Utilization of Oral Health Services and Barriers to Dental Visits among Pregnant Women in Alahsa, Saudi Arabia

Utilization of Oral Health Services and Barriers to Dental Visits among Pregnant Women in Alahsa, Saudi Arabia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Utilization of Oral Health Services and Barriers to Dental Visits among Pregnant Women in Alahsa, Saudi Arabia Zainab Lutfi AlSadiq, Syed Akhtar Hussain Bokhari, Nada Suleman, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7834744/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 12 You are reading this latest preprint version Abstract Aim Research reports a limited utilization of dental services among pregnant women. This study explored utilization of oral health services and the barriers to dental visits among pregnant women. Materials and Methods Aanalytical cross-sectional study was carried out at antenatal clinics of two government hospitals in Alahsa. A structured data collection form comprising on demographics, oral health awareness and practices, utilization of dental services and barriers was used through face-to-face interviews. Chi-squared test and regression analysis was performed with a statistical significance level of p < 0.050. Results Among 225 pregnant women, 97% were Saudi with mean age of 30.8 ± 5.8 years, 50% demonstrated high level of oral health awareness, 96% reported good oral hygiene practices and 26% visited dental clinic. Regression analysis showed that participants aged 31–40 years were significantly less likely to visit dental clinics (OR = 0.153, p = 0.017) compared to those aged > 40 years. Participants with low income were significantly less likely to visit dental clinics (OR = 0.385, p = 0.019) compared to high income, and those in the second trimester of pregnancy were significantly less likely to visit dental clinics (OR = 0.197, p = 0.001) compared to the third trimester of pregnancy. Low oral health awareness was also significantly associated with a lack of visits to dental clinics (OR = 0.484, p = 0.040) compared to high oral health awareness. Participants with high incomes had been significantly shown to have barriers in visiting dental clinics (OR = 2.626, p = 0.045) compared to low incomes. Conclusion Most females did not visit the dental clinics and visited only when experienced pain. Many postponed dentalcare due to misperceptions about the importance of oral health, along with worries about pregnancy risks. Age, income, pregnancy stage, and oral health awareness have shown significant role in defining visits to dental care. Income status demonstrated Pregnancy Oral Health Services Utilization Barriers Dental Visits Introduction Pregnancy is a unique stage that involves hormonal, immunologic, dietary, and behavioral changes may impose a burden on women, leading them to neglect their general and oral health ( 1 , 2 ). Various oral pathologies in pregnant women have negative consequences of functional limitations and physical pain that influence quality of life ( 3 , 4 ). Forty percent of pregnant women are affected with periodontal diseases, which are connected to low birthweight, preterm birth, and preeclampsia ( 5 ) and pregnant women with periodontitis are thought to be six times more likely to have low birth weight children ( 6 , 7 ). Prevalence of oral mucosal lesions are higher in pregnant women ( 8 ). Dental caries is also common in pregnant women, with nearly 30% having untreated decay ( 9 ) and caries tend to transmit cariogenic bacteria to their children, who then develop early childhood caries ( 10 ). Regular dental appointments for an oral health check-up and risk assessment are recommended throughout pregnancy ( 3 ). However, numerous studies have found limited utilization of dental services by pregnant women ( 1 , 11 ). Studies conducted in the United States and Australia showed that pregnant women's utilization of dental services was less than 50% and 36%, respectively ( 12 ). In Saudi Arabia, there is an underutilization of dental services by pregnant women ( 13 ) as Moawed et al. (2019) ( 14 ) reported 65% of pregnant women didn’t go to dental clinic and Al-Turck et al., (2021) ( 15 ) recorded 44.5% did not visit the dentist during pregnancy. To improve the delivery of oral healthcare services to expectant mothers, perceived barriers to utilization of care must be identified ( 8 ) and there are some barriers from oral healthcare services to offer suitable treatment and other barriers to pregnant women ( 11 , 16 ). Medical and dental professionals can play an important role in assuring the well-being of women during their pregnancies by promoting and maintaining their oral health ( 14 ). Some dentists are unwilling to perform dental care during pregnancy, thus hindering oral health care, and 61% of pregnant women were not advised by their healthcare providers to visit a dentist during pregnancy. Expectant mothers usually do not consult a gynecologist and do not believe that dental treatment or radiography can be done at any time during pregnancy if necessary ( 17 , 18 ). Other barriers to the utilization of oral health care services are misconceptions about the appropriateness of routine procedures, dental fear, difficulty in accessing dental treatment, time constraints, dissatisfaction with the quality of services, and beliefs that dental treatment is unsafe ( 19 ). In Saudi Arabia, a study reported “local anaesthesia” as the most common cause for avoiding dental visits, second cause was “transportation is difficult” and lastly, “dental treatment is not safe during pregnancy” ( 20 ). In another study, the reported barriers found were negative perception about the safety of dental treatment during pregnancy, the fear/anxiety of dental treatment, transportation problems, dissatisfaction with the quality of dental services, and lack of time to visit a dentist ( 5 ). Each female population faces different barriers to dental visits that cannot be generalized to others. Having very few studies from Saudi Arabia and no previous study from the Alahsa region, this study was designed to assess the utilization of oral health services by pregnant females and investigate barriers to their dental visits. Methodology This study employed an analytical cross-sectional design. The research was conducted at two prominent governmental hospitals: the prenatal clinics at the Maternity and Children Hospital and King Faisal Hospital in Al Ahsa. These facilities were selected because to their substantial patient volume and extensive antenatal services. Moreover, these hospitals receive referrals from basic healthcare providers, underscoring their pivotal role in prenatal care. This study concentrated on pregnant women aged 18 years and older. Pregnant women unable to participate due to physical, mental, or cultural reasons were excluded. Participated in the antenatal clinics at the Maternity, Children Hospital, and King Faisal Hospital in Alahsa. Inclusion Criteria was defined to include pregnant women aged ≥ 18 years. Exclusion Criteria included pregnant women who refuse to consent to participate in the study. Pregnant women who are unable to participate owing to physical, mental, or cultural constraints. A minimum sample size of 218 pregnant women (n) was determined based on an expected prevalence of dental visits during pregnancy of 50% (p), a population size of 500 pregnant women (N), a confidence interval of 95% (d), and a design effect of 1 (DEFF). The sample size was determined to be n = 240, incorporating a 10% adjustment for non-participation. A systematic random sampling method was utilized. The study occurred over three months, from October to December 2023. Data collection was performed by face-to-face interviews with participants prior to their standard prenatal check-ups. The interviews occurred in a private clinic room, attended solely by the participant and the researcher. This guarantees secrecy and promotes candid and transparent responses from participants, since they are more inclined to feel at ease in a secure setting. A standardized 'Data Collection Form' ( 5 , 8 , 10 , 11 , 21 , 22 ) was developed, implemented, and utilized to gather information from study participants via face-to-face interviews. The data collection form encompassed demographic information, obstetric characteristics, oral health awareness, oral hygiene practices, and the utilization and barriers to dental treatments during pregnancy. Section I: Demographic Information and Obstetric Profiles. Section II: Awareness of Oral Health and Practices of Oral Hygiene. Section III: Utilization of Dental Services and Barriers During Pregnancy. A test-retest was performed to ascertain the reliability of the questionnaire among 10 pregnant women. The principal investigator conducted the study independently to ensure uniformity. A pilot research was done with 10 pregnant women to validate the questionnaire. The pilot test feedback facilitated the refinement of the language and structure of the questions, so ensuring the final version of the questionnaire's validity for the study's objectives. The study's findings cannot be extrapolated to the national or global population due to the restricted geographical scope, as it concentrated solely on a single region in the Eastern Province of Saudi Arabia. Statistical analysis was performed utilizing the Statistical Package for Social Sciences (IBM SPSS Statistics for Windows, Version 22.0). Descriptive statistics were employed to encapsulate the demographic and health-related information, encompassing frequencies for categorical data and mean and standard deviation (S.D.) for numerical data. The chi-squared test was employed to investigate relationships between independent variables (general characteristics of research participants, oral health awareness, and oral hygiene habits) and the dependent variable (utilization/barriers to dental services during pregnancy). Binary logistic regression was utilized to ascertain determinants of the utilization and non-utilization of dental care, as well as to uncover predictors of misconceptions and barriers to dental services during pregnancy. The statistical significance threshold was established at p < 0.05, accompanied by a 95% confidence range. Results Sample profile A total of 225 pregnant women participated in the present study. Participants' ages varied from 18 to 45 years, with the predominant group being 30 years or younger. Over fifty percent (52.9%) had achieved a college degree or higher. A significant proportion were unemployed (77.3%), and 67.1% were without health insurance coverage. The average total monthly family income was 9,166.8 Saudi Riyals, with a range from 1,000 to 30,000 Saudi Riyals. More than half of the participants (58.7%) have a poor income. Sixty percent of the subjects were in their third trimester. While 14.2% had no prior pregnancies, 20.0% had no offspring. A significant majority (79.1%) indicated that they received consistent prenatal care (Table 1 ). Table 1 Frequency distribution of sociodemographic characteristics, oral health awareness score, and oral hygiene scores among participants, and comparison between pregnant women who visited a dental clinic (n = 58) and those who did not (n = 167). Sociodemographic Characteristics Total n (%) Not Visit n (%) Visit n (%) P value (OR, 95% CI) Visited/Not visited Age ≤ 30years 114 (50.7) 85 (74.6) 29 (25.4) 1.000 (1.03, 0.57–1.88) > 30years 111(49.3) 82 (73.9) 29 (26.1) Education ≤ School Education 106 (47.1) 84 (79.2) 22 (20.8) 0.127 (1.65, 0.89–3.05) ≥ College Education 119 (52.9) 83 (69.7) 36 (30.3) Employment status Not employed 174(77.3) 133 (76.4) 41 (23.6) 0.202 (1.62, 0.82–3.19) Employed (Government/Private) 51(22.7) 34 (66.7) 17 (33.3) Income per month from all resources Low income (≤ 9166.8 Saudi Riyals) 132 (58.7) 108 (81.8) 24 (18.2) 0.003* (2.59, 1.40–4.77) High income (> 9166.8 Saudi Riyals) 93 (41.3) 59 (63.4) 34 (36.6) Insurance No 151 (67.1) 112 (74.2) 39 (25.8) 1.000 (0.99, 0.52–1.87) Yes 74 (32.9) 55 (74.3) 19 (25.7) Stage of pregnancy First trimester (1–3 months) 18 (8.0) 12 (66.7) 6 (33.3) 0.001* Second trimester (4–6 months) 71 (31.6) 64 (90.1) 7 (9.9) Third trimester (7–9 months) 136 (60.4) 91 (66.9) 45 (33.1) Number of pregnancies before None 32 (14.2) 25 (78.1) 7 (21.9) 0.277 ≤Two 93 (41.3) 73 (78.5) 20 (21.5) ≥Three 100 (44.4) 69 (69.0) 31 (31.0) Number of children None 45 (20.0) 35 (77.8) 10 (22.2) 0.347 ≤Two 97 (43.1) 75 (77.3) 22 (22.7) ≥Three 83 (36.9) 57 (68.7) 26 (31.3) Prenatal care Irregular (≥ 2 Months) 47 (20.9) 35 (74.5) 12 (25.5) 0.965 (1.01, 0.48–2.12) Regular (Monthly) 178 (79.1) 132 (74.2) 46 (25.8) Oral health awareness score Low score 112 (49.7) 91 (81.3) 21 (18.8) 0.016* (2.11, 1.13–3.90) High score 113 (50.2) 76 (67.3) 37 (32.7) Oral Hygiene score Poor score 9 (4.0%) 7 (77.8) 2 (22.2) 1.000 (1.22, 0.24–6.07) High score 216 (96.0) 160 (74.1) 56 (25.9) OR = Odds Ratio; P-value < 0.05, *=Significant Awareness of oral health Among all participants, only 49.8% recognized that dental consultations are permissible during pregnancy. Although 72% accepted that hormonal fluctuations during pregnancy can influence dental health, merely 27.1% recognized the correlation between oral illnesses and negative pregnancy outcomes. Overall, 50.2% of the participants achieved a high awareness score level (Table 1 ). Oral hygiene practices almost all participants (96.4%) indicated that they clean their teeth, with 97.3% brushing at least once daily. Nonetheless, the use of supplementary oral hygiene methods, including dental floss and mouthwash, was restricted; 77.8% indicated they did not employ any adjunctive hygiene aids. Notwithstanding this, a high oral hygiene score level was recorded among 96% of participants (n = 216) (Table 1 ). Dental care utilization The study found that only 58 pregnant women pursue dental consultations. The majority (89.7%) did so due to pre-existing oral health issues, whereas only 10.3% pursued preventative care, and 5.2% were referred through prenatal care. Most of these appointments consisted of a solitary consultation (70.7%), indicating a problem-focused approach to dental care rather than a preventive strategy. On the other hand, self-reported reasons for not pursuing dental care during pregnancy was affirmed by 167 (74.2%) pregnant women. Most of the non-utilizers (79%) were affected by misconceptions. The prevalent misconceptions encompassed the notion that dental care is unnecessary in the absence of symptoms (44.3%), apprehensions that dental therapy may jeopardize the pregnancy (28.7%), and a widespread perception that oral health is insignificant during pregnancy (5.4%). Practical barriers, like financial constraints, time limitations, transportation difficulties, or restricted access to dental clinics, were identified by 21.6% of the women. Sociodemographic features and dental consultations during pregnancy Income and gestational stage identified as the sole significant determinants affecting dental care utilization. Women with higher incomes (exceeding 9,166.8 SAR) were more inclined to pursue dental treatment, while low-income women saw a 62% decrease in utilization. In terms of gestational stage, women in the second trimester had the lowest dental visit attendance at 9.9%, in contrast to 33.3% in the first trimester and 33.1% in the third trimester. High oral health awareness was significantly associated with greater utilization of dental services during pregnancy, whereas oral hygiene score showed no significant association (Table 1 ). The analysis demonstrated a significant correlation between oral health knowledge (low versus high), oral hygiene behaviours (poor versus good), and sociodemographic characteristics. Factors such as employment status, income, health insurance coverage and oral hygiene score, were substantially correlated with oral health awareness. Unemployed women, had lower incomes, or lack health insurance exhibited diminished levels of awareness. Additionally, good oral hygiene was strongly associated with higher oral health awareness among pregnant women (Table 2 ). Conversely, pregnant women with regular prenatal care had 5.17 times higher odds of having good oral hygiene compared to those with irregular prenatal care (Table 3). Table 2 Association Between Oral Health Awareness (Low vs High) and Sociodemographic Factors Among Pregnant Women [N = 225) Sociodemographic Characteristics Low awareness level (n = 112) High awareness level (n = 113) P value (OR, 95% CI) n (%) n (%) Age groups 30years 56 (50.5) 55 (49.5) Education ≤ School Education 59 (55.7) 47 (44.3) 0.110 (1.56, 0.92–2.64) ≥College Education 53 (44.5) 66 (55.5) Employment status Not employed 94 (54.0) 80 (46.0) 0.019* (2.15, 1.12–4.11) Employed (Government/Private) 18 (35.3) 33 (64.7) Income per month from all resources Low income (≤ 9166.8 Saudi Riyals) 74 (56.1) 58 (43.9) 0.025* (1.84, 1.07–3.16) High income (> 9166.8 Saudi Riyals) 38 (40.9) 55 (59.1) Insurance No 83 (55.0) 68 (45.0) 0.026* (1.89, 1.07–3.33) Yes 29 (39.2) 45 (60.8) Stage of pregnancy First trimester (1–3 months) 8 (44.4) 10 (55.6) 0.878 Second trimester (4–6 months) 35 (49.3) 36 (50.7) Third trimester (7–9 months) 69 (50.7) 67 (49.3) Number of pregnancies before None 17 (53.1) 15 (46.9) 0.749 ≤Two 48 (51.6) 45 (48.4) ≥Three 47 (47.0) 53 (53.0) Number of children None 21 (46.7) 24 (53.3) 0.89 ≤Two 49 (50.5) 48 (49.5) ≥Three 42 (50.6) 41 (49.4) Prenatal care Irregular prenatal care 24 (51.) 23 (48.9) 0.843 (1.06, 0.56–2.03) Regular prenatal care 88 (49.4) 90 (50.6) Oral Hygiene score Poor 8 (88.9) 1 (11.1) 0.017* (8.61, 1.05–70.06) Good 104 (48.1) 112 (51.9) OR = Odds Ratio; P-value < 0.05, *=Significant Table 3. Association Between Oral Hygiene Practices and Sociodemographic Factors Among Pregnant Women (N=225) Sociodemographic Characteristics Poor Oral Hygiene Practices (n=9) Good Oral Hygiene Practices (n=216) P value (OR, 95% CI) n (%) n (%) Age groups Group1 (30years) 7 (6.3) 104 (93.7) Education ≤ School Education 6 (5.7) 100 (94.3) 0.230 (2.32, 0.56 - 9.51) ≥College Education 3 (2.5) 116 (97.5) Employment status Not employed 8 (4.6) 166 (95.4) 0.398 (2.41, 0.29 - 19.7) Employed (Government/Private) 1 (2.0) 50 (98.0) Income per month from all resources Low income (≤9166.8 Saudi Riyals) 6 (4.5) 126 (95.5) 0.619 (1.42, 0.34 – 5.86) High income (>9166.8 Saudi Riyals) 3 (3.2) 90 (96.8) Insurance No 8 (5.3) 143 (94.7) 0.156 (4.08, 0.50 – 33.2) Yes 1 (1.4) 73 (98.6) Stage of pregnancy First trimester (1-3 months) 0 (0.0) 18 (100.0) 0.664 Second trimester (4-6 months) 3 (4.2) 68 (95.8) Third trimester (7-9 months) 6 (4.4) 130 (95.6) Number of pregnancies before None 0 (0.0) 32 (100.0) 0.408 ≤Two 5 (5.4) 88 (94.6) ≥Three 4 (4.0) 96 (96.0) Number of children None 0 (0.0) 45 (100.0) 0.308 ≤Two 5 (5.2) 92 (94.8) ≥Three 4 (4.8) 79 (95.2) Prenatal care Irregular prenatal care 5 (10.6) 42 (89.4) 0.021* (5.17, 1.33 - 20.12) Regular prenatal care 4 (2.2) 174 (97.8) OR=Odds Ratio; P-value < 0.05, *=Significant Determinants of dental service usage Multivariate logistic regression study indicated that, following the adjustment for additional factors, certain correlations reversed direction. Women with elevated salaries were less inclined to utilize dental care throughout pregnancy, although looking more probable in the unadjusted study. Likewise, elevated oral health awareness shown a positive initial correlation with utilization; however, this effect diminished and slightly reversed following adjustment. These alterations indicate that additional factors—such as gestational stage or access impediments—may have affected the observed trends. Women in their second trimester are much less likely to pursue dental care than those in the first trimester (Table 4 ). Table 4 Logistic Regression: Likelihood of Not Utilizing Dental Services Versus Utilizing Dental Services Among Pregnant Women (N = 225) Sociodemographic Characteristics P value (Unadjusted OR, 95% CI) P value (Adjusted OR, 95% CI) Income per month Low income (≤ 9166.8 Saudi Riyals) 0.003 (2.59, 1.40–4.77) 0.006 (0.32, 0.14–0.73) High income (> 9166.8 Saudi Riyals) . Stage of pregnancy First trimester (1–3 months) Second trimester (4–6 months) 0.001 0.000 (0.19, 0.07–0.48) Third trimester (7–9 months) Oral health awareness score Low awareness 0.016 (2.11, 1.13–3.90) 0.050 (0.50, 0.25–1.00) High awareness Variable(s) entered; age, education, employment, income, pregnancy before, no. Of child, insurance, stage of pregnancy, awareness, prenatal care Examination of the Underutilization of Dental Services : Among women who did not access dental services, those with higher income were markedly less likely to identify misperceptions as the primary obstacle compared to their lower-income counterparts (OR = 0.40, 95% CI: 0.18–0.86, p = 0.017). The insurance status did not show a significant correlation with the stated kind of barrier; nevertheless, uninsured women exhibited a higher likelihood of stating misperceptions (OR = 2.13, 95% CI: 0.86–5.26, p = 0.096). The number of children had a borderline connection (p = 0.067), with women having three or more children more often citing practical reasons than those with fewer or no children (Table 5 ). A logistic regression analysis was performed to examine the factors influencing the non-utilization of dental treatment among pregnant women who did not visit a dentist, distinguishing between misconceptions and practical or emotional barriers. All sociodemographic variables, together with oral hygiene and awareness levels, were incorporated as independent variables. Women with elevated monthly income were markedly more inclined to cite misconceptions rather than practical obstacles as the rationale for non-utilization after adjustment (AOR = 2.99, 95% CI: 1.08–8.26, p = 0.034). The unadjusted model indicated a contrary pattern (OR = 0.40, p = 0.017). The insurance status was not significantly correlated with the type of barrier reported; nevertheless, insured women exhibited a tendency towards reduced odds of reporting misunderstandings compared to their uninsured counterparts in the adjusted model (AOR = 0.36, 95% CI: 0.12–1.00, p = 0.052). The overall correlation between the number of children and the reported type of barrier is statistically significant; however, when comparing each specific group (no children vs. ≥3, ≤ 2 vs. ≥3), the adjusted results lack significance—probably due to smaller sample sizes and broader confidence intervals (Table 6 ). Table 5 Association Between Barries and Sociodemographic Factors Among Pregnant Pregnant Women Who Not visited Dental clinic/ Not utilized dental services (N = 167) Sociodemographic Characteristics Others/practical reasons 34 (20.5%) Misperception 132 (79.5%) P value (OR, 95% CI) n (%) n (%) Age groups 30years) 20 (24.4) 62 (75.6) Education ≤ School Education 14 (16.7) 70 (83.3) 0.218 (0.62, 0.28–1.33) ≥College Education 20 (24.4) 62 (75.6) Employment status Not employed 26 (19.7) 106 (80.3) 0.621 (0.79, 0.32–1.96) Employed (Government/Private) 8 (23.5) 26 (76.5) Income(monthly) Low income (≤ 9166.8 Saudi Riyals) 16 (15.0) 91 (85.0) 0.017* (0.40, 0.18–0.86) High income (> 9166.8 Saudi Riyals) 18 (30.5) 41 (69.5) Insurance No 27 (24.1) 85 (75.9) 0.096 (2.13, 0.86–5.26) Yes 7 (13.8) 47 (87.0) Stage of pregnancy First trimester (1–3 months) 2 (16.7) 10 (83.3) 0.519 Second trimester (4–6 months) 16 (25.0) 48 (75.0) Third trimester (7–9 months) 16 (17.8) 74 (82.2) Number of pregnancies before None 3 (12.5) 21 (87.5) 0.151 ≤Two 12 (16.4) 61 (83.6) ≥Three 19 (27.5) 50 (72.5) Number of children None 7 (20.6) 27 (79.4) 0.067 ≤Two 10 (13.3) 65 (86.7) ≥Three 17 (29.8) 40 (70.2) Prenatal care Irregular prenatal care 6 (17.1) 29 (82.9) 0.582 (0.76, 0.28–2.01) Regular prenatal care 28 (21.4) 103 (78.6) Oral health awareness score level Law score 19 (20.9) 72 (79.1) 0.889 (1.05, 0.49–2.25) High score 15 (20.0) 60 (80.0) Oral hygiene score Poor 3 (42.9) 4 (57.1) 0.134 (3.09, 0.65–14.5) Good 31 (19.5) 128 (80.5) OR = Odds Ratio; P-value < 0.05, *=Significant Table 6 Likelihood of Reporting Practical Barriers Versus Misconceptions for Not Utilizing Dental Services Among Pregnant Women Who Did Not Visit the Dentist (N = 167) Sociodemographic Characteristics P value (Unadjusted OR, 95% CI) P value (Adjusted OR, 95% CI) Income per month Low income (≤ 9166.8 Saudi Riyals) 0.017* (0.40, 0.18–0.86) 0.034 (2.99, 1.08–8.26) High income (> 9166.8 Saudi Riyals) Insurance No Yes 0.096 (2.13, 0.86–5.26) 0.052 (0.36, 0.12- 1.00) Number of children 0.037 None 0.355 (0.32, 0.02–3.55) ≤Two 0.067 0.314 (2.47,0.42–14.50) ≥Three Variable(s) entered; age, education, employment, income, pregnancy before, no. Of child, insurance, stage of pregnancy, awareness, prenatal care Discussion Good oral health care is essential for antenatal mothers. Studies have reported limited utilization of oral health services and have examined the reasons for avoidance of dental treatment during pregnancy ( 23 – 25 ). This study explored the utilization of oral health care services by pregnant women and identified the barriers faced by them in visiting dental clinics to receive treatment. Findings of this study show that half of the participants had high level of oral health awareness, majority reported good oral hygiene practices, one-quarter visited a dental clinic during pregnancy. It was observed that the participants had misperceptions regarding dental visits including absence of dental problems, oral health was not or less important during pregnancy, and potential negative effects of dental treatment on pregnancy status. Barriers to visit dental clinics included inconvenience in accessing dental services, dental fears, accessibility, and dissatisfaction with the quality of services, personal reasons, and multiple reasons. Ninety seven percent of participants were Saudi national, consistent with a local study by Azab et al. (2024) ( 1 ), 47% were aged 21–30 years, which is inconsistent with a study (Swathi et al., 2021) ( 26 ), half of the women had a college or higher education, in contrast with pregnant women of the United Arab Emirates;( 27 ). Seventy-seven percent reported as unemployed, which is comparable with 75% of unemployed pregnant women in another study ( 13 ).Ahmed et al. (2019) ( 13 ) reported that 20% of participants’ income was more than 10,000 Saudi Riyals, while in our study, 41% were classified as having high income (SAR 9166.8). Insurance coverage for dental treatment is crucial as it plays a significant role in improving access to oral healthcare and reducing financial barriers. Thirty-two point six percent of pregnant females in the cities of Khobar, Dammam, and Qatif, Saudi Arabia, have insurance coverage, as reported by another study ( 5 ), which is similar to pregnant females in Alahsa, where 33% had insurance. In a study conducted by Albasry et al. (2019) ( 5 ), 41% of pregnant women were in their third trimester, 33% in second trimester and 26% in first trimester. Similarly, this study found a comparable sequence, with 60% in third trimester, 32% in second trimester, and 8.0% in the first trimester. The findings of this study show that 14% women were in their first pregnancy, and 86% had multiple pregnancies that is comparable with another study (Saddki et al. 2010) ( 8 ). 41% participants of this study had two or fewer children, 44% had three or more, and 14% had no children that is comparable with a similar Tanzanian study ( 28 ). Antenatal care is available in Saudi Arabia throughout pregnancy, however women turning up to use this facility is very low, and studies have noted poor utilization of the service ( 29 ). In this study, 79% of participants have received monthly antenatal care. Our study results presented that a quarter of women (25.8%) visited dental clinics during pregnancy that is comparable with other studies. Gaffar et al. (2016) ( 2 ) reported 18%, Albasry et al. (2019) ( 5 ) 13.7% and AlHumaid et al (2024) ( 6 ) mentioned 22.5% of pregnant women visited dental offices for dental check-up. John and AlMesmar (2021) ( 30 ) found that dental attendance during pregnancy in Dubai was 17.4% and in China it was 16.7% (Sun et al., 2014) ( 31 ). Centre for Disease Control and Prevention (CDC) using Pregnancy Risk Assessment Monitoring System (PRAMS) data reported that half of pregnant women had routine dental care during pregnancy (Lee et al., 2024) ( 32 ) and Barman et al. (2019) ( 11 ) showed 29.7% of pregnant women in India. Saddki et al. (2010) ( 8 ) found that 10.2% of the participants reported oral health as not or less important and this study showed 5% of participants had a similar perception. A systematic review (Kamalabadi et al., 2023) ( 33 ) highlighted negative attitudes, such as concerns about dental procedures potentially harming the fetus that often discourage pregnant women from seeking dental care, which was not investigated in this study. Saddki et al. (2010) ( 8 ) reported 15.9% of participants were concerned about the negative effects of dental treatment on their pregnancy, 29% of participants in this study reported similar concerns. The study by Albasry et. al. (2019) ( 5 ) regarding barriers revealed that the inconvenience of dental services was 8.1%, the fear/anxiety of dental treatment was 17%, accessibility to the dental clinic was 0.7%, lack of time to visit a dentist was 2.2%, and dissatisfaction with the quality of dental services was 1.5%. These figures align closely with the findings of our study, such as inconvenience of dental services (7.8%), accessibility to dental clinics (0.6%), personal reasons (1.8%), and dissatisfaction with the quality of dental services by 0.6% women, but dental fear reported by 3.6% of females in this study is inconsistent. Adverse beliefs regarding oral health and dental care utilization are prevalent among pregnant women and across a wide range of geographic areas ( 33 ) that is consistent with our study. A professional determines normative needs using recognized dental health parameters and clinical exams ( 34 ). According to our research, 44.3% of pregnant women did not seek dental care because they believed they had no problems. Since they might not be aware of the underlying oral health issues that potentially necessitate professional attention, this suggests a discrepancy between perceived and possible normative demands. Conclusion The study identifies the gaps in dental care utilization among pregnant women. Pregnant participants were observed as having high level of oral health awareness, good oral hygiene practices. One-quarter visited a dental clinic and only a few had regular visits due to antenatal care advice. Majority of the participants had oral/dental problems. The women demonstrated misperceptions regarding dental visits; such as the absence of dental problems, oral health not or less important, potential negative effects of dental treatment on pregnancy status. The reported barriers included inconvenience in accessing dental services, dental fears, accessibility to dental clinics, and dissatisfaction with the quality of services, personal reasons, and multiple other reasons. Strengths of the Study Strengths of this study include 1. first multi-centered study from Alahsa, Saudi Arabia to explore the utilization of oral health services and the barriers to dental visits experienced by pregnant women; 2. conduction of the study by a single examiner minimized the discrepancies in administering the questionnaire; 3. selection bias was minimized due to systematic random sampling; 4. research provides insights into the relationship between dental visit avoidance with socio-demographic factors, oral health awareness, oral hygiene practices and utilization of dental services. Limitations of Study Limitations of this study include 1. cross-sectional study design that provides a glimpse of the parameters at one point in time, like a snapshot, 2. absence of dental examinations to determine the treatment needs 3. information about family members, personal habits like smoking, family support, work environment, and the impact of social media on perceptions were not explored, which could further influence the utilization of dental care among pregnant women. Recommendations To improve the utilization and minimize the barriers to dental services among pregnant women, several steps may be taken: First, healthcare providers need to integrate oral health education and dental check-up during prenatal care visits to address common misperceptions regarding dental treatments during pregnancy, Second, collaboration between obstetricians and dentists in developing and activating referral system that encourages pregnant women to seek dental care, Third, increased access to dental clinics through flexible appointments and prioritization for pregnant women, Increasing insurance coverage for dental services during pregnancy may lessen economic challenges and increase dental visits. Abbreviations AOR-Adjusted Odds Ratio OR-Odds Ratio PRAMS Pregnancy Risk Assessment Monitoring System SPSS Statistical Package for Social Sciences Declarations Ethical Declarations This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Deanship of Scientific Research at King Faisal University [KFU-REC-2023-JUN-ETHICS958], and from AlAhsa Health Cluster [IRB KFHH No. (H-05-HS-065)] prior to data collection. Informed consent was obtained from all participants. Declaration of Conflict Declared as None Funding None Data availability All relevant data and supporting information files generated and/or analyzed during this study are available from the corresponding author upon reasonable request.The data sets can be accessed on request to corresponding author. Authors’ contributions Conceptualization: Z.A. and S.A.H.B.; Formal analysis: Z.A.; Investigation and Methodology: Z.A.; E.F.N.. N.S. and S.A.H.B; Supervision: S.A.H.B.; Visualization: M.F.U. and N.S..; Writing – original draft: Z.A.; Writing – review & editing: W.A.; M.F.U.; and S.A.H.B Consent for publication Not applicable Clinical Trial Number Not applicable References Azab RY, Binyaseen JA, Almuwallad AS, Alomiri SS, Faden NM, Ramadan MM et al. Treatment Perception and Utilization of Dental Care During Pregnancy Among Women Visiting Antenatal Clinics in King Abdulaziz Medical City & Primary Healthcare, National Guard, Jeddah, Saudi Arabia. Cureus. 2024;16(3). Gaffar B, El Tantawi M, Al Ansari A, Al Agl A. Association between oral health knowledge and practices of Saudi pregnant women in Dammam, Saudi Arabia. EMHJ-Eastern Mediterranean Health J. 2016;22(6):411–6. Javali MA, Saquib SA, Khader MA, Khalid I, AlShahrani AY, Kanji MA, et al. Oral health knowledge, attitude, and practice of pregnant women in Deccan, South India: a cross-sectional prenatal survey. J Med Life. 2022;15(3):420. Lu H-X, Xu W, Wong MCM, Wei T-Y, Feng X-P. Impact of periodontal conditions on the quality of life of pregnant women: a cross-sectional study. Health Qual Life Outcomes. 2015;13:1–14. Albasry Z, Alhaddad B, Benrashed MA, Al-Ansari A, Nazir MA. A cross-sectional analysis of dental care utilization among pregnant women in Saudi Arabia. Open access Macedonian J Med Sci. 2019;7(23):4131. AlHumaid GA, Alshehri T, Alwalmani RM, Alsubaie RM, Alshehri AD, Aljoghaiman E et al. Assessment of Oral Health Status and Pregnancy Outcomes Among Women in Saudi Arabia. Patient Prefer Adherence. 2024:1027–38. Hammad OA, Binsaad SM, Gasim RA, Jambi S, Haidary R, Afandi A, et al. Assessing expectant mothers’ knowledge and beliefs about oral healthcare during infancy and pregnancy: a cross sectional survey in Saudi Arabia. Pesqui Bras Odontopediatria Clin Integr. 2018;18(01):e4027. Saddki N, Yusoff A, Hwang YL. Factors associated with dental visit and barriers to utilisation of oral health care services in a sample of antenatal mothers in Hospital Universiti Sains Malaysia. BMC Public Health. 2010;10:1–11. Robison V, Bauman B, D’Angelo DV, Espinoza L, Thornton-Evans G, Lin M. The impact of dental insurance and medical insurance on dental care utilization during pregnancy. Matern Child Health J. 2021;25:832–40. Liu PP, Wen W, Yu KF, Gao X, Wong MCM. Dental care-seeking and information acquisition during pregnancy: a qualitative study. Int J Environ Res Public Health. 2019;16(14):2621. Barman D, Ranjan R, Kundu A. Factors associated with dental visit and barriers to the utilization of dental services among tribal pregnant women in Khurda district, Bhubaneswar: a cross-sectional study. J Indian Soc Periodontology. 2019;23(6):562–8. Rahebi D, Valadbeigi T, Hasani J, Hajipour M, Erfanpoor S, Etemad K, et al. 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Qualitative exploration of barriers and facilitators of dental service utilization of pregnant women: A triangulation approach. BMC Pregnancy Childbirth. 2018;18:1–11. Maybodi FR, Vaziri F, Bidoki NZ, Fakhari M. Knowledge and Practice of General Dentists and Dental Students about Treatment Considerations during Pregnancy and lactation in Yazd, Iran. J Midwifery Reproductive Health. 2022;10(1):3144–54. Rocha JS, Arima L, Chibinski AC, Werneck RI, Moysés SJ, Baldani MH. Barriers and facilitators to dental care during pregnancy: a systematic review and meta-synthesis of qualitative studies. Cadernos de saude publica. 2018;34:e00130817. Dar-Odeh N, Binsaad SM, Gasim RA, Haidary R, Afandi A, Abu-Hammad S, et al. Why do women avoid dental visits during pregnancy? A cross-sectional survey in al madinah, Western Saudi Arabia. Pesquisa Brasileira em Odontopediatria e Clin Integrada. 2018;18(1):3934. Amin M, ElSalhy M. Factors affecting utilization of dental services during pregnancy. J Periodontol. 2014;85(12):1712–21. Malkawi ZA, Tubaishat RS. Knowledge, practice and utilization of dental services among pregnant women in the north of Jordan. J Contemp Dent Pract. 2014;15(3):345–51. Pinasti RA, Agustia L. Determinants Factors to Increase Dental Care During Pregnancy: A Systematic Review. J Syiah Kuala Dentistry Soc. 2023;8(1):61–8. Testa A, Jackson DB, Simon L, Ganson KT, Nagata JM. Stressful life events, oral health, and barriers to dental care during pregnancy. J Public Health Dent. 2023;83(3):275–83. Al-Swuailem A, Al-Jamal F, Helmi M. Treatment perception and utilization of dental services during pregnancy among sampled women in Riyadh, Saudi Arabia. Saudi J Dent Res. 2014;5(2):123–29. Swathi K, Koothati RK, Motor RR, Priyadarshini, RajaShekar CH, Vallakonda S. Knowledge and Experience of Women about Dental Services Utilization during Pregnancy: A Cross-Sectional Questionnaire Study. J Pharm Bioallied Sci. 2021;13(Suppl 2):S1042–6. Hashim R. Self-reported oral health, oral hygiene habits and dental service utilization among pregnant women in United Arab Emirates. Int J Dent Hyg. 2012;10(2):142–6. Mwangosi IE, Kiango MM. Oral health experience during pregnancy and dental service utilization in Bariadi District, Tanzania. Tanzan J Health Res. 2012;14(2):146–51. Alanazy W, Brown A. Individual and healthcare system factors influencing antenatal care attendance in Saudi Arabia. BMC Health Serv Res. 2020;20(1):49. John S, AlMesmar HS. Oral Health Status, Oral Hygiene Practices, and Factors Affecting Dental Treatment Utilization among Pregnant Women in Dubai. Dubai Med J. 2021;4(4):320–8. Sun W, Guo J, Li X, Zhao Y, Chen H, Wu G. The routine utilization of dental care during pregnancy in eastern China and the key underlying factors: a Hangzhou City study. PLoS ONE. 2014;9(6):e98780. Lee H, Ramphoma KJ, Horowitz AM, Walker D. Oral health is an integral part of maternal and child health. Springer; 2024. Kamalabadi YM, Campbell MK, Zitoun NM, Jessani A. Unfavourable beliefs about oral health and safety of dental care during pregnancy: a systematic review. BMC Oral Health. 2023;23(1):762. Baskaradoss JK, Geevarghese A. Utilization of dental services among low and middle income pregnant, post-partum and six-month post-partum women. BMC Oral Health. 2020;20(1):120. Additional Declarations No competing interests reported. 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Various oral pathologies in pregnant women have negative consequences of functional limitations and physical pain that influence quality of life (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Forty percent of pregnant women are affected with periodontal diseases, which are connected to low birthweight, preterm birth, and preeclampsia (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) and pregnant women with periodontitis are thought to be six times more likely to have low birth weight children (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Prevalence of oral mucosal lesions are higher in pregnant women (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Dental caries is also common in pregnant women, with nearly 30% having untreated decay (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) and caries tend to transmit cariogenic bacteria to their children, who then develop early childhood caries (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRegular dental appointments for an oral health check-up and risk assessment are recommended throughout pregnancy (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). However, numerous studies have found limited utilization of dental services by pregnant women (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Studies conducted in the United States and Australia showed that pregnant women's utilization of dental services was less than 50% and 36%, respectively (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). In Saudi Arabia, there is an underutilization of dental services by pregnant women (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) as Moawed et al. (2019) (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) reported 65% of pregnant women didn\u0026rsquo;t go to dental clinic and Al-Turck et al., (2021) (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e) recorded 44.5% did not visit the dentist during pregnancy.\u003c/p\u003e \u003cp\u003eTo improve the delivery of oral healthcare services to expectant mothers, perceived barriers to utilization of care must be identified (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) and there are some barriers from oral healthcare services to offer suitable treatment and other barriers to pregnant women (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Medical and dental professionals can play an important role in assuring the well-being of women during their pregnancies by promoting and maintaining their oral health (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Some dentists are unwilling to perform dental care during pregnancy, thus hindering oral health care, and 61% of pregnant women were not advised by their healthcare providers to visit a dentist during pregnancy. Expectant mothers usually do not consult a gynecologist and do not believe that dental treatment or radiography can be done at any time during pregnancy if necessary (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOther barriers to the utilization of oral health care services are misconceptions about the appropriateness of routine procedures, dental fear, difficulty in accessing dental treatment, time constraints, dissatisfaction with the quality of services, and beliefs that dental treatment is unsafe (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). In Saudi Arabia, a study reported \u0026ldquo;local anaesthesia\u0026rdquo; as the most common cause for avoiding dental visits, second cause was \u0026ldquo;transportation is difficult\u0026rdquo; and lastly, \u0026ldquo;dental treatment is not safe during pregnancy\u0026rdquo; (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). In another study, the reported barriers found were negative perception about the safety of dental treatment during pregnancy, the fear/anxiety of dental treatment, transportation problems, dissatisfaction with the quality of dental services, and lack of time to visit a dentist (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Each female population faces different barriers to dental visits that cannot be generalized to others. Having very few studies from Saudi Arabia and no previous study from the Alahsa region, this study was designed to assess the utilization of oral health services by pregnant females and investigate barriers to their dental visits.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003eThis study employed an analytical cross-sectional design. The research was conducted at two prominent governmental hospitals: the prenatal clinics at the Maternity and Children Hospital and King Faisal Hospital in Al Ahsa. These facilities were selected because to their substantial patient volume and extensive antenatal services. Moreover, these hospitals receive referrals from basic healthcare providers, underscoring their pivotal role in prenatal care. This study concentrated on pregnant women aged 18 years and older. Pregnant women unable to participate due to physical, mental, or cultural reasons were excluded. Participated in the antenatal clinics at the Maternity, Children Hospital, and King Faisal Hospital in Alahsa. Inclusion Criteria was defined to include pregnant women aged\u0026thinsp;\u0026ge;\u0026thinsp;18 years. Exclusion Criteria included pregnant women who refuse to consent to participate in the study. Pregnant women who are unable to participate owing to physical, mental, or cultural constraints.\u003c/p\u003e \u003cp\u003eA minimum sample size of 218 pregnant women (n) was determined based on an expected prevalence of dental visits during pregnancy of 50% (p), a population size of 500 pregnant women (N), a confidence interval of 95% (d), and a design effect of 1 (DEFF). The sample size was determined to be n\u0026thinsp;=\u0026thinsp;240, incorporating a 10% adjustment for non-participation. A systematic random sampling method was utilized. The study occurred over three months, from October to December 2023.\u003c/p\u003e \u003cp\u003eData collection was performed by face-to-face interviews with participants prior to their standard prenatal check-ups. The interviews occurred in a private clinic room, attended solely by the participant and the researcher. This guarantees secrecy and promotes candid and transparent responses from participants, since they are more inclined to feel at ease in a secure setting.\u003c/p\u003e \u003cp\u003eA standardized 'Data Collection Form' (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e) was developed, implemented, and utilized to gather information from study participants via face-to-face interviews. The data collection form encompassed demographic information, obstetric characteristics, oral health awareness, oral hygiene practices, and the utilization and barriers to dental treatments during pregnancy. Section I: Demographic Information and Obstetric Profiles. Section II: Awareness of Oral Health and Practices of Oral Hygiene. Section III: Utilization of Dental Services and Barriers During Pregnancy.\u003c/p\u003e \u003cp\u003eA test-retest was performed to ascertain the reliability of the questionnaire among 10 pregnant women. The principal investigator conducted the study independently to ensure uniformity. A pilot research was done with 10 pregnant women to validate the questionnaire. The pilot test feedback facilitated the refinement of the language and structure of the questions, so ensuring the final version of the questionnaire's validity for the study's objectives. The study's findings cannot be extrapolated to the national or global population due to the restricted geographical scope, as it concentrated solely on a single region in the Eastern Province of Saudi Arabia.\u003c/p\u003e \u003cp\u003eStatistical analysis was performed utilizing the Statistical Package for Social Sciences (IBM SPSS Statistics for Windows, Version 22.0). Descriptive statistics were employed to encapsulate the demographic and health-related information, encompassing frequencies for categorical data and mean and standard deviation (S.D.) for numerical data. The chi-squared test was employed to investigate relationships between independent variables (general characteristics of research participants, oral health awareness, and oral hygiene habits) and the dependent variable (utilization/barriers to dental services during pregnancy). Binary logistic regression was utilized to ascertain determinants of the utilization and non-utilization of dental care, as well as to uncover predictors of misconceptions and barriers to dental services during pregnancy. The statistical significance threshold was established at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, accompanied by a 95% confidence range.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eSample profile\u003c/h2\u003e \u003cp\u003eA total of 225 pregnant women participated in the present study. Participants' ages varied from 18 to 45 years, with the predominant group being 30 years or younger. Over fifty percent (52.9%) had achieved a college degree or higher. A significant proportion were unemployed (77.3%), and 67.1% were without health insurance coverage. The average total monthly family income was 9,166.8 Saudi Riyals, with a range from 1,000 to 30,000 Saudi Riyals. More than half of the participants (58.7%) have a poor income. Sixty percent of the subjects were in their third trimester. While 14.2% had no prior pregnancies, 20.0% had no offspring. A significant majority (79.1%) indicated that they received consistent prenatal care (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency distribution of sociodemographic characteristics, oral health awareness score, and oral hygiene scores among participants, and comparison between pregnant women who visited a dental clinic (n\u0026thinsp;=\u0026thinsp;58) and those who did not (n\u0026thinsp;=\u0026thinsp;167).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSociodemographic Characteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNot Visit\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eVisit\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP value (OR, 95% CI)\u003c/p\u003e \u003cp\u003eVisited/Not visited\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026le;\u0026thinsp;30years\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e114 (50.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e85 (74.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29 (25.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.000 (1.03, 0.57\u0026ndash;1.88)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026gt;\u0026thinsp;30years\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e111(49.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e82 (73.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29 (26.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026le; School Education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e106 (47.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e84 (79.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22 (20.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.127 (1.65, 0.89\u0026ndash;3.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026ge; College Education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e119 (52.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83 (69.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36 (30.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNot employed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e174(77.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e133 (76.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41 (23.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.202 (1.62, 0.82\u0026ndash;3.19)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployed (Government/Private)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e51(22.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34 (66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIncome per month from all resources\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLow income (\u0026le;\u0026thinsp;9166.8 Saudi Riyals)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e132 (58.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e108 (81.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24 (18.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.003* (2.59, 1.40\u0026ndash;4.77)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHigh income (\u0026gt;\u0026thinsp;9166.8 Saudi Riyals)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e93 (41.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59 (63.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34 (36.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInsurance\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNo\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e151 (67.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112 (74.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e39 (25.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.000 (0.99, 0.52\u0026ndash;1.87)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e74 (32.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55 (74.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19 (25.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStage of pregnancy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFirst trimester (1\u0026ndash;3 months)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18 (8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12 (66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSecond trimester (4\u0026ndash;6 months)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e71 (31.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64 (90.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (9.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThird trimester (7\u0026ndash;9 months)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e136 (60.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e91 (66.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45 (33.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of pregnancies before\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNone\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32 (14.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25 (78.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (21.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.277\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026le;Two\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e93 (41.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73 (78.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20 (21.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026ge;Three\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e100 (44.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69 (69.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31 (31.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of children\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNone\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35 (77.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10 (22.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.347\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026le;Two\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e97 (43.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75 (77.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22 (22.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026ge;Three\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e83 (36.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57 (68.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26 (31.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrenatal care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIrregular (\u0026ge;\u0026thinsp;2 Months)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47 (20.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35 (74.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12 (25.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.965 (1.01, 0.48\u0026ndash;2.12)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRegular (Monthly)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e178 (79.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e132 (74.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e46 (25.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOral health awareness score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLow score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e112 (49.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e91 (81.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21 (18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.016* (2.11, 1.13\u0026ndash;3.90)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHigh score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e113 (50.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e76 (67.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37 (32.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOral Hygiene score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePoor score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9 (4.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (77.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2 (22.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.000 (1.22, 0.24\u0026ndash;6.07)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHigh score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e216 (96.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e160 (74.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e56 (25.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eOR\u0026thinsp;=\u0026thinsp;Odds Ratio; P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05, *=Significant\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eAwareness of oral health\u003c/strong\u003e \u003cp\u003eAmong all participants, only 49.8% recognized that dental consultations are permissible during pregnancy. Although 72% accepted that hormonal fluctuations during pregnancy can influence dental health, merely 27.1% recognized the correlation between oral illnesses and negative pregnancy outcomes. Overall, 50.2% of the participants achieved a high awareness score level (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eOral hygiene practices\u003c/strong\u003e \u003cp\u003e almost all participants (96.4%) indicated that they clean their teeth, with 97.3% brushing at least once daily. Nonetheless, the use of supplementary oral hygiene methods, including dental floss and mouthwash, was restricted; 77.8% indicated they did not employ any adjunctive hygiene aids. Notwithstanding this, a high oral hygiene score level was recorded among 96% of participants (n\u0026thinsp;=\u0026thinsp;216) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eDental care utilization\u003c/strong\u003e \u003cp\u003eThe study found that only 58 pregnant women pursue dental consultations. The majority (89.7%) did so due to pre-existing oral health issues, whereas only 10.3% pursued preventative care, and 5.2% were referred through prenatal care. Most of these appointments consisted of a solitary consultation (70.7%), indicating a problem-focused approach to dental care rather than a preventive strategy. On the other hand, self-reported reasons for not pursuing dental care during pregnancy was affirmed by 167 (74.2%) pregnant women. Most of the non-utilizers (79%) were affected by misconceptions. The prevalent misconceptions encompassed the notion that dental care is unnecessary in the absence of symptoms (44.3%), apprehensions that dental therapy may jeopardize the pregnancy (28.7%), and a widespread perception that oral health is insignificant during pregnancy (5.4%). Practical barriers, like financial constraints, time limitations, transportation difficulties, or restricted access to dental clinics, were identified by 21.6% of the women.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eSociodemographic features and dental consultations during pregnancy\u003c/strong\u003e \u003cp\u003eIncome and gestational stage identified as the sole significant determinants affecting dental care utilization. Women with higher incomes (exceeding 9,166.8 SAR) were more inclined to pursue dental treatment, while low-income women saw a 62% decrease in utilization. In terms of gestational stage, women in the second trimester had the lowest dental visit attendance at 9.9%, in contrast to 33.3% in the first trimester and 33.1% in the third trimester. High oral health awareness was significantly associated with greater utilization of dental services during pregnancy, whereas oral hygiene score showed no significant association (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e The analysis demonstrated a significant correlation between oral health knowledge (low versus high), oral hygiene behaviours (poor versus good), and sociodemographic characteristics. Factors such as employment status, income, health insurance coverage and oral hygiene score, were substantially correlated with oral health awareness. Unemployed women, had lower incomes, or lack health insurance exhibited diminished levels of awareness. Additionally, good oral hygiene was strongly associated with higher oral health awareness among pregnant women (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Conversely, pregnant women with regular prenatal care had 5.17 times higher odds of having good oral hygiene compared to those with irregular prenatal care (Table\u0026nbsp;3).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation Between Oral Health Awareness (Low vs High) and Sociodemographic Factors Among Pregnant Women [N\u0026thinsp;=\u0026thinsp;225)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSociodemographic Characteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLow awareness level (n\u0026thinsp;=\u0026thinsp;112)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHigh awareness level (n\u0026thinsp;=\u0026thinsp;113)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP value (OR, 95% CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge groups\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;= 30years\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e56 (49.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58 (50.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.842 (0.94, 0.56\u0026ndash;1.59)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026gt;\u0026thinsp;30years\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e56 (50.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55 (49.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026le; School Education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e59 (55.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47 (44.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.110 (1.56, 0.92\u0026ndash;2.64)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026ge;College Education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e53 (44.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66 (55.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNot employed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e94 (54.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e80 (46.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.019* (2.15, 1.12\u0026ndash;4.11)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployed (Government/Private)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18 (35.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (64.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIncome per month from all resources\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLow income (\u0026le;\u0026thinsp;9166.8 Saudi Riyals)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e74 (56.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58 (43.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.025* (1.84, 1.07\u0026ndash;3.16)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHigh income (\u0026gt;\u0026thinsp;9166.8 Saudi Riyals)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38 (40.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55 (59.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInsurance\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNo\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e83 (55.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68 (45.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.026* (1.89, 1.07\u0026ndash;3.33)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29 (39.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45 (60.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStage of pregnancy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFirst trimester (1\u0026ndash;3 months)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (44.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (55.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.878\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSecond trimester (4\u0026ndash;6 months)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35 (49.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36 (50.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThird trimester (7\u0026ndash;9 months)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e69 (50.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67 (49.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of pregnancies before\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNone\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17 (53.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15 (46.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.749\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026le;Two\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e48 (51.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45 (48.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026ge;Three\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47 (47.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53 (53.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of children\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNone\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21 (46.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24 (53.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026le;Two\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49 (50.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e48 (49.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026ge;Three\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e42 (50.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41 (49.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrenatal care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIrregular prenatal care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24 (51.)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23 (48.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.843 (1.06, 0.56\u0026ndash;2.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRegular prenatal care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e88 (49.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e90 (50.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOral Hygiene score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePoor\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (88.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.017* (8.61, 1.05\u0026ndash;70.06)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGood\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e104 (48.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112 (51.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eOR\u0026thinsp;=\u0026thinsp;Odds Ratio; P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05, *=Significant\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"586\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 577px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eAssociation Between\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eOral Hygiene Practices\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eand Sociodemographic Factors Among Pregnant Women\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;(N=225)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSociodemographic Characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePoor Oral Hygiene Practices (n=9)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGood Oral Hygiene Practices (n=216)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value (OR, 95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge groups\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup1 (\u0026lt;= 30years)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e2 (1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e112 (98.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e0.082 (0.26, 0.05 - 1.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup2 (\u0026gt;30years)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e7 (6.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e104 (93.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026le; School Education \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e6 (5.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e100 (94.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e0.230 (2.32, 0.56 - 9.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026ge;College Education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e3 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e116 (97.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmployment status\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot employed\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e8 (4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e166 (95.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e0.398 (2.41, 0.29 - 19.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmployed (Government/Private)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e1 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e50 (98.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIncome per month from all resources\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLow income (\u0026le;9166.8 Saudi Riyals)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e6 (4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e126 (95.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e0.619 (1.42, 0.34 \u0026ndash; 5.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHigh income (\u0026gt;9166.8 Saudi Riyals)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e3 (3.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e90 (96.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInsurance\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e8 (5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e143 (94.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e0.156 (4.08, 0.50 \u0026ndash; 33.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e1 (1.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e73 (98.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStage of pregnancy\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFirst trimester (1-3 months)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e18 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e0.664\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSecond trimester (4-6 months)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e3 (4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e68 (95.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThird trimester (7-9 months)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e6 (4.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e130 (95.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of pregnancies before\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNone\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e32 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e0.408\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026le;Two\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e5 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e88 (94.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026ge;Three\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e4 (4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e96 (96.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of children\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNone\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e45 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e0.308\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026le;Two\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e5 (5.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e92 (94.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026ge;Three\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e4 (4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e79 (95.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrenatal care\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIrregular prenatal care\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e5 (10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e42 (89.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e0.021* (5.17, 1.33 - 20.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 205px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegular prenatal care\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e4 (2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e174 (97.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;OR=Odds Ratio; P-value \u0026lt; 0.05, *=Significant\u003c/p\u003e\n \u003cp\u003e \u003cstrong\u003eDeterminants of dental service usage\u003c/strong\u003e \u003cp\u003eMultivariate logistic regression study indicated that, following the adjustment for additional factors, certain correlations reversed direction. Women with elevated salaries were less inclined to utilize dental care throughout pregnancy, although looking more probable in the unadjusted study. Likewise, elevated oral health awareness shown a positive initial correlation with utilization; however, this effect diminished and slightly reversed following adjustment. These alterations indicate that additional factors\u0026mdash;such as gestational stage or access impediments\u0026mdash;may have affected the observed trends. Women in their second trimester are much less likely to pursue dental care than those in the first trimester (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLogistic Regression: Likelihood of Not Utilizing Dental Services Versus Utilizing Dental Services Among Pregnant Women (N\u0026thinsp;=\u0026thinsp;225)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSociodemographic Characteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP value (Unadjusted OR, 95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP value (Adjusted OR, 95% CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncome per month\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLow income (\u0026le;\u0026thinsp;9166.8 Saudi Riyals)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.003 (2.59, 1.40\u0026ndash;4.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.006 (0.32, 0.14\u0026ndash;0.73)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHigh income (\u0026gt;\u0026thinsp;9166.8 Saudi Riyals)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStage of pregnancy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFirst trimester (1\u0026ndash;3 months)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSecond trimester (4\u0026ndash;6 months)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.000 (0.19, 0.07\u0026ndash;0.48)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThird trimester (7\u0026ndash;9 months)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOral health awareness score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLow awareness\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.016 (2.11, 1.13\u0026ndash;3.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.050 (0.50, 0.25\u0026ndash;1.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHigh awareness\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003eVariable(s) entered; age, education, employment, income, pregnancy before, no. Of child, insurance, stage of pregnancy, awareness, prenatal care\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/p\u003e \u003cp\u003e\u003cb\u003eExamination of the Underutilization of Dental Services\u003c/b\u003e: Among women who did not access dental services, those with higher income were markedly less likely to identify misperceptions as the primary obstacle compared to their lower-income counterparts (OR\u0026thinsp;=\u0026thinsp;0.40, 95% CI: 0.18\u0026ndash;0.86, p\u0026thinsp;=\u0026thinsp;0.017). The insurance status did not show a significant correlation with the stated kind of barrier; nevertheless, uninsured women exhibited a higher likelihood of stating misperceptions (OR\u0026thinsp;=\u0026thinsp;2.13, 95% CI: 0.86\u0026ndash;5.26, p\u0026thinsp;=\u0026thinsp;0.096). The number of children had a borderline connection (p\u0026thinsp;=\u0026thinsp;0.067), with women having three or more children more often citing practical reasons than those with fewer or no children (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e5\u003c/span\u003e). A logistic regression analysis was performed to examine the factors influencing the non-utilization of dental treatment among pregnant women who did not visit a dentist, distinguishing between misconceptions and practical or emotional barriers. All sociodemographic variables, together with oral hygiene and awareness levels, were incorporated as independent variables. Women with elevated monthly income were markedly more inclined to cite misconceptions rather than practical obstacles as the rationale for non-utilization after adjustment (AOR\u0026thinsp;=\u0026thinsp;2.99, 95% CI: 1.08\u0026ndash;8.26, p\u0026thinsp;=\u0026thinsp;0.034). The unadjusted model indicated a contrary pattern (OR\u0026thinsp;=\u0026thinsp;0.40, p\u0026thinsp;=\u0026thinsp;0.017). The insurance status was not significantly correlated with the type of barrier reported; nevertheless, insured women exhibited a tendency towards reduced odds of reporting misunderstandings compared to their uninsured counterparts in the adjusted model (AOR\u0026thinsp;=\u0026thinsp;0.36, 95% CI: 0.12\u0026ndash;1.00, p\u0026thinsp;=\u0026thinsp;0.052). The overall correlation between the number of children and the reported type of barrier is statistically significant; however, when comparing each specific group (no children vs. \u0026ge;3, \u0026le;\u0026thinsp;2 vs. \u0026ge;3), the adjusted results lack significance\u0026mdash;probably due to smaller sample sizes and broader confidence intervals (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation Between Barries and Sociodemographic Factors Among Pregnant Pregnant Women Who Not visited Dental clinic/ Not utilized dental services (N\u0026thinsp;=\u0026thinsp;167)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSociodemographic Characteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers/practical reasons\u003c/p\u003e \u003cp\u003e34 (20.5%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMisperception\u003c/p\u003e \u003cp\u003e132 (79.5%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value (OR, 95% CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge groups\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;= 30years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70 (83.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.218 (0.62, 0.28\u0026ndash;1.33)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026gt;\u0026thinsp;30years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (24.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62 (75.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026le; School Education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70 (83.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.218 (0.62, 0.28\u0026ndash;1.33)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026ge;College Education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (24.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62 (75.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNot employed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26 (19.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e106 (80.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.621 (0.79, 0.32\u0026ndash;1.96)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployed (Government/Private)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (23.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26 (76.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIncome(monthly)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLow income (\u0026le;\u0026thinsp;9166.8 Saudi Riyals)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (15.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91 (85.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.017* (0.40, 0.18\u0026ndash;0.86)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHigh income (\u0026gt;\u0026thinsp;9166.8 Saudi Riyals)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (30.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41 (69.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInsurance\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNo\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (24.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e85 (75.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.096 (2.13, 0.86\u0026ndash;5.26)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (13.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47 (87.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStage of pregnancy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFirst trimester (1\u0026ndash;3 months)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (83.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.519\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSecond trimester (4\u0026ndash;6 months)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48 (75.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThird trimester (7\u0026ndash;9 months)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (17.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74 (82.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of pregnancies before\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNone\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21 (87.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.151\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026le;Two\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (16.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61 (83.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026ge;Three\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (27.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50 (72.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of children\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNone\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (20.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27 (79.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.067\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026le;Two\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (13.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65 (86.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026ge;Three\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17 (29.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40 (70.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrenatal care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIrregular prenatal care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (17.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (82.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.582 (0.76, 0.28\u0026ndash;2.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRegular prenatal care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (21.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e103 (78.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOral health awareness score level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLaw score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (20.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72 (79.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.889 (1.05, 0.49\u0026ndash;2.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHigh score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60 (80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOral hygiene score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePoor\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (42.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (57.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.134 (3.09, 0.65\u0026ndash;14.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGood\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31 (19.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e128 (80.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eOR\u0026thinsp;=\u0026thinsp;Odds Ratio; P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05, *=Significant\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLikelihood of Reporting Practical Barriers Versus Misconceptions for Not Utilizing Dental Services Among Pregnant Women Who Did Not Visit the Dentist (N\u0026thinsp;=\u0026thinsp;167)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSociodemographic Characteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP value (Unadjusted OR, 95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP value (Adjusted OR, 95% CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncome per month\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLow income (\u0026le;\u0026thinsp;9166.8 Saudi Riyals)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.017* (0.40, 0.18\u0026ndash;0.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.034 (2.99, 1.08\u0026ndash;8.26)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHigh income (\u0026gt;\u0026thinsp;9166.8 Saudi Riyals)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInsurance\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNo\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.096 (2.13, 0.86\u0026ndash;5.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.052 (0.36, 0.12- 1.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of children\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.037\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNone\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.355 (0.32, 0.02\u0026ndash;3.55)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026le;Two\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.067\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.314 (2.47,0.42\u0026ndash;14.50)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026ge;Three\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003eVariable(s) entered; age, education, employment, income, pregnancy before, no. Of child, insurance, stage of pregnancy, awareness, prenatal care\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eGood oral health care is essential for antenatal mothers. Studies have reported limited utilization of oral health services and have examined the reasons for avoidance of dental treatment during pregnancy (\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). This study explored the utilization of oral health care services by pregnant women and identified the barriers faced by them in visiting dental clinics to receive treatment.\u003c/p\u003e \u003cp\u003e Findings of this study show that half of the participants had high level of oral health awareness, majority reported good oral hygiene practices, one-quarter visited a dental clinic during pregnancy. It was observed that the participants had misperceptions regarding dental visits including absence of dental problems, oral health was not or less important during pregnancy, and potential negative effects of dental treatment on pregnancy status. Barriers to visit dental clinics included inconvenience in accessing dental services, dental fears, accessibility, and dissatisfaction with the quality of services, personal reasons, and multiple reasons.\u003c/p\u003e \u003cp\u003eNinety seven percent of participants were Saudi national, consistent with a local study by Azab et al. (2024) (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e), 47% were aged 21\u0026ndash;30 years, which is inconsistent with a study (Swathi et al., 2021) (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), half of the women had a college or higher education, in contrast with pregnant women of the United Arab Emirates;(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). Seventy-seven percent reported as unemployed, which is comparable with 75% of unemployed pregnant women in another study (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).Ahmed et al. (2019) (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) reported that 20% of participants\u0026rsquo; income was more than 10,000 Saudi Riyals, while in our study, 41% were classified as having high income (SAR 9166.8). Insurance coverage for dental treatment is crucial as it plays a significant role in improving access to oral healthcare and reducing financial barriers. Thirty-two point six percent of pregnant females in the cities of Khobar, Dammam, and Qatif, Saudi Arabia, have insurance coverage, as reported by another study (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e), which is similar to pregnant females in Alahsa, where 33% had insurance.\u003c/p\u003e \u003cp\u003eIn a study conducted by Albasry et al. (2019) (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e), 41% of pregnant women were in their third trimester, 33% in second trimester and 26% in first trimester. Similarly, this study found a comparable sequence, with 60% in third trimester, 32% in second trimester, and 8.0% in the first trimester. The findings of this study show that 14% women were in their first pregnancy, and 86% had multiple pregnancies that is comparable with another study (Saddki et al. 2010) (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). 41% participants of this study had two or fewer children, 44% had three or more, and 14% had no children that is comparable with a similar Tanzanian study (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Antenatal care is available in Saudi Arabia throughout pregnancy, however women turning up to use this facility is very low, and studies have noted poor utilization of the service (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). In this study, 79% of participants have received monthly antenatal care.\u003c/p\u003e \u003cp\u003eOur study results presented that a quarter of women (25.8%) visited dental clinics during pregnancy that is comparable with other studies. Gaffar et al. (2016) (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) reported 18%, Albasry et al. (2019) (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) 13.7% and AlHumaid et al (2024) (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) mentioned 22.5% of pregnant women visited dental offices for dental check-up. John and AlMesmar (2021) (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e) found that dental attendance during pregnancy in Dubai was 17.4% and in China it was 16.7% (Sun et al., 2014) (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). Centre for Disease Control and Prevention (CDC) using Pregnancy Risk Assessment Monitoring System (PRAMS) data reported that half of pregnant women had routine dental care during pregnancy (Lee et al., 2024) (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e) and Barman et al. (2019) (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) showed 29.7% of pregnant women in India.\u003c/p\u003e \u003cp\u003eSaddki et al. (2010) (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) found that 10.2% of the participants reported oral health as not or less important and this study showed 5% of participants had a similar perception. A systematic review (Kamalabadi et al., 2023) (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e) highlighted negative attitudes, such as concerns about dental procedures potentially harming the fetus that often discourage pregnant women from seeking dental care, which was not investigated in this study. Saddki et al. (2010) (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) reported 15.9% of participants were concerned about the negative effects of dental treatment on their pregnancy, 29% of participants in this study reported similar concerns.\u003c/p\u003e \u003cp\u003eThe study by Albasry et. al. (2019) (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) regarding barriers revealed that the inconvenience of dental services was 8.1%, the fear/anxiety of dental treatment was 17%, accessibility to the dental clinic was 0.7%, lack of time to visit a dentist was 2.2%, and dissatisfaction with the quality of dental services was 1.5%. These figures align closely with the findings of our study, such as inconvenience of dental services (7.8%), accessibility to dental clinics (0.6%), personal reasons (1.8%), and dissatisfaction with the quality of dental services by 0.6% women, but dental fear reported by 3.6% of females in this study is inconsistent. Adverse beliefs regarding oral health and dental care utilization are prevalent among pregnant women and across a wide range of geographic areas (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e) that is consistent with our study. A professional determines normative needs using recognized dental health parameters and clinical exams (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). According to our research, 44.3% of pregnant women did not seek dental care because they believed they had no problems. Since they might not be aware of the underlying oral health issues that potentially necessitate professional attention, this suggests a discrepancy between perceived and possible normative demands.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study identifies the gaps in dental care utilization among pregnant women. Pregnant participants were observed as having high level of oral health awareness, good oral hygiene practices. One-quarter visited a dental clinic and only a few had regular visits due to antenatal care advice. Majority of the participants had oral/dental problems. The women demonstrated misperceptions regarding dental visits; such as the absence of dental problems, oral health not or less important, potential negative effects of dental treatment on pregnancy status. The reported barriers included inconvenience in accessing dental services, dental fears, accessibility to dental clinics, and dissatisfaction with the quality of services, personal reasons, and multiple other reasons.\u003c/p\u003e"},{"header":"Strengths of the Study","content":"\u003cp\u003eStrengths of this study include 1. first multi-centered study from Alahsa, Saudi Arabia to explore the utilization of oral health services and the barriers to dental visits experienced by pregnant women; 2. conduction of the study by a single examiner minimized the discrepancies in administering the questionnaire; 3. selection bias was minimized due to systematic random sampling; 4. research provides insights into the relationship between dental visit avoidance with socio-demographic factors, oral health awareness, oral hygiene practices and utilization of dental services.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eLimitations of Study\u003c/h2\u003e \u003cp\u003eLimitations of this study include 1. cross-sectional study design that provides a glimpse of the parameters at one point in time, like a snapshot, 2. absence of dental examinations to determine the treatment needs 3. information about family members, personal habits like smoking, family support, work environment, and the impact of social media on perceptions were not explored, which could further influence the utilization of dental care among pregnant women.\u003c/p\u003e \u003c/div\u003e"},{"header":"Recommendations","content":"\u003cp\u003eTo improve the utilization and minimize the barriers to dental services among pregnant women, several steps may be taken: First, healthcare providers need to integrate oral health education and dental check-up during prenatal care visits to address common misperceptions regarding dental treatments during pregnancy, Second, collaboration between obstetricians and dentists in developing and activating referral system that encourages pregnant women to seek dental care, Third, increased access to dental clinics through flexible appointments and prioritization for pregnant women, Increasing insurance coverage for dental services during pregnancy may lessen economic challenges and increase dental visits.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAOR-Adjusted Odds Ratio\u003c/p\u003e\n\u003cp\u003eOR-Odds Ratio\u003c/p\u003e\n\u003cp\u003ePRAMS \u0026nbsp; \u0026nbsp;Pregnancy Risk Assessment Monitoring System\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSPSS \u0026nbsp; \u0026nbsp;Statistical Package for Social Sciences\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eDeclarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the principles of the Declaration of Helsinki.\u0026nbsp;Ethical approval was obtained from the Deanship of Scientific Research at King Faisal University [KFU-REC-2023-JUN-ETHICS958], and from AlAhsa Health Cluster [IRB KFHH No. (H-05-HS-065)] prior to data collection. Informed consent was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of Conflict\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDeclared as None\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll relevant data and supporting information files generated and/or analyzed during this study are available from the corresponding author upon reasonable request.The data sets can be accessed on request to corresponding author.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization: Z.A. and S.A.H.B.; Formal analysis: Z.A.; Investigation and Methodology: Z.A.; E.F.N.. N.S. and S.A.H.B; Supervision: S.A.H.B.; Visualization: M.F.U. and \u0026nbsp;N.S..; Writing \u0026ndash; original draft: Z.A.; Writing \u0026ndash; review \u0026amp; editing: W.A.; M.F.U.; and S.A.H.B\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial Number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAzab RY, Binyaseen JA, Almuwallad AS, Alomiri SS, Faden NM, Ramadan MM et al. Treatment Perception and Utilization of Dental Care During Pregnancy Among Women Visiting Antenatal Clinics in King Abdulaziz Medical City \u0026amp; Primary Healthcare, National Guard, Jeddah, Saudi Arabia. Cureus. 2024;16(3).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGaffar B, El Tantawi M, Al Ansari A, Al Agl A. Association between oral health knowledge and practices of Saudi pregnant women in Dammam, Saudi Arabia. EMHJ-Eastern Mediterranean Health J. 2016;22(6):411\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJavali MA, Saquib SA, Khader MA, Khalid I, AlShahrani AY, Kanji MA, et al. Oral health knowledge, attitude, and practice of pregnant women in Deccan, South India: a cross-sectional prenatal survey. J Med Life. 2022;15(3):420.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLu H-X, Xu W, Wong MCM, Wei T-Y, Feng X-P. Impact of periodontal conditions on the quality of life of pregnant women: a cross-sectional study. Health Qual Life Outcomes. 2015;13:1\u0026ndash;14.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlbasry Z, Alhaddad B, Benrashed MA, Al-Ansari A, Nazir MA. A cross-sectional analysis of dental care utilization among pregnant women in Saudi Arabia. Open access Macedonian J Med Sci. 2019;7(23):4131.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlHumaid GA, Alshehri T, Alwalmani RM, Alsubaie RM, Alshehri AD, Aljoghaiman E et al. Assessment of Oral Health Status and Pregnancy Outcomes Among Women in Saudi Arabia. Patient Prefer Adherence. 2024:1027\u0026ndash;38.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHammad OA, Binsaad SM, Gasim RA, Jambi S, Haidary R, Afandi A, et al. Assessing expectant mothers\u0026rsquo; knowledge and beliefs about oral healthcare during infancy and pregnancy: a cross sectional survey in Saudi Arabia. Pesqui Bras Odontopediatria Clin Integr. 2018;18(01):e4027.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSaddki N, Yusoff A, Hwang YL. Factors associated with dental visit and barriers to utilisation of oral health care services in a sample of antenatal mothers in Hospital Universiti Sains Malaysia. BMC Public Health. 2010;10:1\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRobison V, Bauman B, D\u0026rsquo;Angelo DV, Espinoza L, Thornton-Evans G, Lin M. The impact of dental insurance and medical insurance on dental care utilization during pregnancy. Matern Child Health J. 2021;25:832\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiu PP, Wen W, Yu KF, Gao X, Wong MCM. Dental care-seeking and information acquisition during pregnancy: a qualitative study. Int J Environ Res Public Health. 2019;16(14):2621.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBarman D, Ranjan R, Kundu A. Factors associated with dental visit and barriers to the utilization of dental services among tribal pregnant women in Khurda district, Bhubaneswar: a cross-sectional study. J Indian Soc Periodontology. 2019;23(6):562\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRahebi D, Valadbeigi T, Hasani J, Hajipour M, Erfanpoor S, Etemad K, et al. Utilization of dental care in Iranian pregnant women: findings from a population-based study. Dent Res J. 2021;18(1):26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAhmed AE, AlBlaihed RM, Albalawi AN, Alshehri A. Oral health problems among pregnant Saudi Arabian women: a self-report survey. J Clin Res Dentistry. 2019;2(1):1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoawed S, Badawy A, Alosimi S, Alrowily M. The oral health knowledge and self-care practices of pregnant women in Saudi Arabia. Am J Nurs Res. 2019;7(4):643\u0026ndash;51.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Turck K, Alsaeri N, Alanazi R, Alajaji R, Alsulaiman S, Al-Jehani N, et al. Self-reported oral care and oral health among women during pregnancy, Riyadh, Saudi Arabia. Annals Dent Specialty. 2021;9(2\u0026ndash;2021):79\u0026ndash;85.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAljulayfi I, Alrusayni A, Alqahtani S, Hamam MK. Awareness of dental interns in managing cases of pregnant women in Saudi Arabia. Saudi J Dent Res. 2015;6(1):26\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBahramian H, Mohebbi SZ, Khami MR, Quinonez RB. Qualitative exploration of barriers and facilitators of dental service utilization of pregnant women: A triangulation approach. BMC Pregnancy Childbirth. 2018;18:1\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMaybodi FR, Vaziri F, Bidoki NZ, Fakhari M. Knowledge and Practice of General Dentists and Dental Students about Treatment Considerations during Pregnancy and lactation in Yazd, Iran. J Midwifery Reproductive Health. 2022;10(1):3144\u0026ndash;54.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRocha JS, Arima L, Chibinski AC, Werneck RI, Moys\u0026eacute;s SJ, Baldani MH. Barriers and facilitators to dental care during pregnancy: a systematic review and meta-synthesis of qualitative studies. Cadernos de saude publica. 2018;34:e00130817.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDar-Odeh N, Binsaad SM, Gasim RA, Haidary R, Afandi A, Abu-Hammad S, et al. Why do women avoid dental visits during pregnancy? A cross-sectional survey in al madinah, Western Saudi Arabia. Pesquisa Brasileira em Odontopediatria e Clin Integrada. 2018;18(1):3934.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmin M, ElSalhy M. Factors affecting utilization of dental services during pregnancy. J Periodontol. 2014;85(12):1712\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMalkawi ZA, Tubaishat RS. Knowledge, practice and utilization of dental services among pregnant women in the north of Jordan. J Contemp Dent Pract. 2014;15(3):345\u0026ndash;51.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePinasti RA, Agustia L. Determinants Factors to Increase Dental Care During Pregnancy: A Systematic Review. J Syiah Kuala Dentistry Soc. 2023;8(1):61\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTesta A, Jackson DB, Simon L, Ganson KT, Nagata JM. Stressful life events, oral health, and barriers to dental care during pregnancy. J Public Health Dent. 2023;83(3):275\u0026ndash;83.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Swuailem A, Al-Jamal F, Helmi M. Treatment perception and utilization of dental services during pregnancy among sampled women in Riyadh, Saudi Arabia. Saudi J Dent Res. 2014;5(2):123\u0026ndash;29.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSwathi K, Koothati RK, Motor RR, Priyadarshini, RajaShekar CH, Vallakonda S. Knowledge and Experience of Women about Dental Services Utilization during Pregnancy: A Cross-Sectional Questionnaire Study. J Pharm Bioallied Sci. 2021;13(Suppl 2):S1042\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHashim R. Self-reported oral health, oral hygiene habits and dental service utilization among pregnant women in United Arab Emirates. Int J Dent Hyg. 2012;10(2):142\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMwangosi IE, Kiango MM. Oral health experience during pregnancy and dental service utilization in Bariadi District, Tanzania. Tanzan J Health Res. 2012;14(2):146\u0026ndash;51.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlanazy W, Brown A. Individual and healthcare system factors influencing antenatal care attendance in Saudi Arabia. BMC Health Serv Res. 2020;20(1):49.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJohn S, AlMesmar HS. Oral Health Status, Oral Hygiene Practices, and Factors Affecting Dental Treatment Utilization among Pregnant Women in Dubai. Dubai Med J. 2021;4(4):320\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSun W, Guo J, Li X, Zhao Y, Chen H, Wu G. The routine utilization of dental care during pregnancy in eastern China and the key underlying factors: a Hangzhou City study. PLoS ONE. 2014;9(6):e98780.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee H, Ramphoma KJ, Horowitz AM, Walker D. Oral health is an integral part of maternal and child health. Springer; 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKamalabadi YM, Campbell MK, Zitoun NM, Jessani A. Unfavourable beliefs about oral health and safety of dental care during pregnancy: a systematic review. BMC Oral Health. 2023;23(1):762.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBaskaradoss JK, Geevarghese A. Utilization of dental services among low and middle income pregnant, post-partum and six-month post-partum women. BMC Oral Health. 2020;20(1):120.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Pregnancy, Oral Health Services, Utilization, Barriers, Dental Visits","lastPublishedDoi":"10.21203/rs.3.rs-7834744/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7834744/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eAim\u003c/h2\u003e \u003cp\u003eResearch reports a limited utilization of dental services among pregnant women. This study explored utilization of oral health services and the barriers to dental visits among pregnant women.\u003c/p\u003e\u003ch2\u003eMaterials and Methods\u003c/h2\u003e \u003cp\u003eAanalytical cross-sectional study was carried out at antenatal clinics of two government hospitals in Alahsa. A structured data collection form comprising on demographics, oral health awareness and practices, utilization of dental services and barriers was used through face-to-face interviews. Chi-squared test and regression analysis was performed with a statistical significance level of p\u0026thinsp;\u0026lt;\u0026thinsp;0.050.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAmong 225 pregnant women, 97% were Saudi with mean age of 30.8\u0026thinsp;\u0026plusmn;\u0026thinsp;5.8 years, 50% demonstrated high level of oral health awareness, 96% reported good oral hygiene practices and 26% visited dental clinic. Regression analysis showed that participants aged 31\u0026ndash;40 years were significantly less likely to visit dental clinics (OR\u0026thinsp;=\u0026thinsp;0.153, p\u0026thinsp;=\u0026thinsp;0.017) compared to those aged\u0026thinsp;\u0026gt;\u0026thinsp;40 years. Participants with low income were significantly less likely to visit dental clinics (OR\u0026thinsp;=\u0026thinsp;0.385, p\u0026thinsp;=\u0026thinsp;0.019) compared to high income, and those in the second trimester of pregnancy were significantly less likely to visit dental clinics (OR\u0026thinsp;=\u0026thinsp;0.197, p\u0026thinsp;=\u0026thinsp;0.001) compared to the third trimester of pregnancy. Low oral health awareness was also significantly associated with a lack of visits to dental clinics (OR\u0026thinsp;=\u0026thinsp;0.484, p\u0026thinsp;=\u0026thinsp;0.040) compared to high oral health awareness. Participants with high incomes had been significantly shown to have barriers in visiting dental clinics (OR\u0026thinsp;=\u0026thinsp;2.626, p\u0026thinsp;=\u0026thinsp;0.045) compared to low incomes.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eMost females did not visit the dental clinics and visited only when experienced pain. Many postponed dentalcare due to misperceptions about the importance of oral health, along with worries about pregnancy risks. Age, income, pregnancy stage, and oral health awareness have shown significant role in defining visits to dental care. Income status demonstrated\u003c/p\u003e","manuscriptTitle":"Utilization of Oral Health Services and Barriers to Dental Visits among Pregnant Women in Alahsa, Saudi Arabia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-20 10:13:25","doi":"10.21203/rs.3.rs-7834744/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-03-11T10:57:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"41464732843481815672000178489855476374","date":"2026-03-05T07:29:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"259601268611979656591647627077580139822","date":"2026-02-23T02:50:26+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-14T14:25:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"332842630782181721118169529217704624705","date":"2026-01-22T04:33:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"223973313520916965395511197378229893137","date":"2026-01-20T15:02:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"24886120149036070227688201787213187300","date":"2026-01-18T11:31:20+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-16T11:28:47+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-01-02T08:07:58+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-26T12:54:13+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-26T12:53:25+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Oral Health","date":"2025-10-11T11:10:24+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"bf6d8aea-b234-4f10-aeb8-f87017454bed","owner":[],"postedDate":"January 20th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-01-20T10:13:25+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-20 10:13:25","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7834744","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7834744","identity":"rs-7834744","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}