Non-Cochrane · intervention · PM42464286
Effectiveness of community and primary-care-based maternal oral health interventions on pregnancy and infant outcomes: a systematic review.
Thakkar Abhi, Bhattu Bharani Kumar, Desai Chintan, et al. · BMC oral health · 2026 · PubMed · doi:10.1186/s12903-026-09220-7
Findings
3 findings
| Population | ||||
|---|---|---|---|---|
| Pregnant women and postpartum mothers | Community and primary care based maternal oral health interventions | Usual antenatal care or no structured oral health intervention | Low birth weight (<2500 g) At birth · Antenatal, primary care and community settings | RR 0.76 [0.51, 1.13] Low Downgraded: imprecision, inconsistency 2 studies |
| Pregnant women and postpartum mothers | Community and primary care based maternal oral health interventions | Usual antenatal care or no structured oral health intervention | Preterm birth (<37 weeks) At birth · Antenatal, primary care and community settings | RR 0.80 [0.60, 1.05] Low Downgraded: imprecision, inconsistency 2 studies |
| Infants of mothers receiving the intervention | Community and primary care based maternal oral health interventions | No maternal oral health intervention or conventional care | Early childhood caries prevalence Approximately 24 months · Antenatal, primary care and community settings | RR 0.66 [0.59, 0.74] Low Downgraded: risk of bias 2 studies |
Included primary studies 21
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Adams et al., 2017 Integrating a Nurse-Midwife-Led Oral Health Intervention Into CenteringPregnancy Prenatal Care: Results of a Pilot Study. PMID:28686808 | 2017 | 1 other review | not stated | not extracted yet |
| George 2018 Evaluation of a midwifery initiated oral health-dental service program to improve oral health and birth outcomes for pregnant women: A… PMID:29605753 | 2018 | 1 other review | Preterm birth (<37 weeks); Low birth weight (<2500 g) | not extracted yet |
| George et al., 2018 Evaluation of a midwifery initiated oral health-dental service program to improve oral health and birth outcomes for pregnant women: A… DOI:10.1016/j.ijnurstu.2018.03.006 | 2018 | 1 other review | Preterm birth (<37 weeks); Low birth weight (<2500 g) | not extracted yet |
| Turton 2021 Evaluation of a community-based early childhood caries (ECC) intervention in Cambodia. PMID:33200439 | 2021 | 1 other review | Early childhood caries prevalence | not extracted yet |
| Bansal 2019 Effectiveness of an integrated perinatal oral health assessment and promotion program on the knowledge in Indian pregnant women. PMID:31710014 | 2019 | this review only | not stated | not extracted yet |
| Bansal et al., 2019 Effectiveness of an integrated perinatal oral health assessment and promotion program on the knowledge in Indian pregnant women DOI:10.4103/jisppd.jisppd_201_19 | 2019 | this review only | not stated | not extracted yet |
| Deghatipour 2022 Effect of oral health promotion interventions on pregnant women dental caries: a field trial. PMID:35804346 | 2022 | this review only | not stated | not extracted yet |
| Deghatipour et al., 2022 Effect of oral health promotion interventions on pregnant women dental caries: a field trial DOI:10.1186/s12903-022-02292-1 | 2022 | this review only | not stated | not extracted yet |
| Gomez 2001 Effectiveness of a caries preventive program in pregnant women and new mothers on their offspring. PMID:11310134 | 2001 | this review only | not stated | not extracted yet |
| Gomez and Weber, 2001 Effectiveness of a caries preventive program in pregnant women and new mothers on their offspring DOI:10.1046/j.1365-263x.2001.00255.x | 2001 | this review only | not stated | not extracted yet |
| Johnson et al., 2012 When can oral health education begin? Relative effectiveness of three oral health education strategies starting pre-partum. PMID:22779378 | 2012 | this review only | not stated | not extracted yet |
| Miyoshi 2017 Efficacy of a prospective community-based intervention to prevent preterm birth. PMID:27089398 | 2017 | this review only | not stated | not extracted yet |
| Miyoshi et al., 2017 Efficacy of a prospective community-based intervention to prevent preterm birth DOI:10.1515/jpm-2015-0408 | 2016 | this review only | not stated | not extracted yet |
| Sampaio et al., 2021 Sociodemographic, Behavioral and Oral Health Factors in Maternal and Child Health: An Interventional and Associative Study from the… PMID:33917677 | 2021 | this review only | not stated | not extracted yet |
| Tannous 2021 Economic evaluation of the Midwifery Initiated Oral Health-Dental Service programme in Australia. PMID:34341045 | 2021 | this review only | not stated | not extracted yet |
| Tannous et al., 2021 Economic evaluation of the Midwifery Initiated Oral Health-Dental Service programme in Australia DOI:10.1136/bmjopen-2020-047072 | 2021 | this review only | not stated | not extracted yet |
| Turton et al., 2021 Evaluation of a community‐based early childhood caries (ECC) intervention in Cambodia DOI:10.1111/cdoe.12599 | 2020 | this review only | Early childhood caries prevalence | not extracted yet |
| Valentine 2025 A cluster randomized trial of xylitol chewing gum for prevention of preterm birth: The PPaX trial. PMID:39541971 | 2025 | this review only | Preterm birth (<37 weeks); Low birth weight (<2500 g) | not extracted yet |
| Valentine et al., 2025 A cluster randomized trial of xylitol chewing gum for prevention of preterm birth: The PPaX trial DOI:10.1016/j.medj.2024.10.016 | 2025 | this review only | Preterm birth (<37 weeks); Low birth weight (<2500 g) | not extracted yet |
| Zanata 2003 Effect of caries preventive measures directed to expectant mothers on caries experience in their children. PMID:12964648 | 2003 | this review only | Early childhood caries prevalence | not extracted yet |
| Zanata et al., 2003 Effect of caries preventive measures directed to expectant mothers on caries experience in their children DOI:10.1590/s0103-64402003000200001 | 2003 | this review only | Early childhood caries prevalence | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Pregnant women at any trimester and mothers up to 12 months postpartum; infants up to 24 months for infant outcomes | Pregnant women attending antenatal care and mother-child dyads (n=12 studies; sample sizes 100 to 10,069) |
| Intervention | Community or primary care based maternal oral health interventions (education, counselling, mHealth, screening and referral, preventive services, community health worker programs) | Oral health education and counselling, xylitol gum, midwife-led screening and referral, fluoride and antimicrobial preventive care (n=12 studies) |
| Comparison | Usual antenatal care without structured oral health components, no intervention, or alternative intervention models | Standard antenatal care, no intervention, conventional care, historical controls, non-participating pairs |
| Outcomes | Maternal oral health status and behaviours; preterm birth and low birth weight; infant oral health (early childhood caries, feeding practices); service utilization and implementation outcomes | Preterm birth (n=2 RCTs), low birth weight (n=2 RCTs), early childhood caries prevalence (n=2 non-randomized studies), maternal knowledge, behaviours and clinical indices (narrative), dental service uptake, cost-effectiveness |
| Study designs | RCTs, quasi-experimental studies, controlled before-after studies, cohort intervention studies, mixed-methods and qualitative implementation studies; English, 2000 to 2025 | 2 RCTs (1 cluster RCT, 1 multicentre RCT), 1 economic evaluation alongside an RCT, 9 non-randomized intervention studies |
| Timing | Infant outcomes at 24 months or younger | Short-term assessments in pregnancy to infant follow-up up to 24 months; one study to 4.5 years |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | NRSI: Yes · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: No | NRSI: No · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |