Oral health promotion interventions during pregnancy: A systematic review

Objectives Maternal oral disease during pregnancy is a significant public health issue due to its prevalence and lifecourse connections with adverse pregnancy/birth outcomes, early childhood caries, and chronic diseases. Although both medical and dental professional organizations have discipline-specific and co-endorsed guidelines, whether interventions exist that translate oral health evidence into practice remains unknown. Thus, we conducted a systematic review to examine the range, scope and impact of existing oral health promotion interventions during pregnancy. Methods Search terms related to oral health, health promotion, and pregnancy produced 7754 articles published before March 2013 from five search engines. Inclusion criteria: (i) intervention-based; (ii) quasi-experimental, experimental, or pretest/post-test design; (iii) pregnant women participants; (iv) outcomes including oral health knowledge, attitudes, and/or behaviors; (v) ≥5 participants; (vi) peer-review publication; and (vii) English language. Results All interventions (n = 7) were delivered in prenatal care settings and focused on education. Modalities varied, including the use of oral instruction and audiovisual presentations, in both individual and group formats; however, content was directed toward infant oral health. Few studies specifically addressed prenatal oral health guidelines. Primary outcomes measured included knowledge, beliefs, attitudes, self-efficacy and oral hygiene, and health-seeking behaviors. All but one study showed significant improvement in one of these outcomes postintervention. Conclusions 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 current prenatal oral health guidelines using rigorous designs are needed to improve oral and systemic health for both women and their offspring.