination and implementation

Phase 6: Evaluation and revision

Funding is gratefully acknowledged from:

• Western Sydney University

• NSW Centre for Oral Health Strategy

• Australian Dental Association

• Phillips Australia

Project team:

• Assoc Prof. Ajesh George – Western Sydney University, SWSLHD, University of Sydney, Ingham Institute

• Prof Maree Johnson – Australian Catholic University, Ingham Institute

• Prof Hannah Dahlen – Western Sydney University

• Dr Shilpi Ajwani – SLHD Oral health services, Sydney Dental Hospital, University of Sydney

• Clinical Associate Prof Sameer Bhole – SLHD Oral health services, Sydney Dental Hospital, University of Sydney

• Prof Jenny Reath – Western Sydney University

• Prof Andrew Korda – Western Sydney University