Oral Health Needs Assessment of Pregnant Women/Mothers in Berkeley: A Mixed-Methods Approach

Background Optimal oral health during pregnancy is important for maternal and child health.Aim To assess the prenatal oral health needs of low-income women in Berkeley, California, and identify barriers and facilitators to dental care.Methods The study surveyed 57 pregnant and post-partum women receiving public health services, and descriptive and multivariate logistic regression analysis was performed. A community focus group further explored dental service utilization, and content analysis identified themes.Results Overall, 43% of women reported dental problems during pregnancy. While 80% of the women reported that their prenatal medical provider recommended a prenatal dental visit and 75% knew that their health insurance covered dental visits, 41% did not have a prenatal dental visit. Women were significantly more likely to have had a prenatal dental visit if they knew that their health insurance covered it. The survey identified barriers to accessing prenatal dental care: financial, difficulty getting timely appointments, lack of awareness, fear and anxiety from dental procedures, time constraints, and not having a dentist. Barriers identified in the focus group were as follows: 1) Dental fear, mistrust, and perceived disrespect in dental settings; 2) Uncertainties and misconceptions about dental services; and 3) Limited dental insurance and access to dental providers/services.Conclusion To improve perinatal oral health and utilization of prenatal dental care, policies and programs are needed to support prenatal medical-dental integration, coverage for Medi-Cal dental services during pregnancy, and recruitment and training of Medi-Cal dental providers in cultural sensitivity, communication, trauma-informed care, and minimally-invasive care.