Oral Health Conditions and Care Needs of Expectant Females in Warri, Nigeria

Annals of R.S.C.B., ISSN: 1583-6258, Vol.25, Issue 4, 2021, Pages. 19449 - 19457 Received 05 March 2021; Accepted 01 April 2021. Oral Health Conditions and Care Needs of Expectant Females in Warri, Nigeria

Mabel Okiemute Etetafia 1, Ese Anibor 2 and Martins Obaroefe 2

1Department of Oral/Maxillofacial Surgery, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria.

2 Department of Human Anatomy and Cell Biology, Faculty of Basic Medical Sciences, College of Health Sciences, Delta State University, P.M.B. 1, Abraka, Delta State, Nigeria. Corresponding author: Martins Obaroefe, E-mail: [email protected],

ABSTRACT Objective: This appraisal was performed to define the dental health condition and care exigencies of expectant mothers in Warri, Nigeria. Materials and Methods: This descriptive cross-sectional scrutiny involved self- reported questionnaires and oral examination. The subjects were 542 gravid females who are Nigerians, aged 10 to 50 years. The dental health condition and care exigencies of the gestating females that presented at the antenatal facility of the Central Hospital, Warri were investigated. Results: The preponderance of cariosity and periodontal infections was 22.5% and 26.7%, respectively. Gingival bleeding was observed in 26.7% and calculus in 86.5%. Findings revealed that 48 (22.5%) of the pregnant females needed dental amalgam, 56 (26.3%) stood in need of extraction attributable to caries and 56 (26.7%) required scaling, polishing and dental hygiene instructions. A larger number of the attendees (63.5%) had fair oral hygiene, even though 88.2% had gingivitis. Conclusion: The dental health statuses of the pregnant Nigerian women were poor with numerous treatment needs. Pregnancy has a definite impact on the oral health status. KEY WORDS: Oral, health, pregnant, Nigerian, women.

INTRODUCTION

Pregnancy also known as gravidity or gestation occurs concurrently with changes that affect the hard and soft tissues of the mouth (1). Pregnant women alter their dietary patterns as they frequently ingest meals abundant in carbohydrates and acids. The decrease in salivary pH associated with frequent nauseousness and emesis is also remarkable. Hence gravid females who do not employ regular and careful oral hygiene suffer from erosions of tooth enamel and develop dental caries. Dental structures are not spared in pregnancy as frequent and remarkable changes befall the gingiva (2). There is increased susceptiblity to periodontal lesion since accumulation of estrogen with progesterone can induce hyperaemia, edema and bleeding in periodontal tissues, increasing the likelihood of bacterial infections (3).

http://annalsofrscb.ro 19449 Annals of R.S.C.B., ISSN: 1583-6258, Vol.25, Issue 4, 2021, Pages. 19449 - 19457 Received 05 March 2021; Accepted 01 April 2021.

Numerous studies have investigated dental health among the gravid (4-11). Nigerians are not left out as an inquiry that considered the attitudes and oral habits of expectant females in a large hospital was done a decade ago(12). An inquiry considered the dental health condition and care requisites of expectant females in a Port(13). An intriguing inquisition considered periodontal health and some factors among expectant females in a large dental center (14). Literature search divulged scanty literature on the dental condition and oral care requisites of expectant females in Nigeria. This appraisal was performed to define the dental health conditions and care exigencies of expectant mothers in Warri, Nigeria.

METHODS

Details of sociological and demographic features, fetal age and previous dental visit were obtained using a questionnaire. Oral examinations were performed in a well-lit room using additional artificial light by the dentist with the use of a mouth mirror and a periodontal probe. Other instruments used include the sharp probes meant for identification of caries. The clinical parameters noted include gingival bleeding on probing (presence or absence) and calculus (presence or absence). Prevalence of gingival hemorrhage and calculus was determined as a proportion of attendees affected. The pregnant females were investigated for oral treatment needs and oral hygiene. Prior to this study, ethical approval was taken from the Central Hospital, Warri. Voluntary informed consent was also gotten from participants. Data collection occurred over a period of 12 months from January to December. The statistics was dissected with SPSS version 18.0 package. Descriptive statistics namely the percentage was used. Interdependence of categorical variables was considered using chi-square. Any p value below 0.05 was reckoned as consequential.

RESULTS

The gravid females are mostly young adults (Table I) and the preponderance (526) of the attendees are married, 15 are single and 1 divorced (Figure 1). The greater numbers of the gravid females investigated are educated (Table 3). In total, 194 (35.8%) subjects had dental problem before pregnancy while 348 (64.2%) didn’t experience dental pathology prior to gestation (Figure 2). Gingival bleeding and toothache were common conditions disclosed (Table 4). The findings exposed that gingival hemorrhage occurred in 26.7% and calculus in 86.5% (Table 6). Findings revealed that 48 (22.5%) of the gravid females needed dental amalgam, 56 (26.3%) needed extraction secondary to caries and 56 (26.7%) required scaling, polishing and dental hygiene instructions. Major part of the attendees (63.5%) had fair oral hygiene, even though 88.2% had gingivitis. There wasn’t any significant consociation relating the level of education and oral hygiene status in this scrutiny (p >0.05).

http://annalsofrscb.ro 19450 Annals of R.S.C.B., ISSN: 1583-6258, Vol.25, Issue 4, 2021, Pages. 19449 - 19457 Received 05 March 2021; Accepted 01 April 2021.

DISCUSSION The frequentness of cariosity in this inquiry is 22.54%. The preponderance of caries in this investigation is below the 60.4% reported in Belgaum (15). The rampancy of dental cavities was documented as 62.7% in India (16). An investigation disclosed dental caries in 53.8% of attendees (17). The rampancy of periodontal diseases was high in this research with only 11.8% of gravid females having healthy periodontium. Studies done on pregnant women by Gupta and Acharya revealed the rampancy of periodontal diseases as 95% (16), Jago et al. in Brisbane, Australia revealed 97% (18), Miyazaki et al. in Japan revealed 95% (19), and Tonello et al. in Brazil revealed 83.0%(20). Other findings are lower values like the frequentness of periodontal diseases in gravidity at Uganda (67.3%) (21 ) and at Baltimore (76.7%) (22). This inquiry revealed gum haemorrhage in only 26.7% even though calculus manifested in 86.5%. In India, haemorrhagic gum was observed in about 76% of entrants even though calculus showed in only about 14% (23). Another study done five years ago observed gingival bleeding as a finding present in 47.5% while calculus manifested in 24.2%(17).

This academic work revealed that 19 (3.5%) portrayed satisfactory oral hygiene, 344 (63.5%) had fair oral hygiene and 179 (33%) presented with poor oral hygiene. This differs from another study that noted that 159 (39.3%) of the gravid females had satisfactory dental hygiene; others showed moderate aggregation of plaque and calculus with one person who had bad dental hygiene (24). Findings from this scrutiny revealed that 48 (22.5%) of the gestating females needed amalgam restorations, 56 (26.3%) had need of exodontia secondary to caries and 56 (26.7%) required scaling, polishing and dental hygiene instructions. A Nigerian study disclosed that 50% required teeth scaling and dental hygiene education, 13.60% needed dental hygiene teaching only, half of the gravid females required amalgam restorations and 23.27% had need of teeth removal as aftereffect of curiosity (13).

The various inquisitions disserted reflected differences regarding the dental health condition and care needs considered. There may be many explanations for this such as differing socioeconomic factors, methodology and age. This inquiry involved restriction, precisely the self-reported information, like the past dental history of the participants. This is associative with response bias due to misinterpretations by the individuals concerned.

CONCLUSION The dental health statuses of the pregnant Nigerian women were poor with numerous treatment needs. Pregnancy has a definite impact on the oral health status.

REFERENCES

1. Bogges KA, Edelstein BL. Oral Health in Women during Preconception and Pregnancy: Implications for Birth Outcomes and Infant Oral Health. Matern Child Health J. 2006;10:169- 74.

http://annalsofrscb.ro 19451 Annals of R.S.C.B., ISSN: 1583-6258, Vol.25, Issue 4, 2021, Pages. 19449 - 19457 Received 05 March 2021; Accepted 01 April 2021.

2. Laine MA. Effect of Pregnancy on periodontal and dental health. Acta Odontol Scand. 2002; 60:257-64.

3. Mamatha B, Rekha R, Radha G , Pallavi SK. Oral health status and treatment needs for pregnant women: a review. Int J Dent Health Sci. 2015;2:619-27.

4. Gaffield ML, Colley-Gilbert BJ, Malvitz DM, Romaguera R. Oral health during pregnancy: an analysis of information collected by the Pregnancy Risk Assessment Monitoring System. J Am Dent Assoc. 2001;132:1009-16.

5. Zanata RL, Fernandes KB, Navarro PS. Prenatal dental care: evaluation of professional knowledge of obstetricians and dentists in the cities of Londrina/PR and Bauru/SP, Brazil, 2004. J Appl Oral Sci. 2008;16:194-200.

6. Rakchanok N, Amporn D, Yoshida Y, Harunor-Rashid M, Sakamoto J. Dental caries and gingivitis among pregnant and non-pregnant women in Chiang Mai, Thailand. Nagoya J Med Sci. 2010;72:43-50.

7. Karunachandra NN, Perera IR, Fernando G. Oral health status during pregnancy: rural- urban comparisons of oral disease burden among antenatal women in Sri Lanka. Rural Remote Health. 2012;12:1902.

8. Merglova V, Hecova H, Stehlikova J, Chaloupka P. Oral health status of women with high- risk pregnancies. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2012;156:337- 41.

9. Wandera M, Astrom AN, Okullo I, Tumwine JK. Determinants of periodontal health in pregnant women and association with infants’ anthropometric status: a prospective cohort study from Eastern Uganda. BMC Pregnancy Childbirth. 2012;12:90.

10. Kumar S, Tadakamadla J, Tibdewal H, Duraiswamy P, Kulkarni S. Factors influencing caries status and treatment needs among pregnant women attending a maternity hospital in Udaipur city, India. J Clin Exp Dent. 2013; 5:e72-6.

11. Amin R, Shetty P. Oral health status during pregnancy in Mangalore. NUJHS. 2014; 4:114-7.

12. Abiola A, Olayinka A, Mathilda B, Ogunbiyi O, Modupe S, Olubunmi O. A survey of the oral health knowledge and practices of pregnant women in a Nigerian Teaching Hospital. Afr J Reprod Health. 2011;15: 14-9.

13. Agbelusi GA, Akinwande JA, Shutti YO. Oral health status and treatment needs of pregnant women in Lagos State. Niger Postgrad Med J. 2000;7:96-100.

14. Onigbinde O, Sorunke ME, Braimoh MO, Adeniyi AO. Periodontal Status and Some Variables among Pregnant Women in a Nigeria Tertiary Institution. Ann Med Health Sci Res. 2014;4: 852-7.

http://annalsofrscb.ro 19452 Annals of R.S.C.B., ISSN: 1583-6258, Vol.25, Issue 4, 2021, Pages. 19449 - 19457 Received 05 March 2021; Accepted 01 April 2021.

15. Murthy S, Mubashir A, Kodkany BS, Mallapur M D. Pregnancy periodontitis and low birth weight: a cohort study in rural Belgaum, India. GJMPH. 2012;1: 42-7.

16. Gupta R, Acharya AK. Oral Health Status and Treatment Needs among Pregnant Women of Raichur District, India: A Population Based Cross-Sectional Study. Scientifica. 2016; Article ID 9860387, 8 pages

17. Talwar PS, Gambhir RS, Talwar D, Sohi RK, Vashist A, Munjal V. Oral health status and adverse pregnancy outcomes among pregnant women in Haryana, India: A prospective study. J Indian Assoc Public Health Dent. 2015;13: 138-43.

18. Jago JD, Chapman P J, Aitken JF, McEniery TM. Dental status of pregnant women attending a Brisbane maternity hospital.” Community Dent Oral Epidemiol. 1984;12: 398- 401. 19. Miyazaki H, YamashitaY, ShirahamaR et al.,.Periodontal condition of pregnant women assessed by CPITN. J Clin Periodontol. 1991;18: 751-4. 20. Tonello AS, Zuchieri MABO, Pardi V. Assessment of oral health status of pregnant women participating in a family health program in the city of Lucas do Rio Verde—MT— Brazil. Braz J Oral Sci. 2007;6: 1265-8. 21. WanderaM, Engebretsen IMS, Okullo I, Tumwine JK, Åstrøm AN. Socio-demographic factors related to periodontal status and tooth loss of pregnant women in Mbale District, Uganda. BMC Oral Health. 2009;9: 8-29. 22. Arafat AH. Periodontal status during pregnancy. J Periodontol. 1974;45: 641-3.

23. Sharma A, Bansal P, Grover A, Sharma S, Sharma A. Oral health status and treatment needs among primary school going children in Nagrota Bagwan block of Kangra, Himachal Pradesh. J Indian Soc Periodontol. 2014;18: 762-6. 24. Ifesanya JU, Ifesanya AO, Asuzu MC, Oke GA. Determinants of good oral hygiene among pregnant women in Ibadan, South-Western Nigeria. Ann Ib Postgrad Med. 2010;8: 95-100.

Table 1: The age distribution of the subjects

Age (years) Frequency Percentage (%) 10-19 14 2.6 20-29 261 48.2 30-39 248 45.8 40 -50 19 3.5

Table 2: The ethnicity of the subjects Ethnic group Frequency Percentage (%) Urhobo 211 38.9 Isoko 70 12.9 Itsekiri 56 10.3 Ijaw 18 3.3

http://annalsofrscb.ro 19453 Annals of R.S.C.B., ISSN: 1583-6258, Vol.25, Issue 4, 2021, Pages. 19449 - 19457 Received 05 March 2021; Accepted 01 April 2021.

Igbo 87 16.1 Ukwuani 15 2.8 Yoruba 15 2.8 Others 70 12.9

Table 3: The educational status of the research subjects Education level Frequency Percentage (%) None 3 0.6 Primary 68 12.6 Secondary 275 50.7 Tertiary 196 36.2

Table 4: Gestational age Fertilization age (weeks) Frequency Percentage (%) 25-29 124 22.9 30-35 222 41.0 36-40 196 36.2

Table 5: Dental care exigencies of the gravid women

Dental problem Frequency Percentage (%) Cavity 48 22.5 Gingival Bleeding 56 26.7 Pain 36 16.9 Toothache 56 26.3 Others 17 8.0

Table 6: Intraoral Examination of the attendees Oral hygiene Frequency Percentage (%) Good 19 3.5 Fair 344 63.5 Poor 179 33.0 Calculus Frequency Percentage (%) Absent 73 13.5 + 268 49.5 ++ 161 29.7 +++ 40 7.4 Total 542 100

Periodontal Condition Gingivitis Frequency Percentage (%) Absent 64 11.8

http://annalsofrscb.ro 19454 Annals of R.S.C.B., ISSN: 1583-6258, Vol.25, Issue 4, 2021, Pages. 19449 - 19457 Received 05 March 2021; Accepted 01 April 2021.

Mild 384 70.9 Moderate 90 16.6 Severe 4 0.7 Total 542 100

Gingiva swelling Frequency Percentage (%) Absent 343 63.3 Mild 118 21.8 Moderate 78 14.4 Severe 3 0.6 Tissue destruction in periodontal lesion Class Frequency Percentage (%) None 493 91.0 Class I (Gingivitis) 30 5.5 Class II (Slight periodontitis) 11 2.0 Class III (Moderate periodontitis) 0 0.0 Class IV (Severe periodontitis) 2 0.4 Class V (Refractory periodontitis) 6 1.1

Furcation involvement and exposure Exposure Frequency Percentage (%) Present 33 5.1 Absent 509 93.9

Fractured teeth Frequency Percentage (%) Present 7 1.3 Absent 537 98.7

http://annalsofrscb.ro 19455 Annals of R.S.C.B., ISSN: 1583-6258, Vol.25, Issue 4, 2021, Pages. 19449 - 19457 Received 05 March 2021; Accepted 01 April 2021.

Figure 1: Marital status of the participators

Figure 2: History of dental problem before pregnancy

http://annalsofrscb.ro 19456 Annals of R.S.C.B., ISSN: 1583-6258, Vol.25, Issue 4, 2021, Pages. 19449 - 19457 Received 05 March 2021; Accepted 01 April 2021.

Figure 3: History of dental issues amid gestation

http://annalsofrscb.ro 19457