Oral Health Intervention During Pregnancy: A Systematic Review

Background: Oral health during pregnancy is essential regarding its long-term and short-term effects on maternal and child health. Objective: This study aimed to investigate the strategies and methods used in oral health promotion interventions during pregnancy. Also, it is tried to determine the extent to which environmental barriers and socio-economic factors, in addition to individual factors, have been considered in the design of these interventions. Methods: The data were extracted from Pub-Med, Web of Science, and Scopus databases by searching the published papers before November 2019. The search terms consisted of pregnancy, oral health promotion, health education, and preventive health services, resulting in 2772 records. The inclusion criteria were pregnant women as a target group; study design with randomized (controlled) trials; implementing a minimum of one health promotion intervention; and studying the outcomes including knowledge, attitudes, dental cleaning behaviors, and clinical examinations. On the other hand, the articles only focused on the infant's oral health were excluded. Results: A total of 20 articles were included in this study. The subject of most reviewed studies was the individual-level interventions using various methods, including lectures, role-playing, group discussion, one-on-one counseling, skill-based education, commercials on the video-sharing website, and using social networks. Few studies (n = 4) provided screening and referring to dental services, prophylaxis, nonsurgical therapy, and initial periodontal treatment. Only one study focused on socio-economic factors, including cost and location of dental services and involvement of prenatal care providers. Conclusion: According to ecological approaches, maintenance of outcomes needs addressing multilevel determinants. However, based on the results, a few oral health interventions during pregnancy included environmental/policy-level factors in addition to individual factors. Hence, interventions with different strategies that consider multiple determinants are needed.