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1.  Dentists’ Perceptions of Barriers to Providing Dental Care to Pregnant Women 
The purpose of the study was to understand US dentists’ attitudes, knowledge, and practices regarding dental care for pregnant women and to determine the impact of recent papers on oral health and pregnancy and guidelines disseminated widely.
In 2006–2007, the investigators conducted a mailed survey of all 1,604 general dentists in Oregon; 55.2% responded). Structural equation modeling was used to estimate associations between dentists’ attitudes toward providing care to pregnant women, dentists’ knowledge about the safety of dental procedures, and dentists’ current practice patterns.
Dentist’s perceived barriers have the strongest direct effect on current practice and might be the most important factor deterring dentists from providing care to pregnant patients. Five attitudes (perceived barriers) were associated with providing less dental services: time, economic, skills, dental staff resistance, and peer pressure. The final model shows a good fit with a chi-square of 38.286 (p = .12, n=772, df = 52) and a Bentler-Bonett Normed Fit index of .98, CFI = .993. The Root Mean Square Error of Approximation is .02.
Findings suggest attitudes are significant determinants of accurate knowledge and current practice. Multi-dimensional approaches are needed to increase access to dental care and protect the oral health of women during pregnancy. Despite current clinical recommendations to deliver all necessary care to pregnant patients during 1st, 2nd, and 3rd trimesters, dentists’ knowledge of the appropriateness of procedures continues to lag the state of the art in dental science.
PMCID: PMC2932670  PMID: 20800772
2.  Reducing Oral Health Disparities: A Focus on Social and Cultural Determinants 
BMC Oral Health  2006;6(Suppl 1):S4.
Oral health is essential to the general health and well-being of individuals and the population. Yet significant oral health disparities persist in the U.S. population because of a web of influences that include complex cultural and social processes that affect both oral health and access to effective dental health care.
This paper introduces an organizing framework for addressing oral health disparities. We present and discuss how the multiple influences on oral health and oral health disparities operate using this framework. Interventions targeted at different causal pathways bring new directions and implications for research and policy in reducing oral health disparities.
PMCID: PMC2147600  PMID: 16934121

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