Background: Poor maternal oral health may be associated with adverse pregnancy and infant outcomes. However, women seldom seek dental care during pregnancy, and misconceptions by prenatal care practitioners about oral health care during pregnancy may contribute to the problem. The aim of this study was to review current knowledge, attitudes, and behavior of dental and prenatal care practitioners about oral health care during pregnancy. Methods: This review examined all studies published in English that explored the knowledge, attitude, behavior, and barriers faced by dentists, general practitioners, midwives, and obstetricians/gynecologists with respect to oral health care during pregnancy. Results: Despite acknowledging the importance of maternal oral health, many dentists are uncertain about the safety of dental procedures and are hesitant in treating pregnant women. General practitioners and midwives are poorly informed about the impact of poor maternal oral health and rarely initiate this topic during prenatal care. Many general practitioners also believe that dental procedures are unsafe during pregnancy. Obstetricians/gynecologists are well informed about perinatal oral health and are supportive of dental procedures, but because of lack of training in this area and competing health demands they seldom focus on oral health care during their prenatal care. Conclusion: No real consensus exists among dentists and prenatal care practitioners with respect to oral health care during pregnancy. This issue poses a significant deterrent for pregnant women seeking dental care. Practice guidelines in perinatal oral health are needed for health professionals to emphasize this important aspect of prenatal care. © 2012, The Authors Journal compilation

How do dental and prenatal care practitioners perceive dental care during pregnancy? Current evidence and implications.

Background
The aims of this study were to determine factors associated with dental visit and to describe barriers to utilisation of oral health care services among antenatal mothers attending the Obstetric and Gynaecology Specialist clinic in Hospital Universiti Sains Malaysia.

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Factors associated with dental visit and barriers to utilisation of oral health care services in a sample of antenatal mothers in Hospital Universiti Sains Malaysia

This systematic review explored associations between smoking and health outcomes involving the musculoskeletal system. AMSTAR criteria were followed. A comprehensive search of PubMed, Web of Science, and Science Direct returned 243 articles meeting inclusion criteria. A majority of studies found smoking has negative effects on the musculoskeletal system. In research on bones, smoking was associated with lower BMD, increased fracture risk, periodontitis, alveolar bone loss, and dental implant failure. In research on joints, smoking was associated with increased joint disease activity, poor functional outcomes, and poor therapeutic response. There was also evidence of adverse effects on muscles, tendons, cartilage, and ligaments. There were few studies on the musculoskeletal health outcomes of secondhand smoke, smoking cessation, or other modes of smoking, such as waterpipes or electronic cigarettes. This review found evidence that suggests tobacco smoking has negative effects on the health outcomes of the musculoskeletal system. There is a need for further research to understand mechanisms of action for the effects of smoking on the musculoskeletal system and to increase awareness of healthcare providers and community members of the adverse effects of smoking on the musculoskeletal system.

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The Effect of Tobacco Smoking on Musculoskeletal Health: A Systematic Review.

Background/Aims: Traditionally, tobacco is considered as part of the military culture A cross-sectional survey was designed to clarify if smoking habit increases the caries risk in

Does Smoking Increase Risk for Caries? A Cross-Sectional Study in an Italian Military Academy

Objective: The aim of this study was to assess the level of salivary immunoglobulins and periodontal status in smokers and non-smokers. Materials and methods: Unstimulated saliva of 30 subjects (mean age 24.2 ± 3.5 years) who were smokers (test group) and of 30 subjects (mean age 25.3 ± 3.8 years) who were non-smokers (control group) was collected and centrifugated; IgA, IgG, and IgM were measured with the colorimetric immunoenzymatic method. Moreover, the following periodontal clinical parameters were recorded for each subject: plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL). Results: A significantly (p< 0.05) lower Ig level was observed in smoking patients (IgA: 20.0 ± 1.2 mg/dl; IgM: 19.5 ± 1.6 mg/dl; IgG: 8.1 ± 1.4 mg/dl) compared to levels in the non-smoking control group (IgA: 234.1 ± 65.2 mg/dl; IgM: 121.0 ± 31.7 mg/dl; IgG: 1049.4 ± 102 mg/dl). In the test group, PI (2.2 ± 0.3), GI (2.4 ±0.5), PD (49.3 ± 9.2%), and CAL (49.3 ± 4.6%) were higher (p< 0.05) than those observed in the control group (PI: 0.8 ± 0.4; GI: 0.7 ± 0.3; PD: 10.6 ± 2.4%; CAL: 3.1 ± 0.8%). Conclusion: Smoking subjects showed lower levels of salivary IgA, IgG, and IgM and a worse periodontal condition than non-smoking subjects. On the base of our study, as smoking subjects also had lower levels of IgA, IgG, and IgM in their saliva than non-smoking subjects, despite the fact that there is little evidence that the salivary Igs have a protective action against periodontitis and that the whole saliva does not result in whole from the salivary glands, it can be concluded that the deteriorated periodontal health conditions of these patients can be attributed in part to a lowering of the host’s defense due to a decrease in the quantity of Igs in salivary fluid.

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Levels of salivary immunoglobulins and periodontal evaluation in smoking patients

Objectives: The study was designed to assess the views and knowledge of healthcare providers in general medicine and other specialties on the association between oral health and pregnancy outcomes. Material and Methods: Two hundred and fifty physicians practicing in northern Jordan hospitals and healthcare centers were asked to complete a questionnaire. Completed questionnaires with the answers were returned completed by 197 participants (response rate was 79%). Results: The majority of the physicians (81%) agreed that pregnancy increases the tendency to have gingival inflammation. However, 88% of doctors advised delay dental treatment until after pregnancy. Only half (54%) thought that tooth and gums problem can affect the outcomes of pregnancy. Moreover, approximately 50% agreed with the possible association between oral health and pregnancy outcomes. Altogether, 52% agreed

Survey of medical doctors' attitudes and knowledge of the association between oral health and pregnancy outcomes.

Objective:  The aim of this study was to assess the relationships between aggressive periodontitis (AgP), caries and smoking.



Method and materials:  A cross-sectional study was conducted among patients who were specifically referred to the Dental Teaching Clinic in Irbid, Jordan for periodontal treatment. Self-administered questionnaire related to socio-demographic data and smoking habits was completed. The oral hygiene, gingival status, periodontal health and dental status of the participants was determined by using the plaque index of Silness and Loe [Acta Odontol Scand, 22 (1964), 121], the gingival index of Loe and Silness [Acta Odontol Scand, 21 (1963), 233], clinical attachment level (CAL) and decayed, missing and filled teeth (DMFT) index respectively.



Result:  The prevalence of smoking was greater in chronic periodontitis (CP) group (44.2%) than in either chronic gingivitis (CG) (27.4%) or AgP (29.9%) group. Self-reported perio-diseases in the close family was more prevalent (77%) among subjects diagnosed with AgP. The mean plaque scores were significantly higher for smoker than non-smoker in AgP group only (P = 0.04), with significantly greater plaque and gingival scores in CG and CP groups than AgP group (P = 0.012, 0.004). A significantly greater mean gingival scores were noted among CG and CP groups than AgP group (P = 0.004). The mean CAL was higher in smokers than in non-smokers in the three groups, with statistically significant differences in CP and AgP groups (P = 0.04, 0.01 respectively).The mean number of DMFT was significantly higher in smoker than in non-smoker of all age groups (P = 0.016, 0.043 and 0.01). However, mean DMFT was significantly greater in CP and CG than AgP groups.



Conclusion:  It was concluded that (i) higher plaque and gingival index among smokers in all groups; (ii) significant difference in the CAL between smoker and non-smoke in CP and AgP groups; (iii) significant increase in caries risk among smokers in all groups; (iv) smokers and non-smokers of AgP group had significantly lower mean DMFT scores than those of CG or CP groups.

R Al-Habashneh

Papers

Survey of medical doctors' attitudes and knowledge of the association between oral health and pregnancy outcomes.

Smoking and caries experience in subjects with various form of periodontal diseases from a teaching hospital clinic