Objectives: Poor oral hygiene and higher hormone levels during pregnancy always lead to poor periodontal health. Oral health education of the pregnant women to improve the periodontal outcomes might be ineffective and inconsistent. The aim of this study was to assess the effectiveness of a family-centered behavioral and educational counselling program on the pregnant women’s periodontal health and long-term effect after delivery.
Methods: A randomized controlled trial was conducted among first-time pregnant women (10~20th gestational-week) in Hong Kong. Participating families were randomized into test and control group. The intervention in test group included: explanation on oral health education pamphlets, oral hygiene practice training by the “tell-show-do” technique, individualized feedback, and proposed solutions to overcome barriers on self-care. Reinforcement was implemented by interview, phone call or messaging to assess performance, identify barriers and to encourage participants on self-care, in around 32nd gestational-week and 6 months after delivery. Main outcomes assessed were periodontal health measurement including bleeding on probing (BOP), periodontal-pocket (Poc) and loss of clinical attachment levels (LoA); oral hygiene status was assessed by visible plaque index (VPI). The dental examinations were carried out at baseline, 32nd gestational-week and 12-months post-delivery.
Results: 589 pregnant women were recruited and 369 completed all three visits (test 188; control 181). Mixed-effect model ANOVA indicated that in test group, % sites with visible plaque decreased from the baseline to the 32nd gestational-week and maintained to 12-months post-delivery while in control group the effect could not be sustained (p<0.001). Both groups showed significant decrease in BOP over time, and significantly lower % sites with BOP was found in test group than in control group at 12-months post-delivery (p<0.001). Generalized linear mixed model (GLMM) showed that there was significant less in sites with Poc and LoA in the both groups over time at 12-months post-delivery than during pregnancy (p<0.001), whereas there was no significant effect between the two groups (p>0.05).
Conclusions: Providing family-centered, behavioral and educational counselling to pregnant women at early stage of pregnancy and reinforcements can improve their oral hygiene and periodontal health, the effect can be sustained over a longer period.