Use of Dental Services among Low Income Pregnant Women

Objectives: Identify factors that affect use of dental services among low income pregnant women in Connecticut 

Methods: Qualitative methods using focus groups and in-depth interviews identified themes that could explain why low income women do not seek dental care during pregnancy.  Low income, pregnant women were recruited from three community health centers in Connecticut and the Litchfield Oral Health Collaborative. Data were collected at the local sites at times that were convenient for the participants.  Women received $50 for participating in the study. 

 Results: 86 women (70 English/16 Spanish) participated in 10 focus groups and 23 in-depth interviews.  Mean age was 26.5; 63% had a dentist; 92% had medical insurance; 81% had dental insurance (primarily Medicaid); 55% had been to the dentist in the past year.  Emergent themes included: 1) need for good communication with dentist; 2) quality of the dental office environment; 3) fear and/ mistrust of the dental community; 4) financial barriers; 5) need to educate women, dentists and obstetricians about importance and safety of dental care during pregnancy; 6) difficulty in scheduling an appointment.  The most common barriers noted were need to educate pregnant women (51 counts), financial barriers (44 counts) and fear/mistrust of dental providers (44 counts).

 Conclusions: Many women believed that obstetricians should educate women about the importance of dental care during pregnancy for their own health and the health of their babies.  Furthermore, participants stated that when seeking dental care, many dentists recommended delaying care until after birth.  Although most participants reported having Medicaid benefits for dental care, many still stated that insurance did not cover the cost of services that were needed.  Interventions are being developed to integrate oral health education at the offices of obstetricians and to standardize referrals from obstetricians to dental practitioners who accept Medicaid beneficiaries.