Oral Health Skills Framework for Pregnant Women: a Professional Consensus

Abstract

Background Pregnancy is a period susceptible to oral pathologies such as periodontal disease and dental caries, which have been linked to adverse pregnancy outcomes. Research shows that a child’s oral health is shaped by complex individual and collective factors and is closely tied to the health of their parents, particularly their mothers. Although oral health education interventions are offered during pregnancy follow-ups, their effectiveness is difficult to assess. This study presents a competency framework for pregnant women through oral health education programs, serving as a resource for healthcare professionals. Methods A three-round Delphi method assessed professional experts' opinions. A literature review generated 40 resources that informed the first-round questionnaire, structured into two sections (pregnant woman and child). Three main families of skill (preventing, monitoring caries/periodontal disease, seeking dental care) were divided into 96 contributory learning objectives, categorized by knowledge, practices, and attitudes. Experts rated the usefulness of each objective on a 5-point Likert scale, with consensus set at 70%. The expert panel comprised 21 perinatal professionals (midwives, pediatricians, gynecologists, general practitioners, dentists, pharmacists). Results In the first round, 59% of objectives were rated very useful. Forty objectives failed to find consensus and were reformulated for the second round. Oral hygiene achieved better consensus than nutrition-related fields of application. After three rounds, four areas still lacked consensus: the risk of preeclampsia related to periodontal disease, breastfeeding’s impact on oral health, women's search for oral health information, and saliva's protective role. A consensus-based competency framework for pregnant women's oral health education was developed centered on three key competencies: preventing oral diseases, participating in care plans, and asserting rights. Conclusions Reaching a consensus on women's oral health skills is essential for a cross-disciplinary approach to common prevention strategies and oral health education during the perinatal period. Further work is needed to define implementation strategies environments and identify professionals suited for delivering brief oral health interventions during pregnancy follow-ups.