The prevalence of dental consultation in this study was 8.7%. Although it is recommended that women should have dental care while pregnant, studies have shown that dental services utilization among pregnant women has remained very poor [14,15,16]. This trend appears to be a global one. A study done in the United States showed that less than half of pregnant women reported visiting a dentist [15]. Similar studies have also shown low dental consultation among pregnant women ranging from 13.7% to 35% [7, 11, 12, 16,17,18,19]. The prevalence reported in this current study appears to be the lowest and may be a reflection of the low level of awareness of the importance of good dental hygiene in promoting better obstetric outcome, as well as low resources available to the participants.
The most common dental complaint that necessitated dental consultation in our study was toothache. This was at variance to an earlier report by Bashiru and Ilochonwu in Port Harcourt, Nigeria where excessive salivation was the most common oral condition [7] while an Australian study found that gingival bleeding was the most common [18]. Excessive salivation was not reported at all in our study. The reason for the difference may be that our women considered excessive salivation as normal during pregnancy [7].
Although about one fifth of the participants had dental problems, majority of them did not consult the dentists. The most common reason for not visiting the dentists in the current study was the participants thought it was not relevant to their pregnancy outcome and therefore felt there was no need for it. This was one of the reasons noted in a previous study [11]. Oral problems (such as tooth decay, gum bleeding) are believed by most women to be part of the pregnancy changes and this belief serve as barrier to dental consultation [3, 7, 19].
Another reason for non-utilization of dental services was the fear of harm to the unborn child. A similar study showed that majority of the women believed that receiving dental treatment while pregnant could have negative effects on their pregnancy outcome [16,17,18].
Cost of dental treatment was another reason for the low dental consultation in our study. This was in consonant with previous study [3]. That is why health insurance is very important since it has been associated with better use of dental services [14, 18].
Other reasons for not visiting the dentist during pregnancy included; busy schedule and fear of the dentists. These barriers to the utilization of dental services while pregnant have been reported in a similar study [3].
Brushing twice daily was significantly associated with dental consultation. Similar study had shown that there is higher dental consultation among women who brushed regularly [11]. This may be attributed to the fact that women who brushed regularly may likely have better information and understand the need for dental consultation. Women who reported good oral care were more likely to have regular dental check-up [19]. Other factors associated with dental consultation include: place of residence, occupation, religion and frequency of change of toothbrush (p < 0.005).
As shown in the current study, less than half of the women that required dental consultation actually visited the dentist. Dental services may actually be under-utilized probably due to unawareness on the part of the pregnant women as well other barriers earlier listed. It has also been reported that low dental consultation may be attributed to some dentists and obstetricians because they are not counseling their patients about the importance of dental care during pregnancy [20]. This may be because they are not aware of antenatal oral health guidelines thereby not recommending dental care during pregnancy [20]. A previous study showed that antenatal care giver hardly advised pregnant women on good oral hygiene maintenance and routine dental consultations nor checked the oral status of these women [21]. Management of routine and dental emergencies can be denied by dentists because of misconceptions which can be corrected by continuous medical education [2]. Nurses also have a role to play in oral health care of pregnant women. A previous study showed that though the nurses had limited knowledge about oral health care; they had good attitudes [6]. There may be need for more collaboration between the antenatal care providers, the dentists and other health workers to ensure that pregnant women need not postpone or avoid oral health care in pregnancy, consult the dentist as early as possible and encourage good oral health behaviors during pregnancy.
None of the participants in our study had routine dental consultation. They only visited the dentist because they had dental complaints. Majority of them where referred by their Obstetricians after complaining of dental problem. Counselling is also essential as seen in our study where more than half agreed to have dental consultation in their subsequent pregnancies. This counselling should be done more by the obstetricians during antenatal period. This shows that obstetricians have a lot to do in order to improve the oral health of pregnant women. Further study on the knowledge and practices of obstetricians concerning oral health among pregnant women would be beneficial.
This study has some limitations. Convenient sampling method was used to select the participants, and this may affect the generalizability of the study result to the entire population. Also the study was based on self-reported information and may be prone to bias. However, this was minimized by the administration of the questionnaires by trained interviewers.
