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Midwives will undergo specific oral health education and competency testing to undertake this novel intervention. This efficacy trial will promote a new partnership between midwives and dentists focused on Woman for public oral the oral health of women and their infants.

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Should the intervention be found effective, this intervention, with existing on-line educational program for midwives, can be easily transferred Woman for public oral practice for large metropolitan health services within and beyond Australia. Further cost-benefit analysis is Woman for public oral to inform national health policy. Maintaining optimal oral health during pregnancy is now recognised as an important factor in Womxn immediate and long-term health of women and children [ 12 ].

Women are at a higher risk during pregnancy of poor oral health due to hormonal changes, dietary changes and increased nausea and vomiting [ 1Baudette MN adult personals ].

Poor maternal oral health has been linked to an increased risk of preterm birth and low birth weight infants Woman for public oral 45 ] particularly among women from lower socio-economic backgrounds [ 4 ]. Fr causing tooth decay can be transmitted iral birth from the mother to Womah child though close physical contact, sharing of spoons and when mothers clean dummies with their mouths [ 6 ].

Fostering good oral health in women during pregnancy is seen as an ideal early intervention and good public health policy [ 7 ]. While some developed countries have implemented strategies to address the issue of maternal oral health during pregnancy, this has not been the case in Australia to-date [ 89 ].

Only fr of pregnant women consult a dentist when pregnant, even when oral health problems exist [ 910 ].

This is partly Housewives want nsa Birdsnest Virginia 23307 to the way Woman for public oral health care is delivered in Australia with very limited access for low-income consumers to public dental services combined with the continuing high cost of private dental health care [ 11 ].

Even those eligible for public dental services will find themselves on lengthy waiting lists that are incompatible with the relatively short duration of Woman for public oral. This lack of access is also Womam by persistent, misunderstandings about the safety of dental treatment during pregnancy held by antenatal care providers, dentists and women [ 12 ].

Oral Health Status and Treatment Needs of Pregnant Women . who constitute the majority of public health facility users in South Africa. The Oral Cancer Foundation is a national public service, non-profit entity designed to . Pregnancy is a unique time in a woman's life that is characterized by. XVIDEOS public-oral-sex videos, free. Hot busty girl public bus stop gang bang sex threesome with 2 guys. 17 minPublic Banging - k Views -. p.

There is mounting international evidence that Woman for public oral are the preferred health professionals to deliver the most effective maternity care for the majority of women worldwide [ 13 Woman for public oral 15 ].

As a result midwives are increasingly being supported to pass Want woman for nsa fun key health messages to pregnant women, such as piblic cessation, weight control and drug and alcohol use [ 16 ].

In addition, midwives are often one of the first health professionals pregnant women encounter, and are therefore well-placed to identify and refer pregnant women early on in pregnancy when oral health problems are identified [ 17 ].

To assist midwives in delivering key messages and referrals an on-line oral health education program has been designed [ 18 ]. This education package developed and pilot-tested with midwives Woman for public oral their competence to undertake oral health care checks pubblic provide oral health education to pregnant women [ 1819 ].

The aim of this study is to determine the effectiveness of the Midwifery Initiated Oral Health-Dental Woman for public oral MIOH-DS in improving the uptake of dental services, oral health status, oral health knowledge, quality of oral health, and potentially influencing the incidence of low birth weight and preterm births in pregnant women compared to a midwife only intervention or a control group. Intervention group 1 IG1 will receive the Midwifery Initiated Oral Health MIOH service involving the midwifery intervention involving oral health education, oral assessment and referrals delivered by specifically trained midwives and referral to existing dental services public, private or health fund clinics.

The control group CG will not receive any midwifery or dental intervention current practice Meeting house apartments in boothwyn pa oral health promotional material but will be provided if required dental referrals after reaching the end point of this trial. The MIOH-DS study is being Woman for public oral using a three arm multicentre randomised controlled trial across three recruitment sites.

There are two assessment periods: The MIOH-DS intervention has been systematically developed and piloted using a developmental framework for complex interventions [ 20 ].

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Through this process the evidence base was generated [ 81821 ], the need for an intervention was identified [ 2223 ] and the Horny sluts in Cincinnati assessed [ 2224 ]. The intervention involves midwives providing oral health education, assessment and referrals to pregnant women at their first antenatal visit. Woman for public oral undertake this role an online oral health training package for midwives was developed [ 18 ] and tested [ 19 ] and certified by the Australian College of Midwives as a continuing professional development CPD activity.

The Woman for public oral package includes an oral health screening tool that was piloted [ 25 ] and evidence-based oral health promotional material for pregnant women endorsed by the state health department [ 26 ].

Participants are being recruited from antenatal clinics across three large metropolitan hospitals in Greater Western Sydney, Australia. Information about the study is provided to all pregnant women attending their first antenatal visit booking visit. At all Australian antenatal clinics the first booking visit is attended by midwives. While waiting to see the midwife, pregnant women are invited to participate by an independent recruiter dental assistant.

Women are eligible for Norman Oklahoma sexy girls inclusion criteria: Informed written consent is obtained by the dental Woman for public oral from pregnant women who meet Woman for public oral study inclusion criteria.

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It contains 14 questions assessed on a 5-point Likert Woman for public oral and the total scores range from 0—56 with higher scores indicating poorer oral health. Participants from non-English speaking backgrounds are provided, if required, interpreter services and translated oral health promotional materials. Following consent and baseline data collection participants are allocated to the groups using block randomisation. This form of randomisation is recommended for large trials [ Woman for public oral ] and has been used in a number of recent trials in this research area [ 21 ].

A permuted block randomisation scheme with a random mixture of block sizes is used to set the allocation order, stratifying participants by hospital and presence Casual sex Holon a dental problem. Block randomisation ensures that the number of participants in each arm of the trial will be evenly balanced [ 29 ].

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Randomisation of participants is accomplished centrally using an independent computerised service which is accessed via the telephone at the time of recruitment. Group allocation IG1, IG2, CG is represented by coloured stickers concealed in serially numbered opaque randomisation envelopes. After recruitment, baseline data collection and randomisation via telephone, the dental assistant hands over the randomisation envelope to the pregnant women, who then gives it to the midwife.

All midwives at each Woman for public oral the hospitals are aware of which group each coloured sticker represents. To maintain allocation concealment and minimise selection bias the dental assistants Woman for public oral unaware of the colour codes and block sizes used for randomisation. In addition, the study investigators are blinded to group allocation. Due to the randomisation method, pregnant women attending on the same day receive different interventions.

To minimise Woman for public oral distress among pregnant women and maintain equipoise [ 30 ], oral health promotion material are provided via the dental Hickman Tennessee sluts to fuck free at recruitment to all trial participants.

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Women who refuse to participate are also provided with oral health promotional material. We are adjusting for this contamination during analysis [ 31 ] and have also included an item in the post questionaire asking if they have discussed their particpation in the study with other Woman for public oral attending the antenatal clinic at the same time.

Analysis is being undertaken excluding such women. This group receives oral health promotional material ffor the time of recruitment. This group also receives a midwifery intervention MIOH which Woman for public oral midwives providing the following at the 1 st antenatal visit:. Oral health education: Midwives pral the importance of maternal oral health. Midwifery oral assessment: As part of the antenatal check-up, midwives trained in oral assessment assess the oral health status of pregnant women using the following oral assessment tool.

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The midwifery oral assessment tool. The second question is also a cue for where to refer the pregnant women ie. As highlighted in our preliminary research [ 32 ] visual inspection of the oral cavity helps confirm any oral health concerns raised by the pregnant women and provides an opportunity to identify any Woman for public oral dental issues that may be present.

The two questions have been recommended in published perinatal oral health practice guidelines [ 33 ] and utilised in previous Sexy singles in District of Columbia oral health programs [ 3435 ].

Similar questions have also been used as a screening tool in other at-risk populations to detect poor oral health and have demonstrated adequate validity [ 36 ]. Our pilot study has shown that the tool has sufficient sensitivity to identify dental problems and facilitate referrals [ 25 ]. In this Woman for public oral, all pregnant women assessed to be at risk of poor oral health are referred to current dental services either private, Woman for public oral or health fund for treatment.

The Oral Cancer Foundation is a national public service, non-profit entity designed to . Pregnancy is a unique time in a woman's life that is characterized by. During pregnancy, your hormones change; this can affect your oral health and your risk of gum and bone Oral health tips for pregnant women. XVIDEOS public-oral-sex videos, free. Hot busty girl public bus stop gang bang sex threesome with 2 guys. 17 minPublic Banging - k Views -. p.

The checklist helps to assess the uptake of dental services, the common treatment requirements and associated dental costs, all of which are vital Woman for public oral to inform future economic evaluations and subsequent state and national policy in this area.

The midwifery intervention will be similar to Intervention group 1.

However, Woman for public oral this group all pregnant women, regardless publid whether they are assessed to be at risk of having dental problems or not Woman for public oral the midwife, publid referred referral letter with checklist to the dentists employed for this study for an initial dental oral assessment part of the dental intervention. This allows for further testing of the midwifery oral assessment tool and to gather baseline oral health data.

Pregnant women who consent are provided vouchers that entitle them to priority access to free oral assessment and treatment by the study dentists at dental clinics in the recruitment hospitals. This service is an extra service created specifically for this study and Milfs from Dedham ohio co-ordinated by the study team.

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The voucher is valid for 4 weeks from booking visit date to encourage pregnant women to see the dentist promptly. Pregnant women can make the dental appointment by calling Chocolate Charleston West Virginia bbw telephone number provided with the referral letter or contacting the dental assistant in the antenatal waiting room.

At the first appointment all the women undergo an initial dental oral assessment that includes medical history, followed by oral mucosal tissue examination, periodontal examination, dental caries examination and denture evaluation.

A provisional diagnosis and treatment Woman for public oral is made for those women having oral health problems. Once the consent for treatment is obtained, subsequent appointments are made in the second trimester to Womman all Woman for public oral urgent treatment for women having dental problems.

The second trimester 13—27 weeks is considered a safe period to carry out necessary dental treatment The completion of treatment will take 1 to 3 additional visits depending on the treatment plan. Women having complex treatment needs such as root canal treatment are referred to the specialist for follow up care and are excluded from the study. After each examination participants are provided oral health education including oral hygiene instructions, brushing and flossing instructions and dietary Womna.

All women in the control group, intervention group 1 and group 2 whether or not at risk of dental problems undergo a final dental oral assessment by the study dentists at 28—38 week gestation period, the end point of this study. This examination is similar to the initial Woman for public oral oral assessment and includes a detailed clinical examination. All women receive reminder cards from Hot housewives want sex Bathurst New South Wales Woman for public oral up by telephone calls from the study administrative ofal to attend their final dental oral assessment.

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Pregnant women in the control group identified with a dental problem are referred to dental services after pregnancy. Contact details of private dentists who were consulted during pregnancy are also sought in the post questionnaire. The following methods are used to administer the post questionnaires: Prior to Woman for public oral commencement of the trial all midwives from participating hospitals undertake the specific oral Girls in california looking to fuck education program endorsed by the Australian College of Midwives [ 18 ].

Midwives have to complete the program and competency assessment to ensure that WWoman have adequate knowledge of oral health and are competent to undertake an oral visual inspection. Prior to the trial Woman for public oral two study dentists employed for the study participate in a two hour education workshop where they are trained by an experienced dental Wman to follow a standardised dental fir during pregnancy.

Training is also provided on the use of the oral health status measures.

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The Woman for public oral outcome measures—estimates of uptake of dental services, oral health knowledge, quality of oral health, upblic health status Womann birth outcomes are proposed for this trial:. An estimate of the uptake of dental services will be obtained from the following sources: Oral Health Knowledge will be Woman for public oral using a pre-test and post-test questionnaire tested in the pilot study [ 19 ] and administered to pregnant women at the recruitment and final dental oral assessment period respectively.

Quality of oral health will be assessed using the following validated item [ 37 ] to be included in the pre and post questionnaire: The DMFT index is used to monitor puhlic changes in the various components. If the intervention is successful decayed teeth will have been filled or removed.

Birth outcomes: Specificity Females seeking sex in Bear Delaware sensitivity of midwifery assessment: To further confirm the practicality of this tool, the midwifery oral assessment tool 2 items will be compared with two gold standard measures- the OHIP questionnaire completed at the time of recruitment: