Racial and oral health disparity associated with perinatal oral health care utilization among underserved US pregnant women

Objective: The study aims to identify specific determinants of dental care utilization during the perinatal period (prenatal and 1-year postnatal) among underserved US women residing in Upstate New York. Method and materials: The prospective cohort study included 186 low-income US pregnant women. Demographic-socioeconomic parameters and medical-dental conditions were obtained from questionnaires, electronic medical-dental records, and dental examinations. Multivariate regression analyses were used to assess factors associated with perinatal dental care utilization. As an exploratory effort, a separate logistic model assessed factors associated with adverse birth outcomes. Results: The results demonstrated unmet oral health needs among the underserved US pregnant women residing in Upstate New York. Despite an average of 2.7 +/- 3.6 untreated decayed teeth per person during pregnancy, only 39.3% and 19.9% utilized prenatal and 1-year postnatal dental care, respectively. Previous dental care utilization was a notable factor contributing to a higher uptake of perinatal dental care at a subsequent period. Prenatal dental care utilization was significantly lower among African American women (odds ratio 0.43 [95% CI 0.19, 0.98], P = .04) and positively associated with dental caries severity (OR 2.40 [1.09, 5.12], P = .03). Postnatal utilization was as sociated with caries severity (OR 4.70 [1.73, 12.74], P = .002) , prevalent medical conditions (hypertension, diabetes mellitus , emotional conditions). Pregnant women who achieved prenatal caries-free status had a lower odds of experiencing adverse birth outcomes; however, this was an insignificant finding due to limited adverse birth cases. Conclusion: Racial and oral health disparity is associated with perinatal oral health care utilization among under -served US pregnant women in New York. While both prenatal and postnatal dental care utilization was positively associated with oral health status, specifically, postnatal utilization was driven by exist-ing medical conditions such as emotional condition, hypertension, and diabetes mellitus. The results add to existing information on inherent barriers and postulated needs to improve access to peri-natal oral care, thereby informing statewide recommendations to maximize utilization. Considering this is a geographically restricted population, the findings are particularly true to this cohort of un-derserved pregnant women. However, future more robust studies are warranted to assess effective strategies to further improve peri-natal dental care utilization among underserved pregnant women. (Quintessence Int 2022;53: 892-902; doi: 10.3290/j.qi.b3095001)