Can oral health education during pregnancy promote lasting behavioural changes?

Chen P, Li M, Zhang Q, Qiu M, Yu X. Effects of an oral health management program during pregnancy: a randomized controlled trial. Oral Dis. 2026 32:240-50. https://doi.org/10.1111/odi.70076 .

A randomized, controlled, single-blinded clinical trial aimed to evaluate the effectiveness of an educational program based on the Health Belief Model on self-care, oral health behaviors, and periodontal clinical indicators in pregnant women.

Pregnant women from a community health center in China were randomly assigned to two groups in a 1.5:1 ratio-intervention group (n = 39) and control group (n = 26). The control group received one face-to-face education, while the intervention group participated in a 4-week program with online follow-up, lectures, video calls, and ongoing support to encourage oral health care. Oral health self-efficacy, assessed by the Self-efficacy Scale for Self-care (SESS); three periodontal clinical indicators (gingival index - GI, plaque index-PLI, and periodontal index-PI); and oral health-related behaviors, assessed by a self-designed questionnaire, were evaluated at three time points: baseline (T0), post-intervention (T1), and after two months of follow-up (T2).

Between-group comparisons used independent t-test or Mann-Whitney U test for continuous variables, and chi-square for categorical variables. Intervention effects were evaluated by repeated-measures one- way ANOVA; and a significance level was set at 5%.

No statistically significant differences were observed between groups in sociodemographic or gestational characteristics observed in T0. The educational program improved pregnant women's oral health SESS across all three domains relative to baseline (T0: 55.9 ± 8.3), with a significant immediate increase after the intervention (T1: 63.2 ± 7.8). There was a slight decline at two months (T2: 60.8 ± 8.2), but scores remained above baseline. Compared with the control group, the intervention group generally showed significantly higher scores at both T1 and T2. Both groups had significant increases in GI, PLI, and CPI versus baseline. At T1, the intervention group had significantly higher GI and PLI than the control; at T2, only PLI remained significantly higher in the intervention group. Regarding behaviors, the intervention group showed greater improvement at both post-baseline times, with relative maintenance at T2, notably longer brushing time per occasion and higher weekly flossing frequency at T1 and T2. No differences were found between groups in daily brushing frequency or brushing technique.

The study concluded that the Health Belief Model-based educational program was effective in increasing oral health self-efficacy, promoting healthy habits, and improving clinical conditions in pregnant women. However, some outcomes regressed by the second month of follow-up.