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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 7  |  Issue : 2  |  Page : 101-105

Prevalence of orofacial pain in pregnant women: A cross-sectional study


1 Department of Public Health Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
2 Department of Oral Pathology & Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
3 Department of Oral Medicine, Diagnosis & Radiology, Faculty of Dentistry, SEGi University, Jalan Teknologi, Petaling Jaya, Selangor, Malaysia
4 Department of Community Medicine, Krishna Institute of Medical Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India

Date of Web Publication28-Dec-2017

Correspondence Address:
Dr. K M Shivakumar
Public Health Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Malkapur, Karad - 415 539, Satara District, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmd.ijmd_43_17

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  Abstract 


Background: Pregnancy is a special time in woman's life, during this period, they are highly vulnerable for oral changes which would cause orofacial pain. Although the orofacial pain is invariably noticed, their basic data on prevalence and its characteristics has not been evaluated so far. The aim of this study was to assess the prevalence of orofacial pain and its characteristics in pregnancy.
Materials and Methods: A descriptive cross-sectional study was conducted among 100 pregnant women to assess the prevalence orofacial pain and its characteristics. Questionnaire regarding sociodemographics, orofacial pain prevalence and severity were administered. Data were collected and analyzed.
Results: Thirty-three percent reported to have orofacial pain. Most participants were aged 20–34 years. Majority (73%) of respondents were completed secondary School and 74% were homemakers. Large number of participants were belong to lower middle (28%), poor (26%), and below poverty line (21%). In regard to stages of pregnancy, 36% of participants were in second trimester, followed by third trimester (33%) and first trimester (31%). Majority (47%) of patient experienced tooth pain due to hot/cold liquids. Spontaneous burning sensation from tongue and oral mucosa was noticed in 8%. Most of the pregnant women suffered from acute pain (65%). With regard to frequency of pain, 31% of pregnant women get 4–5 episodes of pain weekly, which is followed by once a week (27%), and daily pain in (23%). Duration of pain lasts for <1 h in (38%) pregnant women.
Conclusion: Results draws an insight into baseline data on the prevalence orofacial pain and its characteristics. During pregnancy pain was high and the presence of tooth pain was dominant.

Keywords: Orofacial pain; pregnancy; women


How to cite this article:
Shivakumar K M, Patil S, Kadashetti V, Suresh K V, Raje V. Prevalence of orofacial pain in pregnant women: A cross-sectional study. Indian J Multidiscip Dent 2017;7:101-5

How to cite this URL:
Shivakumar K M, Patil S, Kadashetti V, Suresh K V, Raje V. Prevalence of orofacial pain in pregnant women: A cross-sectional study. Indian J Multidiscip Dent [serial online] 2017 [cited 2019 Jul 21];7:101-5. Available from: http://www.ijmdent.com/text.asp?2017/7/2/101/221768




  Introduction Top


Pregnancy is associated with various physical and hormonal changes which directly affects the women's organ systems, including the oral cavity.[1] During pregnancy, altered estrogen and progesterone level increase the permeability of oral vascular structures and reduce immunocompetence, thereby increasing the tendency for inflammation.[2] Pregnant women are more susceptible to gingivitis, tooth mobility, dental caries, and erosion, and thus should receive appropriate preventive oral health care. Pregnant women also frequently require emergency dental services due to episodes of acute dental pain. Dental treatment during pregnancy is influenced by patients and providers. Pregnant women usually do not seek dental treatment due to fear and anxiety about such treatment, low levels of awareness about dental problems, and misconceptions about the effect of dental treatment on fetal development.[3] Although dental pain and oral health assistance during pregnancy are important outcomes in dentistry, their frequency and association with risk factors have not been well characterized in dental care populations. This study is intended to provide the data on the prevalence orofacial pain and its characteristics, among pregnant patients in the Indian population. The results of our study will help to improve the awareness among pregnant patient for the need of preventive and screening services.


  Materials and Methods Top


A descriptive cross-sectional study was conducted to assess the prevalence orofacial pain and its characteristics among the pregnant women attending the outpatient department. Permissions to conduct the study were obtained from the concerned authorities Ethical approval was obtained from the institutional ethical committee. Informed was obtained from the subjects. Sample size of 100 pregnant women was considered. Questionnaire about sociodemographics, orofacial pain prevalence and severity, and other associated factors were administered. Pilot study was conducted among 30 individuals to assess the validity and reliability of the questionnaire. Inclusion criteria constituted of pregnant women (aged 25–40 years) who are willing to participate and present on the day of examination. Exclusion criteria consisted of pregnant women with systemic illness and not consenting to participate in the study.

Questionnaires

We used a questionnaire especially designed for detection of orofacial pain. The questionnaire included items on the types of pain respondents had experienced during the previous 3 months. Orofacial pain was considered to be present if respondents answered positively to any of these questions. Questionnaires were used to collect the information about the experience and severity of orofacial pain in the 3 months before the survey. The participants were asked whether in the last 3 months they had: “spontaneous toothache; toothache caused by hot/cold liquids or sweets; prolonged burning tongue sensation; pain in the jaw or during chewing; pain when opening the mouth, in the face or around/behind the eyes.” The possible answers “yes” or “no” determined the prevalence of orofacial pain. All pregnant women who answered “yes” were also asked about the intensity of pain on a scale of 1 (mild pain) to 4 (very severe).[4] Patients who responded positively to any of these questions completed the third part of the questionnaire, which enquired about the characteristics of orofacial pain. The questions were phrased so as to obtain data on the time when pain occurred, frequency of pain in the past 3 months, and the duration of the last pain episode. In addition, respondents were asked whether they sought medical/dental help, or received treatment, for pain.[5] Data were analyzed using SPSS version 20.0; (SPSS Inc., Chicago, IL, USA). Descriptive and analytical statistics was used to assess all the variables.


  Results Top


[Table 1] shows the demographic details of the patient. Most participants were aged 20–34 years. The majority (73%) of respondents were completed secondary school education and 74% of participants were homemakers. Large number of participants were belong to lower middle (28%), poor (26%), and below poverty line (BPL) (21%). In regard to stages of pregnancy, 36% of participants were in second trimester, followed by third trimester (33%) and first trimester (31%).
Table 1: Sociodemographic details of pregnant woman

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[Table 2] and [Table 3] show the prevalence of orofacial pain. A total of 100 pregnant women participated in the study of which 33% reported to have orofacial pain. Majority (47%) of patient experienced tooth pain due to hot/cold liquids. Spontaneous burning sensation from tongue and oral mucosa was noticed in 8%. Tooth pain was more common pain followed by temporomandibular joints, pain ears, eyes, and pain while chewing. In regard to severity, majority of pregnant patient had moderate-to-severe pain. [Table 4] shows the characteristics orofacial pain in pregnant woman. Most of the pregnant women suffered acute pain (65%). Chronic pain was reported in 35%. With regard to frequency of pain, 31% of pregnant patient gets 4–5 episodes of pain weekly which is followed by once a week (27%) and daily pain (23%). Duration of pain lasts for less than about 1 h in (38%) pregnant women. Large number of patients (74) sought medical help and took medication (67%) for the orofacial pain.
Table 2: Prevalence of orofacial pain in pregnant woman

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Table 3: Severity of orofacial pain (%) in pregnant woman

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Table 4: Orofacial pain characteristics in pregnant woman

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  Discussion Top


Orofacial pain, a condition associated with head, face and neck area as well as intraoral structures. It represents the most common symptoms of oral health problems. It may have social, economic, and psychological consequences for individuals by interfering with behavior, affecting daily activities, and changing health perceptions. Moreover, it can affect the individual's quality of life.[1] Pregnancy is a special time in a woman's life, in which health care should be greater. During pregnancy, proper oral hygiene care must be taken, but appropriate dental care is essential when oral infections and untreated dental caries can harm the health of the mother and baby. The untreated dental problems can result in orofacial pain. This study evaluated the prevalence and severity of orofacial pain and associated factors such as sociodemographic, in patients who were attending the Outpatient Department of Krishna Hospital, Karad, Satara District, India.

In general, orofacial pain is more common among young females. This could be due to synergic act between biological, psychological, and social factors. Women have a greater biological sensitivity to stimuli and lower threshold for labeling stimuli as painful. Moreover, social differences in the upbringing of boys and girls, which make it more acceptable for women to discuss their experience of pain.[6] Orofacial pain influences the general health and quality of life, many reported that a quarter of the general population had orofacial pain at least once during the previous 6 months.[6],[7],[8] The prevalence and characteristics of pain are determined by demographic, economic, and psychosocial factors.[9] Previous studies had proved that lower socioeconomic status are associated with increased risk for orofacial pain and pain-related behavioral impact.[10]

The pregnant women in this study were predominantly between the age of 20–34 years. Majority (73%) of them completed secondary education. Most respondents (75%) were homemaker and 97% were married. Large respondents were belongs to the lower middle (28), poor (26), and BPL. Demographic data are important to characterize the sample because life and work conditions affect the way in which individuals think and feel. In this study, pregnant women were young, completed secondary schooling and were homemaker. Rosell et al.[4] evaluated the prevalence and severity of oral pain in pregnant women. They reported a higher prevalence of pain (58.8%). The tooth pain was more common followed by periodontal problems. Similar finding was reported in the present study.

In this study, the most frequent pain was tooth pain due to hot and cold food (47%) followed by spontaneous pain (33%) and joint pain (23%). This was in accordance with the studies by Rosell et al.[4] However, study by Oliveira and Nadanovsky reported the most frequent pain was due to headaches (61.5%), followed by pelvic pain (59.3%) and orofacial pain (39.1%).[11] de Oliveira and Nadanovsky [11] investigated the effects of oral pain on oral health-related quality of life during pregnancy and measures taken by pregnant women seeking relief for oral pain. They concluded that oral pain during pregnancy was an important problem for this group of women and had a negative effect on their quality of life.

Another study by Locker and Grushka [12] evaluated the prevalence of orofacial pain in general population. They reported a prevalence of 28.8% orofacial pain caused by hot or cold liquids and spontaneous pain in 14.1%. These rates are lesser than reported in the pregnant women. With regard to the severity of orofacial pain, the most frequent pain was that of moderate and severe intensity, these findings were in accordance with studies reported by Locker and Grushka et al.[12] and Wandera.[13] However, it was reported that few participants had severe or very severe pain in all areas. For example, tooth pain due to hot or cold food, severe pain was evident in 12.5% and very severe pain was seen in 7.8%. The tooth pain is the most common pain of dental origin could be due to caries. This problem can be solved by means of prevention programs and access to treatment. Another explanation for the high prevalence of pain related to dental problems may be the fact that other types, such as pain in the face, pain while chewing or in the joints of the jaw, have to be severe before the individuals actually notice.[4]

LeResche et al.[14] evaluated the musculoskeletal pain in the temporomandibular region as well as psychological distress over the course of pregnancy and 1-year postpartum. They noticed that musculoskeletal orofacial pain and related symptoms appear to improve over the course of pregnancy. The improvement in pain is most likely associated with the dramatic hormonal changes occurring during pregnancy.[14] Study by Acharya et al.[15] noticed, highest impact on quality of life due to “painful mouth” and “difficulty in eating.” They suggested an increased health promotion interventions and simple educational, preventive programs on oral self-care and disease prevention during pregnancy is required to improve the oral health and lessening its impact on the quality of life. A study by Keirse and Plutzer [16] showed that pregnant women rated their general health significantly better than their oral health (P< 0.001) and attributed more importance to healthy teeth for their baby than for themselves (P< 0.001). They concluded that many pregnant women do not perceive gingival bleeding as indicating inflammatory disease and seek no professional help for it. Maternity care providers need to devote more attention to oral health in antenatal clinics and antenatal education.


  Conclusion Top


The present data on the prevalence and characteristics of orofacial pain in pregnant women are very important. It provides baseline data on the prevalence, severity and associated factors of orofacial pain among pregnant women, which will help raise the awareness among the people for the need of preventive and screening services among the women in reproductive age.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Gajendra S, Kumar JV. Oral health and pregnancy: A review. New York State Dent J 2004;70:40-4.  Back to cited text no. 1
    
2.
Romero BC, Chiquito CS, Elejalde LE, Bernardoni CB. Relationship between periodontal disease in pregnant women and the nutritional condition of their newborns. J Periodontol 2002;73:1177-83.  Back to cited text no. 2
    
3.
Dinas K, Achyropoulos V, Hatzipantelis E, Mavromatidis G, Zepiridis L, Theodoridis T, et al. Pregnancy and oral health: Utilisation of dental services during pregnancy in Northern Greece. Acta Obstet Gynecol Scand 2007;86:938-44.  Back to cited text no. 3
    
4.
Rosell FL, Valsecki A, Tagliaferro EP, Silvas RC. Prevalence and severity of orofacial pain in pregnant women. Rev Gaucha Odontol Porto Alegre 2014;62:47-51.  Back to cited text no. 4
    
5.
Smiljic S, Savic S, Stevanovic J, Kostic M. Prevalence and characteristics of orofacial pain in university students. J Oral Sci 2016;58:7-13.  Back to cited text no. 5
    
6.
Kohlmann T. Epidemiology of orofacial pain. Schmerz 2002;16:339-45.  Back to cited text no. 6
    
7.
Macfarlane TV, Blinkhorn AS, Davies RM, Kincey J, Worthington HV. Oro-facial pain in the community: Prevalence and associated impact. Community Dent Oral Epidemiol 2002;30:52-60.  Back to cited text no. 7
    
8.
Jones K. Success for a novel approach to priority setting in South Australian public dental clinics. Aust Dent J 2013;58:378-83.  Back to cited text no. 8
    
9.
Cioffi I, Perrotta S, Ammendola L, Cimino R, Vollaro S, Paduano S, et al. Social impairment of individuals suffering from different types of chronic orofacial pain. Prog Orthod 2014;15:27.  Back to cited text no. 9
    
10.
Riley JL 3rd, Gilbert GH, Heft MW. Socioeconomic and demographic disparities in symptoms of orofacial pain. J Public Health Dent 2003;63:166-73.  Back to cited text no. 10
    
11.
de Oliveira BH, Nadanovsky P. The impact of oral pain on quality of life during pregnancy in low-income Brazilian women. J Orofac Pain 2006;20:297-305.  Back to cited text no. 11
    
12.
Locker D, Grushka M. Prevalence of oral and facial pain and discomfort: Preliminary results of a mail survey. Community Dent Oral Epidemiol 1987;15:169-72.  Back to cited text no. 12
    
13.
Wandera MN, Engebretsen IM, Rwenyonyi CM, Tumwine J, Astrøm AN, PROMISE-EBF Study Group. et al. Periodontal status, tooth loss and self-reported periodontal problems effects on oral impacts on daily performances, OIDP, in pregnant women in Uganda: A cross-sectional study. Health Qual Life Outcomes 2009;7:89.  Back to cited text no. 13
    
14.
LeResche L, Sherman JJ, Huggins K, Saunders K, Mancl LA, Lentz G, et al. Musculoskeletal orofacial pain and other signs and symptoms of temporomandibular disorders during pregnancy: A prospective study. J Orofac Pain 2005;19:193-201.  Back to cited text no. 14
    
15.
Acharya S, Bhat PV, Acharya S. Factors affecting oral health-related quality of life among pregnant women. Int J Dent Hyg 2009;7:102-7.  Back to cited text no. 15
    
16.
Keirse MJ, Plutzer K. Women's attitudes to and perceptions of oral health and dental care during pregnancy. J Perinat Med 2010;38:3-8.  Back to cited text no. 16
    



 
 
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