ORAL HEALTH DURING PREGNANCY: COMMON CONDITIONS, BARRIERS TO DENTAL CARE AND CLINICAL MANAGEMENT - A NARRATIVE REVIEW
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6665Keywords:
Pregnancy, Oral Health, Dental Care, Periodontal Disease, Oral Health Education, Barriers to Dental CareAbstract
Objectives: This narrative review aimed to summarize current evidence on oral health during pregnancy, focusing on common oral conditions, barriers to dental care, dental treatment and its safety, periodontal care, prevention and oral health education.
Methods: Full-text publications were identified through PubMed, Scopus, and Google Scholar. Studies published between 2000 and 2026 were considered. Search terms covered pregnancy, oral health, gingivitis, periodontitis, dental caries, dental erosion, barriers to dental care, dental treatment, dental radiography, local anesthesia, medications, periodontal treatment, and oral health education. Original studies, systematic reviews, meta-analyses, scoping reviews, relevant review articles, clinical guidelines, and professional recommendations were included.
Key Findings: Common oral health problems during pregnancy include gingivitis, periodontal disease, dental caries, and dental erosion. Changes in diet, oral hygiene, vomiting, and the oral environment may contribute to some of these conditions. Periodontitis has been associated with adverse pregnancy outcomes in observational studies, although a causal relationship has not been established. Necessary dental treatment, including radiography, local anesthesia, restorative and endodontic treatment, and extractions, can generally be performed safely during pregnancy when clinically indicated. Many pregnant women nevertheless delay or avoid dental care because of safety concerns, misconceptions, financial and organizational barriers, and gaps in knowledge among patients and healthcare professionals.
Conclusions: Oral health should be included as part of prenatal care. Prevention, timely treatment, patient education, and closer cooperation between dental and prenatal care providers may improve oral health and access to dental care during pregnancy.
References
Fakheran, O., Saied-Moallemi, Z., Khademi, A., & Sahebkar, A. (2020). Oral health-related quality of life during pregnancy: A systematic review. Current Pharmaceutical Design, 26(32), 4014–4021. https://doi.org/10.2174/1381612826666200523171639
Gharehghani, M. A. M., Bayani, A., Bayat, A.-H., Hemmat, M., Karimy, M., Ahounbar, E., Armoon, B., Fakhri, Y., & Schroth, R. J. (2021). Poor oral health-related quality of life among pregnant women: A systematic review and meta-analysis. International Journal of Dental Hygiene, 19(1), 39–49. https://doi.org/10.1111/idh.12465
Anunciação, B. H., Azevedo, M. J., & Pereira, M. D. L. (2023). Knowledge, attitudes, and practices of prenatal care practitioners regarding oral health in pregnancy-A systematic review. International Journal of Gynecology & Obstetrics, 162(2), 449–461. https://doi.org/10.1002/ijgo.14703
Wilson, A., Hoang, H., Bridgman, H., Bettiol, S., & Crocombe, L. (2022). Factors influencing the provision of oral health care practices by antenatal care providers: A systematic review. Journal of Women’s Health, 31(2), 231–241. https://doi.org/10.1089/jwh.2020.8956
Subramaniam, L., Balachandran, P., & Janakiram, C. (2026). Barriers and facilitators of oral health care utilization among pregnant women: A mixed-methods systematic review. Systematic Reviews, 15(1), 182. https://doi.org/10.1186/s13643-026-03151-8
Rocha, J. S., Arima, L. Y., Werneck, R. I., Moysés, S. J., & Baldani, M. H. (2018). Determinants of dental care attendance during pregnancy: A systematic review. Caries Research, 52(1–2), 139–152. https://doi.org/10.1159/000481407
Bhadauria, U. S., Singh, S., Paswan, P., Bhattacharya, P., Purohit, B., & Priya, H. (2024). Assessment of the quality of guidelines on oral health care during pregnancy: A systematic review. Evidence-Based Dentistry, 25(4), 214–215. https://doi.org/10.1038/s41432-024-01046-y
Bao, J., Huang, X., Wang, L., He, Y., Rasubala, L., & Ren, Y.-F. (2022). Clinical practice guidelines for oral health care during pregnancy: A systematic evaluation and summary recommendations for general dental practitioners. Quintessence International, 53(4), 362–373. https://doi.org/10.3290/j.qi.b2644863
Pecci-Lloret, M. P., Linares-Pérez, C., Pecci-Lloret, M. R., Rodríguez-Lozano, F. J., & Oñate-Sánchez, R. E. (2024). Oral manifestations in pregnant women: A systematic review. Journal of Clinical Medicine, 13(3), 707. https://doi.org/10.3390/jcm13030707
Laine, M. A. (2002). Effect of pregnancy on periodontal and dental health. Acta Odontologica Scandinavica, 60(5), 257–264. https://doi.org/10.1080/00016350260248210
Silva de Araujo Figueiredo, C., Gonçalves Carvalho Rosalem, C., Costa Cantanhede, A. L., Abreu Fonseca Thomaz, É. B., & Fontoura Nogueira da Cruz, M. C. (2017). Systemic alterations and their oral manifestations in pregnant women. Journal of Obstetrics and Gynaecology Research, 43(1), 16–22. https://doi.org/10.1111/jog.13150
Yousefi, M., Parvaie, P., & Riahi, S. M. (2020). Salivary factors related to caries in pregnancy: A systematic review and meta-analysis. The Journal of the American Dental Association, 151(8), 576–588.e4. https://doi.org/10.1016/j.aime.2020.04.021
Machado, V., Ferreira, M., Lopes, L., Mendes, J. J., & Botelho, J. (2023). Adverse pregnancy outcomes and maternal periodontal disease: An overview on meta-analytic and methodological quality. Journal of Clinical Medicine, 12(11), 3635. https://doi.org/10.3390/jcm12113635
Karimi, N., Samiee, N., & Moradi, Y. (2023). The association between periodontal disease and risk of adverse maternal or neonatal outcomes: A systematic review and meta-analysis of analytical observational studies. Health Science Reports, 6(10), e1630. https://doi.org/10.1002/hsr2.1630
Corbella, S., Taschieri, S., Del Fabbro, M., Francetti, L., Weinstein, R., & Ferrazzi, E. (2016). Adverse pregnancy outcomes and periodontitis: A systematic review and meta-analysis exploring potential association. Quintessence International, 47(3), 193–204. https://doi.org/10.3290/j.qi.a34980
Yilmaz, F., Carti Dorterler, O., Eren Halici, S., Kasap, B., & Demirbas, A. (2024). The effects of pregnancy on oral health, salivary pH and flow rate. BMC Oral Health, 24, 1286. https://doi.org/10.1186/s12903-024-05057-0
Coffey, N., James, L., Flynn, A. C., El-Dirani, Z., & Khijmatgar, S. (2026). Hyperemesis gravidarum and oral health: A scoping review. International Journal of Gynecology & Obstetrics. Advance online publication. https://doi.org/10.1002/ijgo.70958
Jafarzadeh, H., Sanatkhani, M., & Mohtasham, N. (2006). Oral pyogenic granuloma: A review. Journal of Oral Science, 48(4), 167–175. https://doi.org/10.2334/josnusd.48.167
Bett, J. V. S., Batistella, E. A., Melo, G., de Andrade Munhoz, E., Barcellos Silva, C. A., da Silva Guerra, E. N., Porporatti, A. L., & De Luca Canto, G. (2019). Prevalence of oral mucosal disorders during pregnancy: A systematic review and meta-analysis. Journal of Oral Pathology & Medicine, 48(4), 270–277. https://doi.org/10.1111/jop.12831
American Dental Association. (2025, July 14). Pregnancy. https://www.ada.org/resources/ada-library/oral-health-topics/pregnancy
American College of Obstetricians and Gynecologists. (2013). Committee Opinion No. 569: Oral health care during pregnancy and through the lifespan. Obstetrics & Gynecology, 122(2 Pt 1), 417–422. https://doi.org/10.1097/01.AOG.0000433007.16843.10
Frey-Furtado, L., Fonseca, M., Melo, P., Listl, S., & Pereira, M. L. (2025). Oral healthcare access: Self-perceived barriers faced during pregnancy-A systematic review. BMC Public Health, 25, 1394. https://doi.org/10.1186/s12889-025-22593-8
Rocha, J. S., Arima, L., Chibinski, A. C., Werneck, R. I., Moysés, S. J., & Baldani, M. H. (2018). Barriers and facilitators to dental care during pregnancy: A systematic review and meta-synthesis of qualitative studies. Cadernos de Saúde Pública, 34(8), e00130817. https://doi.org/10.1590/0102-311X00130817
Kamalabadi, Y. M., Campbell, M. K., Zitoun, N. M., & Jessani, A. (2023). Unfavourable beliefs about oral health and safety of dental care during pregnancy: A systematic review. BMC Oral Health, 23(1), Article 762. https://doi.org/10.1186/s12903-023-03439-4
Detman, L. A., Cottrell, B. H., & Denis-Luque, M. F. (2010). Exploring dental care misconceptions and barriers in pregnancy. Birth, 37(4), 318–324. https://doi.org/10.1111/j.1523-536X.2010.00427.x
Wilson, A., Davies, C., Bettiol, S., Bridgman, H., Crocombe, L., & Hoang, H. (2025). Why aren’t antenatal care providers adopting oral health guidelines? A qualitative exploration. Community Dentistry and Oral Epidemiology, 53(3), 286–295. https://doi.org/10.1111/cdoe.13030
Lee, R. S. Y., Milgrom, P., Huebner, C. E., & Conrad, D. A. (2010). Dentists’ perceptions of barriers to providing dental care to pregnant women. Women’s Health Issues, 20(5), 359–365. https://doi.org/10.1016/j.whi.2010.05.007
Lyu, J., Zhang, X., Nie, X., Wei, L., & He, H. (2021). A cross-sectional study of the knowledge, attitudes, and behaviors of obstetricians, gynecologists, and dentists regarding oral health care during pregnancy. Annals of Palliative Medicine, 10(4), 4242–4251. https://doi.org/10.21037/apm-20-1520
Amin, M., & ElSalhy, M. (2014). Factors affecting utilization of dental services during pregnancy. Journal of Periodontology, 85(12), 1712–1721. https://doi.org/10.1902/jop.2014.140235
Robison, V., Bauman, B., D’Angelo, D. V., Espinoza, L., Thornton-Evans, G., & Lin, M. (2021). The impact of dental insurance and medical insurance on dental care utilization during pregnancy. Maternal and Child Health Journal, 25(5), 832–840. https://doi.org/10.1007/s10995-020-03094-z
Favero, V., Bacci, C., Volpato, A., Bandiera, M., Favero, L., & Zanette, G. (2021). Pregnancy and dentistry: A literature review on risk management during dental surgical procedures. Dentistry Journal, 9(4), 46. https://doi.org/10.3390/dj9040046
Yin, Q.-Y., Liang, J., & Wang, F. (2026). Continuous maternal care of oral diseases from preconception to lactation. Journal of Dentistry, 167, 106555. https://doi.org/10.1016/j.jdent.2026.106555
Zhang, J., Zhou, C., Zheng, L., Wang, J., Xia, B., Zhao, W., Wei, X., Huang, Z., Chen, X., Ge, S., Yan, F., Zhou, J., Xuan, K., Wu, L.-A., Cao, Z., Yuan, G., Zhao, J., Chen, Z., Zhang, L., … Guo, W. (2025). Expert consensus on the treatment of oral diseases in pregnant women and infants. International Journal of Oral Science, 17(1), 62. https://doi.org/10.1038/s41368-025-00395-3
Benavides, E., Krecioch, J. R., Connolly, R. T., Allareddy, T., Buchanan, A., Spelic, D., O’Brien, K. K., Keels, M. A., Mascarenhas, A. K., Duong, M.-L., Aerne-Bowe, M. J., Ziegler, K. M., & Lipman, R. D. (2024). Optimizing radiation safety in dentistry: Clinical recommendations and regulatory considerations. Journal of the American Dental Association, 155(4), 280–293.e4. https://doi.org/10.1016/j.adaj.2023.12.002
Benavides, E., Bhula, A., Gohel, A., Lurie, A. G., Mallya, S. M., Ramesh, A., & Tyndall, D. A. (2023). Patient shielding during dentomaxillofacial radiography: Recommendations from the American Academy of Oral and Maxillofacial Radiology. Journal of the American Dental Association, 154(9), 826–835.e2. https://doi.org/10.1016/j.adaj.2023.06.015
da Cunha, Y. G. M., da Silva, E. F., Oliveira, G. M., Santos, C. F., & Calvo, A. M. (2026). The use of different local anesthetics in pregnant women in dentistry: A systematic review. Current Reviews in Clinical and Experimental Pharmacology, 21(2), 133–146. https://doi.org/10.2174/0127724328349965250407082245
Hagai, A., Diav-Citrin, O., Shechtman, S., & Ornoy, A. (2015). Pregnancy outcome after in utero exposure to local anesthetics as part of dental treatment: A prospective comparative cohort study. Journal of the American Dental Association, 146(8), 572–580. https://doi.org/10.1016/j.adaj.2015.04.002
American College of Obstetricians and Gynecologists. (2025, September). Acetaminophen use in pregnancy and neurodevelopmental outcomes. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2025/09/acetaminophen-use-in-pregnancy-and-neurodevelopmental-outcomes
Bookstaver, P. B., Bland, C. M., Griffin, B., Stover, K. R., Eiland, L. S., & McLaughlin, M. (2015). A review of antibiotic use in pregnancy. Pharmacotherapy, 35(11), 1052–1062. https://doi.org/10.1002/phar.1649
U.S. Food and Drug Administration. (2020, October 15). FDA recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later because they can result in low amniotic fluid. https://www.fda.gov/drugs/drug-safety-and-availability/fda-recommends-avoiding-use-nsaids-pregnancy-20-weeks-or-later-because-they-can-result-low-amniotic
Sajjad Khan, N., Craven, R., Rafiq, A., & Rafiq, A. (2023). Treatment of periodontal disease in pregnancy for the prevention of adverse pregnancy outcomes: A systematic review of systematic reviews. Journal of the Pakistan Medical Association, 73(3), 611–620. https://doi.org/10.47391/JPMA.6432
Von Helde, N. M., Martins, M. L., da Costa Motta, M., de Souza, T. F., Magno, M. B., Maia, L. C., & Fonseca-Gonçalves, A. (2024). Are educational tools in oral health programs for pregnant women effective in improving the oral status of mothers and babies? A systematic review. Evidence-Based Dentistry, 25(4), 216. https://doi.org/10.1038/s41432-024-01043-1
Vamos, C. A., Thompson, E. L., Avendano, M., Daley, E. M., Quinonez, R. B., & Boggess, K. (2015). Oral health promotion interventions during pregnancy: A systematic review. Community Dentistry and Oral Epidemiology, 43(5), 385–396. https://doi.org/10.1111/cdoe.12167
Tenenbaum, A., Yazdanbakhsh, M., Cerdan, I., Omiya, J., de Andrade, V., Maurice, A., Marquillier, T., Margat, A., Lombrail, P., Gagnayre, R., Riquet, S., & Azogui-Levy, S. (2026). Oral health skills framework for pregnant women: A professional consensus. BMC Pregnancy and Childbirth. Advance online publication. https://doi.org/10.1186/s12884-026-09331-7
George, A., Dahlen, H. G., Blinkhorn, A., Ajwani, S., Bhole, S., Ellis, S., Yeo, A., Elcombe, E., & Johnson, M. (2018). Evaluation of a midwifery initiated oral health-dental service program to improve oral health and birth outcomes for pregnant women: A multi-centre randomised controlled trial. International Journal of Nursing Studies, 82, 49–57. https://doi.org/10.1016/j.ijnurstu.2018.03.006
Motta, M. C., Gomes, M. B., Martins, M. L., & Fonseca-Gonçalves, A. (2025). Knowledge of pregnant women and healthcare professionals regarding oral health during pregnancy: A data mining analysis. General Dentistry, 73(2), 24–33.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Maria Torchalska, Monika Maria Szerszeń, Martyna Smogór

This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.

