Pregnant women experience increased risk of developing periodontal disease, dental caries, tooth erosion, tooth mobility, pyogenic granuloma, and salivary changes. Despite the high prevalence of oral diseases, only 23% to 42% of women visit the dentist during pregnancy. Access to care during pregnancy is important for the avoidance of possible adverse oral effects, in addition to complications associated with periodontal disease, such as premature birth, low birth weight, and preeclampsia. Seeking dental treatment is not only for the maintenance of the mother’s oral health but also for the infant’s, because if a pregnant woman has dental caries, then the cariogenic bacteria can be transmitted to her infant. Many factors have been associated with the neglect of oral health amongst pregnant women, including patient’s low oral health knowledge, negative dental experience, or the dentist’s misconception of not providing dental treatment during pregnancy. Poor access to oral care amongst pregnant women is also related to low socioeconomic status and instant geographic locations. “Anxiety is irrational, and the perceived feeling is an inability to predict or control future events.” If the feeling is induced by dental situations, the anxiety is considered as dental anxiety (DA), which can stimulate muscle tension and increase the heart rate. Literature indicates that negative oral health outcomes are associated with anxiety and depres-sion.3Similarly, the vicious cycle of DA can also lead to the avoidance of dental care, which can deteriorate oral health and compromise the self-esteem of the patients. There is a lack of evidence on DA and its influence on the patterns of dental visits amongst pregnant women despite the high prevalence of dental and periodontal problems amongst this cohort. In addition, the level of DA in each trimester of pregnancy is still not fully understood. Therefore, this study aimed to assess DA during pregnancy and evaluate its association with previous dental attendance amongst pregnant women in the Eastern province of Saudi Arabia. caries, then the cariogenic bacteria can be transmitted to herinfant.4Many factors have been associated with the neglect of oral health amongst pregnant women, including patient’s low oral health knowledge, negative dental experience, or the dentist’s misconception of not providing dental treatment during pregnancy. Poor access to oral care amongst pregnant women is also related to low socioeconomic status and distant geographic locations. “Anxiety is irrational, and the perceived feeling is an inability to predict or control future events.”6If the feeling is induced by dental situations, the anxiety is considered as dental anxiety (DA), which can stimulate muscle tension and increase the heart rate. Literature indicates that negative oral health outcomes are associated with anxiety and depression. Similarly, the vicious cycle of DA can also lead to the avoidance of dental care, which can deteriorate oral health and compromise the self-esteem of the patients. There is a lack of evidence on DA and its influence on the patterns of dental visits amongst pregnant women despite the high prevalence of dental and periodontal problems amongst this cohort. In addition, the level of DA in each trimester of pregnancy is still not fully understood. Therefore, this study aimed to assess DA during pregnancy and evaluate its association with previous dental attendance amongst pregnant women in the Eastern province of Saudi Arabia. This cross-sectional study included pregnant women visiting prenatal clinics in major hospitals and primary health care centres in Dhahran, Khobar, and Dammam cities in the Eastern Province of Saudi Arabia. Data collection was conducted during June through August 2019. The study included both Saudi and non-Saudi pregnant women of all ages. The study participants were recruited as a convenient sample. The pregnant women willing to participate in the study were provided with a hard copy of the self-administered questionnaire. A sample of 1,014 participants was calculated assuming a 3%margin of error, 95% confidence level, population size of20, 000, and 50% response distribution. The variables related to DA and dental visits were measured using a questionnaire that contained items related to dental visits from the World Health Organization Oral Health Survey for Adults. The items of the Modified Dental Anxiety Scale (MDAS) were included in the questionnaire to evaluate DA. The MDAS is a brief questionnaire with 5 items, and each item uses a 5-point Likert scale that ranges from not anxious (1) to extremely anxious(5). The minimum score of the MDAS is 5, whilst the maximum score is 25. Higher scores of the scale indicate higher DA. The cut off score of the MDAS for no dental anxiety is 5; low anxiety, 6 to 10; moderate anxiety, 11 to 14; high anxiety, 15 to 18; and extreme anxiety≥19. The reliability and validity of the MDAS have been con-firmed in adult populations. It was also found that the use of the MDAS questionnaire did not increase anxiety amongst study participants. Meetings with researchers were held to evaluate the items of the questionnaire from the cultural and religious points of view in the country. The first included socio-demographic information such as age, monthly income, education level, number of previous pregnancies, trimesters, dental pain or problem, negative dental experience, and medical conditions. The participants responded to questions about DA in the second section of the questionnaire. The questions about dental visits were asked in the third section. The frequency of dental visits and timing of the last dental visit were solicited. The questionnaire was available in both English and Arabic languages to accommodate both Arabic and non-Arab study participants. Initially, the questionnaire was pilot tested amongst 30 females. This helped to evaluate the feasibility of the study, estimate the average time needed to fill out the questionnaire, and ensure the understanding of questionnaire items by the participants.

Manuscript submission for dental related issues are accepted, to know more about the journal https://www.omicsonline.org/oral-hygiene-and-health.php

Regards
Sarah eve

Editorial Assistant

Journal of Oral Hygiene and Health