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Objective: Health education interventions during pregnancy can influence maternal oral health (OH), maternal OH-behaviors and children's OH. Interventions that can be delivered at anytime and anywhere, for example mobile-health (mHealth) provides an opportunity to address challenges of health education and support activation of women in underserved and rural communities to modify their health behavior. This pilot study was undertaken as a part of a mHealth initiative to determine knowledge, attitudes, and behaviors related to pregnancy and ECC prevention among women attending obstetrics/gynecology (OB/GYN) practices at a large rurally-based clinic., Methods: A cross-sectional survey study was voluntarily engaged by women (n = 191) aged 18 to 59 years attending OB/GYN visits, over a 3-week period from 12/2019 to 1/2020. Survey results were analyzed applying descriptive statistics, X 2 and Fisher's Exact tests. The significance level was set at P  < .0001 for all analyses., Results: Approximately half of respondents were between 18 and 29 years (53%), had a college degree (55%), and 100% reported cell phone use. Whereas 53% and 31%, respectively, indicated that they were "somewhat" or "very" sure of how to prevent ECC in their children, only 9% recognized evidence of early decay and 30% did not know the purpose of fluoride. Overall, only 27% of participants correctly answered the knowledge-based questions. Further, only 57% reported their provider explained things in a way that was easy to understand. Only 24% reported seeing a dentist during their current pregnancy., Conclusions: Study results suggested potential gaps in knowledge and behaviors related to ECC prevention and provided baseline data to inform future interventions to improve ECC prevention practices. Notably, majority of participants used their cell phones for making medical/dental appointments and reported using their phones to look up health-related information. This demographic represents a potentially receptive target for mHealth approaches to improve understanding of oral health maintenance during pregnancy and ECC prevention.

This cross-sectional study sought to assess the current awareness, knowledge, and behavior regarding diabetes mellitus (DM) and periodontal disease (PD) association among a convenience sample of patients from a large Wisconsin-based integrated medical-dental health care organization serving largely rurally based communities. An anonymous 10-question survey was distributed at regional medical and dental centers of dental and medical clinics of a single health care institution over a 4-week period, to achieve a cross-sectional sampling of patients aged 18 to 80 years. Among 946 respondents, 616 were female. Patient-reported periodicity for dental visits was highest between 6 months and 1 year (56.4%). Respondents reporting "poor-fair" knowledgeability surrounding DM-PD association correlated with highest interest in learning more about DM-PD relationship ( p <.0001). While over 80% of respondents correctly answered questions about gum disease symptomology and contribution of oral health practices on diabetes prevention, only 51% knew that PD affected blood sugar control. Willingness to comply with medical screening conducted by dental providers for diseases affecting oral health was indicated by 44% of respondents ( p < .0001). Study results indicated that knowledgeability levels among patients surrounding the effect of PD on DM needed improvement. Strategic educational interventions targeting improved health literacy among patients may further promote prevention of DM-PD complications. Health literacy gaps remain to be addressed in patient understanding of the importance of detecting and managing dysglycemia for maintenance of periodontal health, creating opportunities for patient education.

Globally, periodontal disease and diabetes have achieved epidemic proportions and have become a top health care priority. Mutual bidirectional exacerbation of these conditions is promoting creation of cross-disciplinary integrated care delivery (ICD) models that bridge the traditionally siloed health care domains of dentistry and medicine. By engaging focus groups inclusive of both medical and dental providers and one-on-one interviews, this qualitative study investigated provider knowledgeability, receptiveness, and readiness to engage ICD and sought input from the medical-dental primary care practitioner participants on perceived opportunities, benefits, and challenges to achieving ICD models for patients with diabetes/prediabetes. Statewide regional representation and inclusivity of diverse practice settings were emphasized in soliciting participants. Thematic analysis of focus group and interview transcripts was undertaken to establish current state of the art, gauge receptivity to alternative ICD models, and seek insights from practitioners surrounding opportunities and barriers to ICD achievement. Forty providers participated, and thematic analyses achieved saturation. Providers were well informed regarding disease interaction; were receptive to ICD, including implementation of better screening and referral processes; and favored improving interdisciplinary communication inclusive of access to integrated electronic health records. Perceived barriers and opportunities communicated by participants for advancing ICD were documented.