Preconception Oral Health Is Associated with Modifiable Health Behaviors

Abstract

The health of prospective parents before conception (i.e., preconception health) has important intergenerational consequences. Although oral health is associated with several reproductive outcomes, it is often absent from preconception health promotion. To generate insights that may inform preconception oral health interventions, we used cross-sectional data from 6,159 US-based participants enrolled in the Pregnancy Study Online, a prospective cohort study of pregnancy planners, to characterize preconception oral health care engagement and self-rated oral health. We used latent class analysis to identify homogenous subgroups (i.e., latent classes) of participants with respect to modifiable risk behaviors and quantified associations between class membership and 3 outcomes—reporting no dental visit within the past year, reporting no dental cleaning within the past year, and self-rated oral health—using log binomial regression models. We identified 3 distinct groups of participants: healthy behavior, high prevalence of healthy behaviors; some risk behavior, higher sugar-sweetened beverage consumption and lower vaccine uptake and multivitamin use; and most risk behavior, high probability of most risk behaviors, including current or former cigarette smoking. The some risk behavior class was more likely to report no dental visit within the past year as compared with the healthy behavior class (prevalence difference [PD] 0.17; 95% confidence interval [95% CI], 0.14 to 0.19). This association strengthened when most risk behavior was compared with healthy behavior (PD, 0.32; 95% CI, 0.28 to 0.36). Similarly, reporting no dental cleaning within the past year was more prevalent among some risk behavior (PD, 0.19; 95% CI, 0.16 to 0.21) and most risk behavior (PD, 0.38; 95% CI, 0.34 to 0.42) as compared with healthy behavior. The pattern was similar for self-rated oral health. Our findings suggest that oral health care engagement and self-rated oral health are associated with other modifiable behaviors in the preconception period. Health promotion efforts in the preconception period must consider oral health care engagement alongside other modifiable health behaviors.