Nruyen J G, Nanayakkara S, Holden A C L. Knowledge, attitudes and practice behaviour of midwives concerning periodontal health of pregnant patients. Int J Environ Res Pub Health 2020; doi:10.3390/ijerph170772246.

Further training and integration is needed.

If you ask 100 Australian midwives how frequently they go to the dentist, 66 say every 6 to 12 months, but 12 only go when they are in pain and 1 never goes at all. Their knowledge of periodontal disease was, however, not correlated with their own personal behaviours.

Most midwives in this study understood that periodontal disease is an inflammatory condition which influences pregnancy outcomes negatively, with correlations to pre-term delivery, low birthweight and pre-eclampsia and also knew the significance of improving oral hygiene and smoking cessation in preventing the disease. Misconceptions included excessive sugar consumption as a risk factor and fluoridated toothpaste as a preventive agent. Only half referred patients at risk to a dentist and 84 felt they were not up to date on the topic.

CPD courses have been shown to increase midwive's knowledge and confidence, other studies show that much of this is lost within a few weeks of the course. Structured pathways of communication and collaboration between the professions may help to improve both oral health and pregnancy outcomes.