Dental anxiety among pregnant women in Yatinuwara MOH area, Kandy district, Sri Lanka

Abstract

Ensuring optimal oral health during pregnancy is crucial to prevent adverse pregnancy outcomes. However, dental anxiety (DA) often acts as a significant barrier to accessing necessary dental care during this period. This study assessed the prevalence of DA and its associated factors among pregnant women attending antenatal clinics in the Yatinuwara Medical Officer of Health (MOH) area, Kandy district, Sri Lanka. A mixed-method approach was used. Descriptive analysis, inferential statistics, and content analysis were used during quantitative and qualitative analyses, respectively. First, a cross-sectional survey was conducted with 138 pregnant women attending antenatal clinics in the Yatinuwara MOH area. An interviewer-administered questionnaire and the Modified Dental Anxiety Scale (MDAS) were used for data collection. The finding revealed that 15.9% of the pregnant women were experiencing severe DA, and while 70.3% were having mild DA. The mean MDAS score was recorded as 12.6±4.7. Higher monthly household income, Sinhalese ethnicity, and gestational hypertension were linked to increased maternal DA. Secondly, the inductive qualitative methodology was used to explore the factors associated with DA in more detail using semi-structured interviews. This was done until the point of data saturation with 20 pregnant women who exhibited severe DA (MDAS scores ≥ 19). Content analysis identified three common factors contributing to DA: (1) anxiety related to the dental setting, (2) anxiety towards the behaviour of the dental team, and (3) women's perceptions and previous experiences of dental care. Based on the factors explored through the qualitative analysis, improvements to the dental healthcare settings and improvement of the behaviour of the healthcare team to build better doctor-patient or nurse-patient relationships would help to alleviate maternal DA, promoting better attendance for dental care during pregnancy.