title: Oral health promotion interventions during pregnancy: a systematic review.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  (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.
authors.affiliation: Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA.
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: Vamos
authors.affiliation: Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA.
authors.forename: Erika L
authors.initials: EL
authors.lastname: Thompson
authors.affiliation: Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA.
authors.forename: Maryouri
authors.initials: M
authors.lastname: Avendano
authors.affiliation: Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Daley
authors.affiliation: Department of Pediatric Dentistry, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Rocio B
authors.initials: RB
authors.lastname: Quinonez
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Kim
authors.initials: K
authors.lastname: Boggess
mesh_terms: D005260:Female; D006293:Health Promotion; D006801:Humans; D009909:Oral Health; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D009057:Stomatognathic Diseases / Q000150:complications / Q000517:prevention & control*
keywords: behavioral science; dental health promotion; health promotion; prevention; public health