Oral Health Service System and Service Model Strengthening for Pregnant Women Under National Health Insurance Schemes: A Current Situation in Bangkok
Article Sidebar
Main Article Content
Abstract
This cross-sectional mixed-methodexploratory study aimed to explore and synthesize policy recommendations for developing alternative oral health services for pregnant women in Bangkok and related national health insurance schemes. The methodology included qualitative data collection from 46 stakeholders (policy stakeholders, antenatal and oral health service providers, and pregnant women as service recipients) through in-depth interviews and focus group discussions about policies to reduce oral health inequalities, service arrangements, experiences, and expectations. Quantitative data were collected via questionnaires from 388 Thai pregnant women in Bangkok regarding general information, oral health status, oral health behaviors, service utilization, and opinions on service alternatives. Findings revealed that policy stakeholders proposed reducing disparities by expanding service units to include private sectors, extending benefit packages, and increasing service reimbursement. While service providers offered specialized oral health services for pregnant women, recipients reported limited-service units, insufficient publicity, lack of awareness about prenatal oral health benefit packages, and constraints related to time, convenience, and coverage. Additionally, service follow-up systems were incomplete with disconnected information. Survey results showed 61.3% of pregnant women received oral health examinations, only 24.2% received oral prophylaxis and polishing, 61.0% had caries, 75.2% had calculus, and only 59.8% were not aware of oral health benefit packages during pregnancy. The study concludes that policies should be developed to promote awareness of oral health benefit packages and improve service accessibility for pregnant women. Especially regarding access to oral health promotion services and disease prevention for civil service beneficiaries and insured persons under the social security insurance, to make access more convenient through service innovation clinics, based on provider and recipient perspectives alongside relevant academic evidence.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Puertas A, Magan-Fernandez A, Blanc V, Revelles L, O’Valle F, Pozo E, León R, Mesa F. Association of periodontitis with preterm birth and low birth weight: a comprehensive review. The Journal of Maternal-Fetal & Neonatal Medicine 2018; 31(5): 597-602.
Shanthi V, Vanka A, Bhambal A, Saxena V, Saxena S, Kumar SS. Association of pregnant women periodontal status to preterm and low-birth weight babies: A systematic and evidence-based review. Dent Res J (Isfahan) 2012; 9(4): 368-80.
Weintraub JA, Prakash P, Shain SG, Laccabue M, Gansky SA. Mothers’ caries increases odds of children’s caries. J Dent Res 2010; 89(9): 954-8.
National Health Security Committee. National Health Security Committee announcement on payment for public health services in the case of health promotion and disease prevention services for basic services, payment according to service list B.E. 2566. 22 May 2023. (in Thai)
Information and Communication Technology Center, Office of the Permanent Secretary, Ministry of Public Health. OHSP Percentage of pregnant women who received oral health examinations in responsible area (persons) (coverage model) [Internet]. Nonthaburi: Ministry of Public Health; 2022 [cited 2025 Aug 20]. Available from: https://hdc.moph.go.th/
center/public/standard-report-detail/
dc5463af059cd3e6c55613fc418ce36e (in Thai)
Information and Communication Technology Center, Office of the Permanent Secretary, Ministry of Public Health. OHSP Percentage of pregnant women who received oral health examinations and professional tooth cleaning in responsible area (persons) (coverage model) [Internet]. Nonthaburi: Ministry of Public Health; 2022 [cited 2025 Aug 20]. Available from: https://hdc.moph.go.th/center/public/standard-
report-detail/8897d18c21ad97d18
cfb0a98abc5fb3f (in Thai)
Seubsingkan C, Kanha S, Nammontri O, Thongpathomwong N. Caries experiences and factors related to receiving dental treatment of pregnancy at Sangkhom hospital, Nong Khai Province. TDNJ 2017; 28(1): 60-72. (in Thai)
Traisuwan W. Oral health status and behaviors of pregnant migrant workers in Bangkok, Thailand: a cross-sectional study. BMC Oral Health 2021; 21(1): 379.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3(2): 77-101.
Daniel WW. Biostatistics: a foundation for analysis in the health sciences. 7th ed. New York: John Wiley & Sons; 1999.
McCarthy M. Epidemiology and policies for health planning. London: King Edward’s Hospital Fund for London; 1982. p. 10-4.
Bureau of Dental Health. The 9th national oral health survey 2023 of Thailand. Nonthaburi: Department of Health; 2024. (in Thai)
Gaszynska E, Klepacz-Szewczyk J, Trafalska E, Garus-Pakowska A, Szatko F. Dental awareness and oral health of pregnant women in Poland. Int J Occup Med Environ Health 2015; 28(3): 603-11.
Rocha JS, Arima LY, Werneck RI, Moyses SJ, Baldani MH. Determinants of dental care attendance during pregnancy: a systematic review. Caries Res 2018; 52(1-2): 139-52.
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. Cad Saude Publica 2018; 34: e00130817.
Bahramian 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 and childbirth 2018; 18(1): 153.
Eua-atthakaroon S, Sukhumalind P. Evaluation of oral health promotion and prevention services focusing on access to dental care in pregnant women under the Fee Schedule policy. JHEALTH 2022; 45(2): 39-49.
Chaianant N, Tussanapirom T, Kettratad M, Prasertsom P, Vejvithee W, Niyomsilp K, et al. Inequalities in dental service utilization among Thai adults from 2000 to 2017. Community Dent Oral Epidemiol 2023; 51(4): 660-70.
Pierce P, Whitten M, Hillman S. The impact of digital healthcare on vulnerable pregnant women: A review of the use of the MyCare app in the maternity department at a central London tertiary unit. Front Digit Health 2023; 5: 1155708.
Adeniyi A, Donnelly L, Janssen P, Jevitt C, Kardeh B, Von Bergmann H, et al. Pregnant women's perspectives on integrating preventive oral health in prenatal care. BMC Pregnancy Childbirth 2021; 21(1): 271.
Al Agili DE, Khalaf ZI. The role of oral and prenatal healthcare providers in the promotion of oral health for pregnant women. BMC Pregnancy Childbirth 2023; 23(1): 313.
Ghanbarzadegan A, Balasubramanian M, Luzzi L, Brennan D, Bastani P. Inequality in dental services: a scoping review on the role of access toward achieving universal health coverage in oral health. BMC Oral Health 2021; 21(1): 404.
Tsakos G, Watt RG, Guarnizo‐Herreño CC. Reflections on oral health inequalities: theories, pathways and next steps for research priorities. Community Dent Oral Epidemiol 2023; 51(1): 17-27.
Watt RG. Oral health inequalities-developments in research, policy and practice over the last 50 years. Community Dent Oral Epidemiol 2023; 51(4): 595-9.
