Factors Related to Periodontal Diseases Among Pregnant Women: A National Cross-Sectional Study in Indonesia
Article Sidebar
Main Article Content
Abstract
Pregnant women are at a high risk of periodontal tissue damage. It is because of changes in food patterns and poor mouth hygiene. This research aims to determine factors associated with periodontal diseases among pregnant women in Indonesia. It was an observational study with a cross-sectional design. The study used secondary data from 2018 Basic Health Research (Riskesdas). From the 300,000 sample households interviewed, there were 8,902 pregnant women. The dependent variable was periodontal diseases, and the independent variables were characteristics, systemic, and behavioral factors. To determine the factors most associated with periodontal disease in pregnant women using multivariate logistic regression. The results of this study indicate that the prevalence of periodontal in pregnant women in Indonesia is 65.7%. The factors most associated with periodontal disease in pregnant mothers are lack of education, living in urban areas, gestational age, brushing teeth after breakfast and before sleeping, and smoking. This research highlights the importance of enhancing oral health education and promoting healthy lifestyles to reduce the risk of periodontal disease in pregnant women.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
• Angarita-Díaz, M. D. P., Fong, C., Bedoya-Correa, C. M., & Cabrera-Arango, C. L. (2022). Does high sugar intake alter the oral microbiota?: A systematic review. Clinical and Experimental Dental Research, 8(6), 1376–1390. https://doi.org/10.1002/cre2.640
• Asawa, K., Sen, N., Bhat, N., Tak, M., Sultane, P., & Patil, V. (2018). Association of sugary foods and drinks consumption with behavioral risk and oral health status of 12- and 15-year-old Indian school children. Journal of Education and Health Promotion, 7, 19. https://doi.org/10.4103/jehp.jehp_53_17
• Azhria, I. N., Arina, Y. M. D., Wahyukundari, M. A., & Kiswaluyo. (2024). Status kesehatan dan kebutuhan perawatan periodontal ibu hamil di wilayah pesisir pantai Puger Jember [Health status and periodontal care needs of pregnant women in the Puger coastal area of Jember]. Interdental: Jurnal Kedokteran Gigi, 20(2), 176–183. https://doi.org/10.46862/interdental.v20i1.7123
• Baumeister, S.-E., Freuer, D., Baurecht, H., Reckelkamm, S. L., Ehmke, B., Holtfreter, B., & Nolde, M. (2022). Understanding the consequences of educational inequalities on periodontitis: A Mendelian randomization study. Journal of Clinical Periodontology, 49(3), 200–209. https://doi.org/https://doi.org/10.1111/jcpe.13581
• Belay, A. S., & Achimano, A. A. (2022). Prevalence and risk factors for periodontal disease among women attending antenatal care in public hospitals, Southwest Ethiopia, 2022: A multicenter cross-sectional study. Clinical, Cosmetic and Investigational Dentistry, 14, 153–170. https://doi.org/10.2147/CCIDE.S367713
• Bhat, M. (2008). Oral health status and treatment needs of a rural Indian fishing community. The West Indian Medical Journal, 57(1), 41–47. https://www.mona.uwi.edu/fms/wimj/article/781
• Borrell, L. N., Burt, B. A., Neighbors, H. W., & Taylor, G. W. (2004). Social factors and periodontitis in an older population. American Journal of Public Health, 94(5), 748–754. https://doi.org/10.2105/ajph.94.5.748
• Bunnatee, P., Abdulsalam, F. I., & Phoosuwan, N. (2023). Factors associated with oral health care behaviors of pregnant women in a northeastern province in Thailand: A hospital-based cross-sectional study. PLOS ONE, 18(8), Article e0290334. https://doi.org/10.1371/journal.pone.0290334
• Centers for Disease Control and Prevention (CDC). (2024). Talking to pregnant women about oral health. https://www.cdc.gov/oral-health/hcp/conversation-tips/talking-to-pregnant-women-about-oral-health.html
• Chambrone, L., Pannuti, C. M., Guglielmetti, M. R., & Chambrone, L. A. (2011). Evidence grade associating periodontitis with preterm birth and/or low birth weight: II: A systematic review of randomized trials evaluating the effects of periodontal treatment. Journal of Clinical Periodontology, 38(10), 902–914. https://doi.org/10.1111/j.1600-051X.2011.01761.x
• Chen, P., Hong, F., & Yu, X. (2022). Prevalence of periodontal disease in pregnancy: A systematic review and meta-analysis. Journal of Dentistry, 125, Article 104253. https://doi.org/10.1016/j.jdent.2022.104253
• Chowdhury, S. F., & Islam, M. N. (2021). Periodontal diseases among pregnant women attending an antenatal clinic at Dhaka, Bangladesh. Journal of Oral Research, 10(5), 1–10. https://doi.org/10.17126/JORALRES.2021.067
• Corridore, D., Saccucci, M., Zumbo, G., Fontana, E., Lamazza, L., Stamegna, C., Di Carlo, G., Vozza, I., & Guerra, F. (2023). Impact of stress on periodontal health: Literature revision. Healthcare (Basel, Switzerland), 11(10), Article 1516. https://doi.org/10.3390/healthcare11101516
• Daalderop, L. A., Wieland, B. V, Tomsin, K., Reyes, L., Kramer, B. W., Vanterpool, S. F., & Been, J. V. (2018). Periodontal disease and pregnancy outcomes: Overview of systematic reviews. JDR Clinical and Translational Research, 3(1), 10–27. https://doi.org/10.1177/2380084417731097
• Dain, C. P., Ganapathi, S., Ranjithkumar, A., Geevar, Z., Harikrishnan, S., & Ammu, J. V. (2023). Prevalence and risk factors of periodontal disease among rural and urban residents of a south Indian city: A cross-sectional study. Journal of International Society of Preventive and Community Dentistry, 13(6), Article 77. https://doi.org/10.4103/jispcd.JISPCD_77_23
• Fakheran, O., Keyvanara, M., Saied-Moallemi, Z., & Khademi, A. (2020). The impact of pregnancy on women’s oral health-related quality of life: A qualitative investigation. BMC Oral Health, 20(1), Article 294. https://doi.org/10.1186/s12903-020-01290-5
• Farsi, N. J., Merdad, Y., Mirdad, M., Batweel, O., Badri, R., Alrefai, H., Alshahrani, S., Tayeb, R., & Farsi, J. (2020). Oral health knowledge, attitudes, and behaviors among university students in Jeddah, Saudi Arabia. Clinical, Cosmetic and Investigational Dentistry, 12, 515–523. https://doi.org/10.2147/CCIDE.S272986
• GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. (2017). Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet (London, England), 390(10100), 1211–1259. https://doi.org/10.1016/S0140-6736(17)32154-2
• George, A., Johnson, M., Duff, M., Ajwani, S., Bhole, S., Blinkhorn, A., & Ellis, S. (2012). Midwives and oral health care during pregnancy: Perceptions of pregnant women in South-Western Sydney, Australia. Journal of Clinical Nursing, 21(7–8), 1087–1096. https://doi.org/https://doi.org/10.1111/j.1365-2702.2011.03870.x
• Gil-Montoya, J. A., Rivero-Blanco, T., Leon-Rios, X., Exposito-Ruiz, M., Pérez-Castillo, I., & Aguilar-Cordero, M. J. (2023). Oral and general health conditions involved in periodontal status during pregnancy: a prospective cohort study. Archives of Gynecology and Obstetrics, 308(6), 1765–1773. https://doi.org/10.1007/s00404-022-06843-3
• Han, K., & Park, J.-B. (2017). Association between oral health behavior and periodontal disease among Korean adults: The Korea national health and nutrition examination survey. Medicine, 96(7), Article 6176. https://doi.org/10.1097/MD.0000000000006176
• Hong, H. H., Chen, Y. H., Cheng, P. J., Chang, M. Y., & Chuang, L. L. (2023). Risk factors associated with periodontal disease and its impact on quality of life among pregnant women. Journal of Obstetrics and Gynaecology, 43(2), Article 2264382. https://doi.org/10.1080/01443615.2023.2264382
• Idaiani, S., & Indrawati, L. (2021). Functional status in relation to depression among elderly individuals in Indonesia: A cross-sectional analysis of the Indonesian National Health Survey 2018 among elderly individuals. BMC Public Health, 21(1), Article 12260. https://doi.org/10.1186/s12889-021-12260-z
• Indonesian Society of Endocrinology (PERKENI). (2019). Konsensus pengelolaan dan pencegahan diabetes melitus tipe 2 di Indonesia [Consensus on management and prevention of type II diabetes mellitus in Indonesia]. Indonesian Society of Endocrinology (PB.PERKENI). https://pbperkeni.or.id/wp-content/uploads/2021/06/Pedoman-Pengelolaan-DM-Tipe-2-Dewasa-di-Indonesia-eBook-PDF.pdf
• Johnson, G. K., & Hill, M. (2004). Cigarette smoking and the periodontal patient. Journal of Periodontology, 75(2), 196–209. https://doi.org/10.1902/jop.2004.75.2.196
• Karobari, M. I., Siddharthan, S., Adil, A. H., Khan, M. M., Venugopal, A., Rokaya, D., Heboyan, A., Marya, C. M., & Marya, A. (2022). Modifiable and non-modifiable risk factors affecting oral and periodontal health and quality of life in South Asia. The Open Dentistry Journal, 16(1), 1–6. https://doi.org/10.2174/18742106-v16-e2209270
• Kloetzel, M. K., Huebner, C. E., & Milgrom, P. (2011). Referrals for dental care during pregnancy. Journal of Midwifery & Women’s Health, 56(2), 110–117. https://doi.org/https://doi.org/10.1111/j.1542-2011.2010.00022.x
• Lafaurie, G. I. (2011). Gingival tissue and pregnancy. In F. S. Panagakos & R. M. Davies (Eds.), Gingival diseases (pp. 101–120). IntechOpen. https://doi.org/10.5772/23796
• Listl, S., Galloway, J., Mossey, P. A., & Marcenes, W. (2015). Global economic impact of dental diseases. Journal of Dental Research, 94(10), 1355–1361. https://doi.org/10.1177/0022034515602879
• Llambés, F., Arias-Herrera, S., & Caffesse, R. (2015). Relationship between diabetes and periodontal infection. World Journal of Diabetes, 6(7), 927–935. https://doi.org/10.4239/wjd.v6.i7.927
• Mariotti, A. (2007). Periodontal diseases. In S. J. Enna & D. B. Bylund (Eds.), xPharm: The comprehensive pharmacology reference (pp. 1–5). Elsevier. https://doi.org/10.1016/B978-008055232-3.60697-X
• Melo, P., Fine, C., Malone, S., Frencken, J. E., & Horn, V. (2018). The effectiveness of the Brush Day and Night programme in improving children’s toothbrushing knowledge and behaviour. International Dental Journal, 68, 7–16. https://doi.org/https://doi.org/10.1111/idj.12410
• Moon, J.-H., Lee, J.-H., & Lee, J.-Y. (2015). Subgingival microbiome in smokers and non-smokers in Korean chronic periodontitis patients. Molecular Oral Microbiology, 30(3), 227–241. https://doi.org/10.1111/omi.12086
• Mulyana, W. (2014, October). Rural-urban linkages: Indonesia case study (Working Paper Series No. 126). Working Group: Development with Territorial Cohesion, Territorial Cohesion for Development Program. https://rimisp.org/wp-content/files_mf/1422298454R_ULinkages_Indonesia_countrycase_Final_edited.pdf
• National Institute of Health Research and Development (NIHRD). (2008, August). Riset Kesehatan Dasar (Riskesdas) 2007 [Basic Health Research 2007]. Ministry of Health, Republic of Indonesia. https://layanandata.kemkes.go.id/katalog-data/riskesdas/ketersediaan-data/riskesdas-2007
• National Institute of Health Research and Development (NIHRD). (2014, April). Riset Kesehatan Dasar (Riskesdas) 2013 [Basic Health Research 2013]. Ministry of Health, Republic of Indonesia. https://layanandata.kemkes.go.id/katalog-data/riskesdas/ketersediaan-data/riskesdas-2013
• National Institute of Health Research and Development (NIHRD). (2019, November). Riset Kesehatan Dasar (Riskesdas) 2018 [Basic Health Research 2018]. Ministry of Health, Republic of Indonesia. https://layanandata.kemkes.go.id/katalog-data/riskesdas/ketersediaan-data/riskesdas-2018
• Nghayo, H. A., Palanyandi, C. E., Ramphoma, K. J., & Maart, R. (2024). Oral health community engagement programs for rural communities: A scoping review. PLOS ONE, 19(2), Article e0297546. https://doi.org/10.1371/journal.pone.0297546
• Nociti, F. H. J., Nogueira-Filho, G. R., Tramontina, V. A., Machado, M. A., Barros, S. P., Sallum, E. A., & Sallum, A. W. (2001). Histometric evaluation of the effect of nicotine administration on periodontal breakdown: An in vivo study. Journal of Periodontal Research, 36(6), 361–366. https://doi.org/10.1034/j.1600-0765.2001.360603.x
• Paropkari, A. D., Leblebicioglu, B., Christian, L. M., & Kumar, P. S. (2016). Smoking, pregnancy and the subgingival microbiome. Scientific Reports, 6, Article 30388. https://doi.org/10.1038/srep30388
• Păunică, I., Giurgiu, M., Dumitriu, A. S., Păunică, S., Pantea Stoian, A. M., Martu, M.-A., & Serafinceanu, C. (2023). The bidirectional relationship between periodontal disease and diabetes mellitus—a review. Diagnostics (Basel, Switzerland), 13(4), Article 681. https://doi.org/10.3390/diagnostics13040681
• Petersen, P. E., Baez, R. J., & World Health Organization. (2013). Oral health surveys: Basic methods (5th ed.). WHO Press. https://iris.who.int/handle/10665/97035
• Petersen, P. E., & Ogawa, H. (2012). The global burden of periodontal disease: Towards integration with chronic disease prevention and control. Periodontology 2000, 60(1), 15–39. https://doi.org/10.1111/j.1600-0757.2011.00425.x
• Pindobilowo, Tjiptoningsih, U. G., & Ariani, D. (2023). Effective tooth brushing techniques based on periodontal tissue conditions : A narrative review. Formosa Journal of Applied Sciences, 2(7), 1649–1662. https://doi.org/10.55927/fjas.v2i7.4838
• Piscoya, M. D. B. de V., Ximenes, R. A. de A., Silva, G. M. da, Jamelli, S. R., & Coutinho, S. B. (2012). Periodontitis-associated risk factors in pregnant women. Clinics (Sao Paulo, Brazil), 67(1), 27–33. https://doi.org/10.6061/clinics/2012(01)05
• Ran, E. L., I, M. N., MC, B.-R. de la H., B, M.-P., & A, P.-M. (2023). Periodontal status and gestational diabetes mellitus: A case-control study. Journal of Dentistry & Oral Disorders, 9(1), 1–6. https://doi.org/10.26420/jdentoraldisord.2023.1177
• Rikawarastuti, R., Ngatemi, N., & Harahap, N. N. (2016). Periodontal disease in pregnant women (Case study: Pondok Labu Village, South Jakarta, Indonesia). International Journal of Public Health Science (IJPHS), 5(2), 170–175. https://doi.org/10.11591/ijphs.v5i2.4782
• Ruan, Y., Shen, L., Zou, Y., Qi, Z., Yin, J., Jiang, J., Guo, L., He, L., Chen, Z., Tang, Z., & Qin, S. (2015). Comparative genome analysis of Prevotella intermedia strain isolated from infected root canal reveals features related to pathogenicity and adaptation. BMC Genomics, 16(1), Article 122. https://doi.org/10.1186/s12864-015-1272-3
• Sahoo, S. R., Nandini, D. B., Basandi, P. S., Selvamani, M., & Donoghue, M. (2022). A comparison of pre-and post-breakfast tooth brushing in caries prevention through the estimation of streptococcus mutans counts: A prospective clinical and microbiological study. Journal of Microscopy and Ultrastructure, 10(4), 168–173. https://doi.org/10.4103/jmau.jmau_90_21
• Salih, Y., Nasr, A. M., Ahmed, A. B. A., Sharif, M. E., & Adam, I. (2020). Prevalence of and risk factors for periodontal disease among pregnant women in an antenatal care clinic in Khartoum, Sudan. BMC Research Notes, 13(1), Article 147. https://doi.org/10.1186/s13104-020-04998-3
• Sathish, A. K., Varghese, J., & Fernandes, A. J. (2022). The impact of sex hormones on the periodontium during a woman’s lifetime: A concise-review update. Current Oral Health Reports, 9(4), 146–156. https://doi.org/10.1007/s40496-022-00321-0
• Silva de Araujo Figueiredo, C., Gonçalves Carvalho Rosalem, C., Costa Cantanhede, A. L., Abreu Fonseca Thomaz, É. B., & Fontoura Nogueira da Cruz, M. C. (2017). Systemic alterations and their oral manifestations in pregnant women. The Journal of Obstetrics and Gynaecology Research, 43(1), 16–22. https://doi.org/10.1111/jog.13150
• Sperandei, S. (2014). Understanding logistic regression analysis. Biochemia Medica, 24(1), 12–18. https://doi.org/10.11613/BM.2014.003
• Susanto, A., Bawono, C. A., & Putri, S. S. (2024). Hormonal changes as the risk factor that modified periodontal disease in pregnant women: A systematic review. Journal of International Oral Health, 16(3), Article 155. https://doi.org/10.4103/jioh.jioh_155_23
• Tedjosasongko, U., Anggraeni, F., Wen, M. L., Kuntari, S., & Puteri, M. M. (2019). Prevalence of caries and periodontal disease among Indonesian pregnant women. Pesquisa Brasileira Em Odontopediatria e Clinica Integrada, 19(1), 1–8. https://doi.org/10.4034/PBOCI.2019.191.90
• Timková, S., Klamárová, T., Kovaľová, E., Novák, B., Kolarčik, P., & Madarasová Gecková, A. (2020). Health literacy associations with periodontal disease among Slovak adults. International Journal of Environmental Research and Public Health, 17(6), Article 2152. https://doi.org/10.3390/ijerph17062152
• Tonetti, M. S., Jepsen, S., Jin, L., & Otomo-Corgel, J. (2017). Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: A call for global action. Journal of Clinical Periodontology, 44(5), 456–462. https://doi.org/10.1111/jcpe.12732
• United States Census Bureau (USCB). (2018, May). CSPro training manual. https://essp.ifpri.info/files/2018/07/CSPro_Training-manual_May28.pdf
• Veiga, N. (2018). Oral manifestations and diabetes. Biomedical Journal of Scientific & Technical Research, 7(5), 6168–6171. https://doi.org/10.26717/bjstr.2018.07.001574
• Vogt, M., Sallum, A. W., Cecatti, J. G., & Morais, S. S. (2012). Factors associated with the prevalence of periodontal disease in low-risk pregnant women. Reproductive Health, 9, 3. https://doi.org/10.1186/1742-4755-9-3
• Wandera, M., Åstrøm, A. N., Okullo, I., & Tumwine, J. K. (2012). Determinants of periodontal health in pregnant women and association with infants’ anthropometric status: A prospective cohort study from Eastern Uganda. BMC Pregnancy and Childbirth, 12. https://doi.org/10.1186/1471-2393-12-90
• Wijaksana, I. K. E., Bargowo, L., & Supandi, S. K. (2020). Peningkatan kesehatan periodontal ibu hamil dalam upaya mengurangi resiko bayi dengan berat badan lahir rendah [Improving periodontal health in pregnant women to reduce the risk of low birth weight babies]. Jurnal Layanan Masyarakat, 4(2), 275–281. https://doi.org/10.20473/jlm.v4i2.2020.275-281
• World Health Organization. (2022, October 25). Action plan for oral health in South-East Asia 2022–2030: Towards universal health coverage for oral health. https://www.who.int/publications/i/item/9789290210061
• Zhong, Y., Tang, Q., Tan, B., & Huang, R. (2021). Correlation between maternal smoking during pregnancy and dental caries in children: A systematic review and meta-analysis. Frontiers in Oral Health, 2, Article 673449. https://doi.org/10.3389/froh.2021.673449