Examination of the oral health-related quality of life in rural pregnant women after receiving the Health Evolution Plan services

Document Type : Original research paper


Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran


Introduction: The aim of this study was to examine the quality of life regarding the oral health in pregnant women in the village of Robat Karim after receiving the Health Evolution Plan services. 
Methods: The research sample population was 554 pregnant women who visited the designated dental clinics. After obtaining the informed consent, the data was collected, recorded, handwritten, and analyzed by content analysis method using Maxqda software version 2020. In order to support the accuracy and robustness of the data, the criteria of acceptability, verifiability, and transferability were considered.
Results: There is a significant relationship between education and enjoying oral care. There was a relationship between benefit and pregnancy rank. It was also found that there was no significant relationship between the reason for visits, insurance of paid expenses, and benefit of care. In the qualitative part, there are three themes of dissatisfaction, lack of good psychological sense, physical problems, nine sub-themes, including lack of services, the unwillingness of dentists to provide services, insufficient awareness of pregnant mothers, distrust of the health care system, out-of-pocket payments, complaints about tooth extraction, remorse for not repairing teeth before pregnancy, dysfunction of daily functioning, and pain were extracted from patients’ shared experiences.
Conclusion: Low use of oral care by pregnant women can mean the Health Evolution Plan approaches for pregnant women have failed, hence the impact of oral problems on quality of life (dissatisfaction, physical and mental health problems) for pregnant women.


Main Subjects

  1. Cordero MJA, Leon-Rios XA, Rivero-Blanco T, Rodriguez[1]Blanque R, Expósito-Ruiz M, Gil-Montoya JA. Quality of life during pregnancy and its influence on oral health: a systematic review. JOR. 2019; 8 (1): 74–81.
  2. Shamsi M, Hidarnia A, Shamsadin N. Predictors of Oral Health Care in Pregnant Women Based on Health Belief Model. JHSR. 2012; 8 (4): 624–34.
  3. Georgea A, Dahlenb HG, Blinkhornc A, Shilpi Ajwanid K,, Sameer Bholee K, Ellisf S, et al. Evaluation of a midwifery Torabi et al. initiated oral health-dental service program to improve oral health and birth outcomes for pregnant women: A Multi Center Randomised Controlled Trial. ijns. 2010; 126: 49–57.
  4. Golpasand L, Zakavi F, Taimuri H. Evaluation of community periodontal index of treatment needs in pregnant and non pregnant women[in persian]. jsm. 2011;10(3):309–16.
  5. Shamsi M, Hidarnia A, Niknami S, Atarha M, Jadidi R. Oral health of pregnant women in Arak, Iran. JIIHSR. 2013;12(4):335–65.
  6. 6. Gharizadeh T, Haghdost M, Saberhaji W, Karimi A. A study of DMFT and oral hygiene and gingival status among pregnant women attending ahwaz health centers. [In prsian]. jsm. 2005; 43: 7–40.
  7. Khodadady E, Seyyed S, Hafry S, Dehghan Z. Oral health status of pregnant women in north of Iran (2010-11). GoUMS. 18 (3): 122–7.
  8. Rahimi.sherbaf F, Rabie M, Darvish.narengbon S, Habibi O. The relationship between periodontal disease and preeclampsia in pregnant women. JMCIRI. 2013; 31 (3): 231–6.
  9. Leao A, Sheiham A. Relationship between Clinical Dental Status and Subjective Impacts on Daily Living. J D R. 1995; 74 (7): 1408–13.
  10. Khadem s. dental considerations in pregnant patient. jdtums. 1999; 12 (2): 62–70.
  11. Bayat F, Ebnahmady A, Samadzadeh H, Khoshnevisan M. A Comparative Study of Oral Health Care Systems and Insurance Models in Selected Countries for Development of Suitable Iranian Model. hhsr. 2013; 17 (1): 1–14.
  12. Moradi-Lakeh M., Vosoogh-Moghaddam A. Health sector evolution plan in Iran; equity and sustainability concerns. ijhm. 2015;4(10):637-640
  13. Shadpour K. health sector reform islamic republic of iran. jref. 2006; 10 (3): 6–20.
  14. MoHME. Instructions for family doctor programs in cities under 20,000 people, villagers and nomads. 2016 : 6–55.
  15. Tahni B, Rezayatmand R, Rahimzamani A. dental care utilization after the implementation of “health reform plan in isfahan province. Hakim J. 2020; 23 (2): 201–10.
  16. Shamim S, Maree Johnson B. How Do Dental and Prenatal Care Practitioners Perceive Dental Care During Pregnancy? Current Evidence and Implications. BIRTH. 2012; 39 (3): 238–48.
  17. Ghorban Z, Pakkhesal M., Mohammad j E, Deghatipour M, Tennant M, And, et al. Eastern Mediterranean Health Journal. EMH. 2017; 23 (12): 802–8. 19. 20.
  18. Vieira P, Figueiredo de Oliveira A, Ferreira Lopes F, de Figueiredo Lopes Maia M. Dentists ‘knowledge of oral health during pregnancy: a review of the last 10 years’ publications. CDH. 2015; 32 (2)
  19. Maryam N, Ehsan Z, Sima M, Nader J. Utilization of Dental Services and Its Out-of-Pocket Payments: A Study in Dental Clinics of Ramsar [in persian]. Jmds. 2017; 41 (2): 171–82.
  20. Fakheran O,Keyvanara M, Saied-Moallemi Z,Khademi A. The impact of pregnancy on women’s oral health-related quality of life: a qualitative investigation.BMC.2020:20(1)
  21. McNeil DW, Hayes S, Randall C L,Neiswanger K,Shaffer J, et al. Depression and Rural Environment Are Associated With Poor Oral Health Among Pregnant Women in Northern Appalachia.BM.2016;2(40):325-340.
  22. Kruger M, Lang C, Almeida L, Bello-Correa F, AR R, Pappen F. Dental Pain and Associated Factors Among Pregnant Women: An Observational Study. MCHJ. 2015; 19 (3): 504–10.
  23. Cavalheiro CH, Abegg C, Fontanive VN, Davoglio RS. Dental pain, use of dental services and oral health-related quality of life in southern Brazil. 2016 18; 30 (1).
  24. Karaaslan F, Dikilitaş A. The association between stage[1]grade of periodontitis and sleep quality and oral health ‒ related quality of life. J Periodontol. 2019 90 (10): 1133–41
  • Receive Date: 26 December 2021
  • Revise Date: 27 January 2022
  • Accept Date: 29 January 2022
  • First Publish Date: 29 January 2022