Oral health skills framework for pregnant women: a professional consensus

Oral health during the perinatal period is essential for maternal and child oral health. Pregnancy increases vulnerability to oral conditions (periodontal disease and dental caries) associated with adverse pregnancy outcomes, while children's oral health is strongly influenced by parental-particularly maternal-knowledge, attitudes, practices, and oral health status. Although oral health education interventions may be offered during pregnancy follow-up, their effectiveness is difficult to evaluate, due to a lack of validated framework. This study aimed to develop a competency framework for oral health education during the perinatal period.

A Delphi study assessed expert opinion on the competencies pregnant women should acquire to ensure good oral health for themselves and their children through oral health education interventions. The questionnaire comprises two sections (pregnant woman and child) and covered core skill domains-preventing oral diseases, monitoring oral health conditions, and seeking dental care- subdivided into 97 contributory learning objectives across knowledge, practices and attitudes. Objective were rated on a 4-point Likert scale, with consensus defined as ≥ 70%. The expert panel included 21 perinatal healthcare professionals (midwives, pediatricians, gynecologists, general practitioners, dentists, and pharmacists).

In the first round, 59% of objectives were rated as very useful, and 40 were revised the second round due to lack of consensus. After three rounds, consensus was reached for all objectives except four: the links between periodontal disease and preeclampsia, impact of breastfeeding on oral health, the protective role of saliva and women's active search for oral health information. The discussion of the unresolved areas highlighted gaps in healthcare professionals' understanding of oral-general health links in the perinatal period, and in perceptions of individuals' autonomy in health information seeking.

This study resulted in a consensus-based competency framework for oral health education during pregnancy, structured around three key competencies: preventing oral diseases, participating in care plans, and asserting health-related rights. Establishing consensus on women's oral health competencies supports a cross-disciplinary approach to prevention and health education during the perinatal period. Future research should focus on translating this framework into practical, implementable strategies across diverse healthcare settings.