Oral Health Promotion Interventions during Pregnancy: A Systematic Review

Background: Poor maternal oral health is a significant public health issue due to its prevalence and connections with adverse pregnancy/birth outcomes and chronic diseases across the lifecourse. Although both medical and dental professional organizations have recently endorsed practice guidelines for prenatal oral health, the extent to which interventions exist that facilitate oral health promotion remains unknown. Thus, a systematic review was conducted to examine the range and impacts of oral health promotion interventions among pregnant women.

Methods: Search terms related to oral health, health promotion, and pregnancy produced 7,754 articles published before March 2013 from five search engines. Inclusion criteria: (1) intervention-based; (2) published in peer-reviewed journal; (3) measured outcomes related to knowledge, attitudes, and/or behaviors; (4) pregnant sample; and (5) English-language.

Results: Seven studies met the inclusion criteria; all interventions were delivered in prenatal care settings and focused on education. Modalities varied, including the use of oral instruction, PPTs and DVDs, in both individual and group formats; however, content was directed towards infant oral health. Few studies specifically addressed the prenatal oral health guidelines. Primary outcomes measured included knowledge, beliefs, attitudes, self-efficacy, and oral hygiene and health-seeking behaviors. Only one study did not show significant improvement in one of these outcomes post-intervention.  

Conclusion: Few oral health interventions among pregnant women addressed oral-related symptoms, hygiene behaviors, and potential oral-systemic implications specific to mothers. Subsequently, more theory- and evidence-based interventions addressing the prenatal oral health guidelines using rigorous designs are needed to improve oral-systemic health for both women and their offspring.