Oral Healthcare during Pregnancy: Sustenance of care and implications for future practice

Abstract

Introduction: An antenatal oral healthcare programme was introduced in Sri Lanka with the collaboration of existing Maternal and Child Health (MCH) programme in 2009. A discussion on sustenance of oral care in< pregnancy will delineate the multiple and diverse factors that reflect the implications in future practice. Objectives: To describe the issues for sustainability of National Oral Healthcare Programme for Pregnant Mothers in the district of Gampaha Methodology: A qualitative study was carried out using the evaluation technique of participatory SWOT analysis. Two focus group discussions were conducted among Dental Surgeons and Medical Officers of< Health (MOH) followed by two key informant interviews with the Regional Dental Surgeon and the Medical Officer - MCH care in the year 2014. The most common items identified were prioritized according to the preference of Dental Surgeons and MOHs in two separate public health forums. Results: The weaknesses pointed out by the professionals were; lack of emergency management facilities and over-crowded nature of some government dental clinics, lack of motivation among mothers and delayed appointments given in government dental clinics. The threats challenging the programme were Dental Surgeons‟ fear for the litigation issues, medically compromised mothers,
myths run in families and risk of being treated by mal-practitioners. The strengths emerged were; team work of the staff, dissemination of practice guideline, benefits gained by mother and child, importance of early detection of oral disease, health education focused on oral health and service rendered by Mobile Dental Service. Several opportunities as suggested were; appointing Community Dental Surgeons to look after the antenatal oral healthcare, review the programme with experts, active involvement of mass media, inclusion of oral healthcare in to the basic curriculum of midwife and obtaining extra-support from private dental clinics. Conclusion & Recommendation: Supervision and monitoring of the programme should be further strengthened by carefully attending on the challenging areas.