Pregnancy-associated unmet dental care need despite lower unmet general care need: evidence of a dental-specific gap from two national surveys

Abstract Background Pregnant women are commonly regarded as a vulnerable, under-served group for oral health, and their low use of dental care is usually framed as a problem of access. Whether this frame fits has rarely been tested with perception, access, and clinical status examined together. Methods We conducted a parallel mixed-methods triangulation in women of reproductive age (19–49 years) across two national surveys. The Korea Community Health Survey (2018–2019) provided self-rated oral health, unmet dental and general care need, and free-text reasons analysed by qualitative content analysis (two independent coders); the Korea National Health and Nutrition Examination Survey (2007–2018) provided clinically examined periodontitis. Both were analysed with complex-sample methods and integrated through a joint display. Results Among 92,130 reproductive-age women (2,070 pregnant), unmet dental care need was higher in pregnancy (adjusted odds ratio 1.26, 95% CI 1.11–1.43), whereas unmet non-dental care need was lower (0.65 in 2018 and 0.56 in 2019). Self-rated oral health did not differ (ordinal odds ratio 0.92, 0.84–1.01). The residual “other” category was the most frequently reported reason among pregnant women (38.3% vs. 6.5%), while cost (6.9% vs. 14.4%) and time/access (30.8% vs. 48.0%) were reported less often; among the 156 analysable free-text responses in that category (Cohen’s κ = 0.72), 92.9% were pregnancy-attributed. Adjusted clinical periodontal outcomes were not lower: the odds ratio was 1.48 (0.96–2.27) for the pocket-based periodontitis definition and 1.40 (1.07–1.83) for any periodontal sign. Conclusions Pregnancy was associated with a dental-specific gap in care: unmet dental-care need was higher while unmet general-care need was not, and pregnancy-related reasons were prominent whereas conventional cost and time/access barriers were reported less often. This occurred despite self-perceived oral health that was no worse and no clear evidence of better clinical periodontal status. Antenatal care may be a useful point at which to address pregnancy-related considerations regarding dental care, while recognising that the timing of elective treatment warrants clinical judgement.