Abstract
Introduction: Despite modest research on oral health care during pregnancy, there is a dearth of evidence describing dental care among pregnant women experiencing homelessness. The purpose of this study was to examine associations between dental care utilization and social and behavioral determinants of health among United States (US) pregnant women who experienced homelessness relative to those who did not.
Methods: This was a cross-sectional study that used data from the 2012-2018 Pregnancy Risk Assessment Monitoring System (PRAMS). The sample consisted of 5,939 homeless and 209,942 non-homeless women. Bivariable and multivariable analyses were conducted to determine associations between dental health-related measures and social, medical, and behavioral determinants of health based on whether a woman experienced homelessness 12 months prior to birth.
Results: In this sample, 41.2% of homeless women saw a dentist for a problem while this was true for only 19.1% of women who were not homeless. Approximately 36.4% of women who experienced homelessness did not have their teeth cleaned before pregnancy compared to 25.7% of women who were not homeless. Lack of preventive care, smoking, older age, and experiencing multiple stressors during pregnancy were positively associated with seeing a dentist during pregnancy for both groups of women.
Conclusions: The results indicate the need for healthcare providers and policy officials to develop targeted interventions and policies to ensure that dental care is readily accessible for all pregnant women and especially those who are homeless.
References
Silk H, Douglass AB, Douglass JM, Silk L.Oral health during pregnancy. Am Fam
Physician 2008;77(8):1139-1144. PMID: 18481562
Northridge ME, Kumar A, Kaur R. Disparities in access to oral health care. Annu Rev
Public Health 2020;41:513-535. https://doi.org/10.1146/annurev-publhealth-040119-094318
Adeniyi AA, Laronde DM, Brondani ML, Donnelly. Perspectives of socially disadvantaged
women on oral healthcare during pregnancy. Community Dent Health 2020;37(1):39-44.
doi:10.1922/CDH_4591Adeniyi06
Centers for Disease Control and Prevention (2019, February 6) About PRAMS.
PRAMS. https://www.cdc.gov/prams/about/prams-faq.htm
Hussaini SK. Pregnancy Risk Assessment Monitoring System Consolidated Report
- 2015. Delaware Department of Health and Social Services, Division of Public Health, 2018.
StataCorp. Stata Statistical Software: Release 16. Published online 2019
Committee Opinion No. 569. Oral health care during pregnancy and through the
lifespan. Obstet Gynecol 2013;122(2 Pt 1):417-422
McGeough C, Aisling Walsh A, Clyne B. Barriers and facilitators perceived by women while homeless and pregnant in accessing antenatal and or postnatal healthcare: A qualitative evidence synthesis. Health Soc Care Community 2020;28(5):1380-1393.
Chandler C. As we age, oral health plays increasing role in overall health, 2019. https://today.uconn.edu/2019/09/age-oral-health-plays-increasing-role-overall-health/# (Assessed on June 6, 2024)
Marchi KS, Fisher-Owens SA, Weintraub JA, Yu Z, Braveman PA. Most pregnant women in California do not receive dental care: findings from a population-based study. Public Health Rep 2010;125(6):831-842. doi:10.1177/003335491012500610
Lee H, Wenzel J, Marsteller JA, Babalola S. Racial disparity in dental
care during pregnancy: An analysis of the Pregnancy Risk Assessment Monitoring System from 2012 to 2015. J Health Care Poor Underserved 2021;32(4):2086-2109. doi:10.1353/hpu.2021.0184
Singhal A, Chattopadhyay A, Garcia AI, Adams AB, Cheng D. Disparities in unmet dental need and dental care received by pregnant women in Maryland. Matern Child Health J 2014;18(7):1658-16667. doi:10.1007/s10995-013-1406-7