Document Type


Publication Date



School of Dentistry


Dental Practice & Rural Health


Background. Chronic poor oral health has a high prevalence in Appalachia, a large region in the eastern USA. The Center for Oral Health Research in Appalachia (COHRA) has been enrolling pregnant women and their babies since 2011 in the COHRA2 study of genetic, microbial, and environmental factors involved in oral health in Northern Appalachia. Methods. The COHRA2 protocol is presented in detail, including inclusion criteria (healthy, adult, pregnant, US Caucasian, English speaking, and nonimmunocompromised women), recruiting (two sites: Pittsburgh, Pennsylvania, and West Virginia, USA), assessments (demographic, medical, dental, psychosocial/behavioral, and oral microbial samples and DNA), timelines (longitudinal from pregnancy to young childhood), quality control, and retention rates. Results. Preliminary oral health and demographic data are presented in 727 pregnant women, half from the greater Pittsburgh region and half from West Virginia. Despite similar tooth brushing and flossing habits, COHRA2 women in West Virginia have significantly worse oral health than the Pittsburgh sample. Women from Pittsburgh are older and more educated and have less unemployment than the West Virginia sample. Conclusions. We observed different prevalence of oral health and demographic variables between pregnant women from West Virginia (primarily rural) and Pittsburgh (primarily urban). These observations suggest site-specific differences within Northern Appalachia that warrant future studies.

Source Citation

Neiswanger, K., McNeil, D. W., Foxman, B., Govil, M., Cooper, M. E., Weyant, R. J., Shaffer, J. R., Crout, R. J., Simhan, H. N., Beach, S. R., Chapman, S., Zovko, J. G., Brown, L. J., Strotmeyer, S. J., Maurer, J. L., & Marazita, M. L. (2015). Oral Health in a Sample of Pregnant Women from Northern Appalachia (2011–2015). International Journal of Dentistry, 2015, 1–12.


Copyright © 2015 Katherine Neiswanger et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.



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