Skip to main content

Oral health behavior of pregnant women in Nigeria: a scoping review

Abstract

Background

Oral health care behaviors during pregnancy affects maternal and child health outcomes. This scoping review sought to map the existing literature on the oral healthcare behaviors of pregnant women in Nigeria.

Methods

PubMed, Science Direct, Web of Science, EBSCOHOST, Sabinet, African Index Medicus, and Scopus data based were searched in August 2023. Articles with reports on the oral health behavior of pregnant women in Nigeria, published in English in peer review were included in the review. Articles whose full lengths could not be accessed, and commentaries on studies, and letters to the editor were also excluded. Data on authors and year of publication of the study, study location, study objective, study design, methodological approach for data collection, and study outcomes were extracted and descriptively synthesized.

Results

The search yielded a total of 595 articles of which 573 were unique. Only 21 articles were left after titles and abstracts screening and only 18 articles met the eligibility criteria. The proportion of pregnant women had utilized dental services ranged from 4 to 62.9%, the use of toothbrush and toothpaste ranged from 59.6 to 99.3%, twice daily tooth brushing ranged from 5.2 to 66.9%, and the use of toothbrush among pregnant women in the studies varies from 70.9 to 100%. Chewing stick was used by 0.1–27.7% of study participants. Dental problems such as caries, pain, swollen gums, and excessive salivation were reasons for seeking dental care. We identified individual, structural, and behavioral factors, including myths as barriers for dental service utilization.

Conclusion

This scoping review shows that dental service utilization by pregnant women in Nigeria is poor and mainly due to curative than preventive needs. Oral health behaviours also need to be improved through tailored oral health education accessible to pregnant women in Nigeria.

Peer Review reports

Introduction

Oral diseases that occur during pregnancy have significant implications for the health of both the expectant mother and the unborn child. The risk for oral diseases is enhanced by the temporary physiological changes experienced by women during pregnancy, including alterations in their physical structure, hormone levels, metabolism, and immune system. [1, 2] These changes often lead to increased consumption of refined carbohydrates, episodes of vomiting, reduced saliva production, and a heightened acidity level in saliva. [3 4] favorable conditions for developing oral health issues, such as periodontal disease and dental caries. [5] Furthermore, the fluctuating levels of estrogen and progesterone during pregnancy can lead to increased absorbency in the oral tissues, rendering the mouth more susceptible to potential infections. [6, 7] Additionally, these hormonal shifts can compromise the efficiency of the host’s immune system, further raising the likelihood of dental infections. [8, 9]

Moreover, oral diseases associated with poor pregnancy outcomes range from gingivitis [10,11,12,13] to periodontitis, the severity of periodontal diseases, periapical infection, severe periodontal disease, gingival recession, periodontal pocket and loss of clinical attachment level. [7, 14,15,16,17] Poor pregnancy outcomes from oral diseases include low birth weight, preterm birth, preterm and low birth weight, neonatal stunting, and wasting. Underweight, and small head circumference, uterine leiomyoma, preterm premature rupture of membranes, pre-eclampsia, eclampsia, spontaneous abortion, vaginal bleeding, chorioamnionitis, stillbirth, macrosomia, congenital anomaly, and infant/neonatal death, gestational diabetes, fetal growth restriction and hypertensive disorders of pregnancy. [7, 16, 18,19,20,21,22]

Despite the widespread prevalence of oral diseases during pregnancy and their well-documented link to adverse pregnancy outcomes, many pregnant women do not actively seek oral care during this crucial period. [23,24,25] This trend can be attributed, in part, to the common misconception among many pregnant women that these oral health issues are a normal part of pregnancy and will naturally resolve after childbirth. [23]. Regrettably, oral healthcare screenings are frequently lacking in antenatal care settings, including many clinics in Nigeria. This deficiency is primarily due to the absence of established guidelines regarding oral health screening and treatment for pregnant women [23, 24]. In addition, oral health care is poorly integrated into the primary health care system, where pregnant women often receive perinatal care in Nigeria [26]. Furthermore, preventive oral care uptake by pregnant women across Nigeria is influenced by multiple social-cultural factors that are yet to be fully explored and understood in ways that can inform policies. [25, 27] This scoping review highlights this knowledge gap by mapping out the knowledge and practice of preventive oral care among pregnant women in Nigeria.

Methods

This scoping review adopted the ‘York methodology’ outlined by Arksey & O’Malley [28]. The review follows the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) extension for the scoping reviews checklist [29, 30].

Research question

The research question was: What are the factors associated with oral healthcare behavior among pregnant women in Nigeria?

Identification of relevant studies

The search was conducted in August 2023 for relevant articles published in English in seven electronic databases (PubMed, Science Direct, Web of Science, EBSCOHOST, Sabinet, African Index Medicus, and Scopus) using the terms shown in Appendix 1. A search of related citations and references was also carried out.

Selection of studies for review

Identified studies were downloaded into Endnote, imported into Rayyan, and duplicates were removed. Rayyan, an automation tool, was utilized to enhance the validity of the selection process for inclusion in reviews. It facilitates easy importation of references, collaboration among researchers, and tracking of screening decisions. Two researchers (LBA and AOE) independently performed title and abstract screening using pre-defined inclusion and exclusion criteria. Articles were selected when there was concurrence among the two. Any discrepancies in the eligibility of publications determined by the two researchers were resolved by a third researcher (OSI) who independently reviewed the publications for its eligibility. A discussion was then held, and consensus reached between the three researchers on the eligibility status of the publication. Following this, the researchers conducted individual assessments of the complete texts of the remaining articles, and supplementary searches were manually performed on the reference compilations of potentially pertinent publications.

Inclusion criteria

Articles with reports on the oral health behavior of pregnant women in Nigeria, published in English in peer review were included in the review. All articles included had undergone peer-review.

Exclusion criteria

Articles with participants outside Nigeria were excluded. Articles whose full lengths could not be accessed, and commentaries on studies, and letters to the editor were also excluded. Narrative reviews which did not focus on the oral health behavior of pregnant women in Nigeria were also excluded along with qualitative studies and gray literature.

Data charting process

The authors developed a data-charting form for extracting pertinent variables and then individually performed data extraction for each study included in the review. Two distinct authors who were uninformed about each other’s findings charted the data, ensuring precision in data extraction. The authors recorded variables associated with the aim of the scoping review, such as authors and year of publication of the study, study location, study objective, study design, methodological approach for data collection, and study outcome.

Data analysis

The data extracted from the included studies underwent thematic analysis to uncover recurring themes, patterns, or trends across the literature. These emerging themes were closely aligned with key concepts, issues, or findings within the scope of the review. Subsequently, the findings from the included studies were synthesized narratively, organized around identified themes or key concepts and elucidating gaps in the literature. The key findings were compared to identify the oral care behaviors by pregnant women in Nigeria. In addition, the reasons for using or not using dental services during pregnancy were summarized.

Results

As can be seen in the flowchart (Fig. 1), the search yielded a total of 595 articles. After removing duplicate records, 573 unique records remained. After an initial screening of titles and abstracts and a subsequent screening process, 21 articles met the eligibility criteria for full-text review. On reviewing the full articles, three were excluded due to data not being pertinent to the target study group and the study not being specific to Nigeria. The final 18 articles were reviewed.

Fig. 1
figure 1

Flow diagram of included studies

Table 1 provides a summary of three studies excluded from the review, along with the reasons for their exclusion. Two studies [31, 32] conducted outside Nigeria, one in Pakistan and the other in Nepal, were excluded due to their geographical location. The third study [33], conducted in Nigeria, was excluded because it focused on pregnancy managed by traditional birth attendants, which fell outside the scope of the review. This suggests that the review focused specifically on studies conducted within Nigeria and within the scope of the review’s objectives.

Table 1 Excluded studies based on country and reasons for exclusion

Characteristics of the selected studies

As shown in Table 2, the year of publication of the 18 included studies ranged from 2010 to 2022. There were 11 (61.1%) studies published between 2010 and 2019 [21, 34, 35, 37,38,39,40,41,42, 45, 46], and seven (38.9%) studies were conducted between 2021 and 2022 [15, 25, 36, 43, 44, 47, 48]. There was no study published in year 2020.

The 18 studies were conducted in five of the six geopolitical zones in Nigeria: Southwest 38.9% (n = 7) [35,36,37,38,39, 43, 46], Southsouth 38.9% (n = 7) [15, 21, 34, 40, 41, 45, 47] Southeast 11.1% (n = 2) [25, 48], Northwest 5.6% (n = 1) [44] and Northeast (n = 1) [40]. The studies conducted in Southwest Nigeria were conducted in four of the six states in the geopolitical zones, namely Lagos (n = 3) [35, 37, 43], Oyo (n = 2) [39, 46], Ogun (n = 1) [36] and Osun (n = 1) [38]. In Southsouth Nigeria, the studies were conducted in three of the six states in the region: Edo (n = 3) [41, 42, 45], Rivers (n = 3) [15, 21, 47], and Cross Rivers (n = 1) [34]. The two studies in Southeast Nigeria were in Enugu State [25, 48], while the single study in Northwest Nigeria was Kaduna State [44], and that in Northeast Nigeria was conducted in two states – Taraba and Maiduguri [40].

The sample sizes across the 18 studies varied, ranging from 77 to 480 participants. In total, these studies involved 5,083 participants. It’s worth noting that the sample size for Onwuka et al. [25] and Onwuka et al. [48], as well as Okeigbemen & Adam [41] and Adam et al. [42], were counted as a single instance in the total sample size calculation. This adjustment was made because these pairs of studies had identical sample sizes and were conducted among the same population during the same period. Of the 18 studies included in this review, 17 (94.1%) were cross-sectional studies. The other study design was a cohort study [46]. None of the studies employed qualitative or mixed research methods. All the studies were facility-based surveys, and none were conducted in a community setting.

Oral hygiene practices

Table 2 highlights the different oral hygiene practices assessed in the study. Oral hygiene practices assessed were a history of dental visits [15, 21, 25, 35,36,37,38,39,40,41,42,43,44,45,46], the use of toothbrush and toothpaste [34, 39, 40, 42, 44, 46,47,48] or its use in combination with chewing sticks [34, 38, 40, 44, 48]. The chewing stick alone [15, 34, 35, 38, 39, 42, 44,45,46]. The proportion of respondents who used toothbrushes with toothpaste ranged from 42 to 100% across different studies. Dental floss [36, 41, 42, 47, 48] for oral hygiene was also assessed. Two studies assessed the rinsing of the mouth with water after vomiting [36, 38]. Only one study documented the dietary choices that affect women’s oral health during pregnancy. [35]

Some of the studies assessed the frequency of oral hygiene practices. These include daily frequency of toothbrushing once daily [15, 25, 35,36,37,38,39,40, 42,43,44,45], 46, 47], twice daily [15, 25, 35, 36, 38, 39, 41, 43,44,45,46,47,48], and more than twice daily [35, 40, 42, 44, 46]. One study also reported frequency of tooth brushing of once a week and 2–6 times a week among pregnant women [42]. The frequency of tooth brushing once daily ranged from 31.1% [44] to 71.4% [46], while the frequency of tooth cleaning twice daily or more ranged from 5.2 [38] to 66.9% [44]. None of the studies provided information on the frequency of toothbrushes and toothpaste usage for oral care among pregnant women. Nevertheless, some alternative cleaning agents used by pregnant women, as reported in the studies, included charcoal in Taraba State [40, 42] and table salt and baking soda in Edo State [42].

The frequency of those who rely solely on chewing sticks for tooth cleaning ranged from 0.1% in Cross River State [34] to 1% in Kaduna State [44] and 10.6% in Oyo State [39]. Also, up to 0.7% in Taraba and Maiduguri [40], 2.4% of respondents in Kaduna State [44], 4.8% in Cross River State [34], 14.4% in Osun State [38], and 15.25% in Enugu State [48] combined toothbrushes and toothpaste with local chewing sticks as part of their oral hygiene routine.

The prevalence of the use of dental floss ranged from 0% in Enugu [48] to 51.7% in Ogun [36], 19.8% in Rivers [47], and 36.8% in Edo [42]. However, out of the 18 studies, only three (16.5%) provided documentation on the utilization of toothpicks [41, 42, 47], the use of fluoride toothpaste [15, 42, 48], and the frequency of changing toothbrushes [25, 45, 48] among pregnant women.

Reasons for use and non-use of dental services

The use of dental services ranged from as low as 3.9% in Oyo State [46] to as high as 62.9% in Lagos State [35]. Dental service utilization by pregnant women was less than 30% in 11 (73.3%) of the 15 studies that reported on dental service utilization [15, 21, 25, 36,37,38,39,40,41, 45, 46]); 54.7% in Lagos [41] and Kaduna States [44] respectively, 55.7% in Edo State [42] and 62.9% in Lagos State [35] as shown in Table 2.

Table 2 Characteristics of the selected studies

Table 3 sheds light on the factors influencing the utilization of dental services among pregnant women in Nigeria. Among the 18 studies examined, eight (44.4%) investigated the drivers of the usage or avoidance of dental services. These determinants encompassed various considerations such as managing dental caries, [21, 25, 42] alleviating pain, [21, 25, 42] and managing periodontal problems. [21, 27, 34].

Four of these eight studies also explored why pregnant women refrained from visiting dental clinics. These rationales were individual, structural, and behavioral-related factors. Individual factors were the fear of dental treatments [15, 45], fear of pain during dental procedures [15], and prior negative encounters at dental clinics [15]. Structural factors encompassed challenges like limited accessibility to dental facilities [45], financial constraints [41, 45], and medical advice against dental visits from healthcare professionals [45]. Lastly, behavioral factors included inadequate awareness about the necessity of dental visits [41], insufficient prioritization of dental care due to time constraints, [45] and an unfavorable attitude, ranging from indifference toward dental health [45] to the belief that dental care was unnecessary. [15, 41, 45] A study also uncovered a misconception that dental visits were unsafe during pregnancy. [41]

Table 3 Reasons for visit and non-visits of dental clinics by pregnant women in Nigeria

Discussion

This scoping review presents a comprehensive overview of the oral health practices among pregnant women in Nigeria. The findings reveal that many pregnant women in Nigeria engage in self-directed oral health behaviors, such as brushing their teeth with toothpaste and using chewing sticks. However, brushing teeth twice daily, considered optimal for good oral self-directed oral health care, is not widely adopted. The utilization of dental services varies across the studies, with the highest proportion of dental service users reported in urban areas like Lagos, Edo, and Kaduna. The reasons for seeking dental services predominantly revolve around curative care, while factors preventing service utilization range from individual characteristics to structural and behavioral factors, as well as misconceptions about receiving dental care during pregnancy.

This study provides the first comprehensive insights into the state of oral health practices among pregnant women in Nigeria. Including studies from a wide geographical range within Nigeria enhances the diversity and applicability of the findings. Furthermore, the study sheds light on the epidemiological profile of oral health behavior among pregnant women, offering valuable information that can inform policies and strategies to reduce the risk of adverse pregnancy outcomes in Nigeria.

Nevertheless, the review has some limitations. First, the exclusion of unpublished gray literature, potentially limiting comprehensiveness of the findings. Also, all included studies were cross-sectional, with only one cohort study, thus constraining the level of evidence. Lastly, the lack of specificity in data collection tools for oral health behavior limited the collection of relevant data regarding oral health products such as fluoride containing toothpastes, name and type of chewing stick the use of sugar free chewing gums and the use of mouth washes. This hinders detailed analysis. Despite these limitations, the findings contribute valuable evidence that can guide future research endeavors.

Oral health behaviors include the frequency and technique of toothbrushing, including the use of fluoride toothpaste [49], regularity and effectiveness of flossing to remove food particles and plaque from between teeth [50, 52], utilization of mouthwash or antimicrobial rinses as part of oral hygiene routines [51, 52], dietary choices, [51] particularly the consumption of sugary and acidic foods and beverages that can contribute to dental caries, [51, 54, 55] tobacco use, both smoking and smokeless forms, [52, 56] excessive alcohol consumption, [57] and the frequency of dental checkups for routine examinations and cleanings [53]. These behaviors are associated with pregnancy outcomes [40, 41, 43,44,45].

First, we observed that the studies do not report on the use of mouthwash (except for rinsing the mouth with water after vomiting), alcohol consumption, tobacco use during pregnancy, and the frequency and quantity of free sugar consumption. These gaps restrict the discussion on the breadth of oral health practices among pregnant women in Nigeria, as these practices vary widely among individuals and populations. It is important to identify every factor that contributes to the country’s unfavorable national maternal and child health indicators as the pooled estimate of adverse birth outcomes in the country is 27.69% [58]. Poor oral health contributes to adverse birth outcomes in Nigeria [59]. The current study highlights that while the daily tooth cleaning using toothbrushes and toothpaste among pregnant women seem optimal, the frequency was not. Adequate frequency is needed to reduce the risk for caries and periodontal diseases [60]. These two oral diseases are risk factors for adverse pregnancy outcomes [5, 10,11,12,13]. Introducing oral health education into the perinatal care of pregnant women in Nigeria could enhance the effectiveness of the current toothbrushing habits of pregnant women in Nigeria [61]. There are currently no established protocols for incorporating oral health education [10]. The current study underscores the need for changes in policy and practices in ways to support pregnant women to optimize their self-care oral health practices.

Furthermore, observations indicate that the utilization of dental services among pregnant women in Nigeria is generally low, with a moderate uptake observed in urbanized areas. Interestingly, these urban centers enhance citizens’ access to information through various educational channels [62, 63] and facilitate increased access to primary, secondary, and tertiary dental care services in Nigeria’s public and private healthcare settings [62]. Integrating dental health services into Nigeria’s primary healthcare system can potentially enhance pregnant women’s access to dental care, given that all primary healthcare services in Nigeria include antenatal care. Regrettably, very few primary healthcare centers in Nigeria offer oral health services [63], and those that do are predominantly located in cosmopolitan areas like Lagos. It becomes imperative to raise oral health awareness among pregnant women by integrating oral health education into routine antenatal check-ups, possibly through a dedicated section in the road to health chart. There is also a need for concerted efforts to promote the integration of oral health services into primary healthcare centers across Nigeria, thereby improving the oral health of pregnant women. This approach serves as a strategy to address structural barriers that hinder access to oral healthcare.

Second, we noticed limited dental service utilization by pregnant women, and when utilized, it is for curative care. The national health insurance scheme, if effectively utilized, provides supports for the access of all pregnant women to primary oral health care. However, the coverage is low – as low as 6.9% - and much lower among women less than 30 years, with no formal education, and primigravidae [67]. Addressing structural barriers to accessing oral health care services by pregnant women will need to be addressed to improve preventive oral health care access by pregnant women in Nigeria. In addition, behavior-related obstacles such as misconceptions and myths about oral health service utilization during pregnancy needs to be tackled through proactive public health education initiatives and awareness campaigns. Active engagement of Community Health Extension workers and Community Health Influencers, Promoters, and Services who are trained to conduct culturally appropriate health promotion and disease prevention services through primary health care and healthy living practices in rural and under-served communities [68,69,70,71,72] can be mobilized to help in this respect. The 625 operational broadcast stations [73] are valuable platforms that can be harnessed to disseminate information on oral health to communities nationwide. In addition, midwives and obstetricians, the primary caregivers that pregnant women interact with during antenatal care can have their competency built to promote the oral health of pregnant women. Currently, they face challenges when discussing oral health concerns and making referrals for dental treatment [74, 75].

However, it is important to emphasize the growing importance of self-care. As highlighted in this review, there is a high level of toothbrush use, which is one form of self-care. There is a rising need to develop and deploy point-of-care devices that empower individuals to assess their oral health needs promptly to enhance the utilization of dental services for oral healthcare. One potential solution is the microbial-enzymatic N-benzoyl-DL-arginine-2-naphthylamide (BANA) test, which is being advocated as a viable point-of-care method for improving oral care among pregnant women [76]. The creation of affordable, sensitive, and precise self-care tools like these can further enhance the practice of oral health self-care among pregnant women.

In addition, we observed regional discrepancies in the volume of published information with extremely few studies from Northern Nigeria, where the maternal and child health crisis is higher [63]. The skewness in the publication volume to Southern Nigeria creates a significant knowledge gap in understanding the multifaceted determinants that impact women’s oral healthcare behaviors during pregnancy. This gap can hinder the development of evidence-based, effective interventions and policies to promote maternal oral health in the country. [64] Thus, future studies from other parts of the country, especially Northcentral Nigeria, where no study exists, are needed.

We also observed the absence of publications in the year 2020. This absence may indicate a lack of research focus or interest in the topic during that specific year. Several factors could have contributed to this, including a potential shift in research priorities, challenges in accessing relevant datasets or research resources, methodological obstacles in conducting studies, or external factors such as funding constraints, policy changes, or global events. Additionally, the absence of publications in 2020 could be attributed to publication lag, where studies conducted during that time were not published until later years, potentially skewing the distribution of studies across different time periods. Further investigation and analysis are necessary to fully comprehend the implications of this absence within the broader research landscape. Nevertheless, the overall trend in publication suggests a progressive increase in the number of publications, indicating a growing interest in the topic. It is anticipated that by the end of the decade, publications on oral health behavior among pregnant women in Nigeria will continue to rise. Therefore, the current review is timely and significant as it can inform and influence the direction of future research in this field.

Of interest is the observed use of chewing sticks by pregnant women [15, 34, 35, 38,39,40, 42, 44,45,46]. Promoting contemporary oral hygiene practices while acknowledging and respecting cultural traditions is crucial to enhancing and preserving pregnant women’s oral health. Although modern oral care products have evolved into advanced multifunctional solutions capable of maintaining the presence and effectiveness of active oral health-enhancing ingredients in the mouth to offer continuous protection throughout the day [65], chewing sticks can also effectively clean oral tissues, may surpass toothbrushes in some respects, and has significant anti-plaque properties [66]. This study highlights the need to include information on the effective use of chewing sticks in the oral health information package for pregnant women in Nigeria. However, there is a lack of research comparing the effectiveness of chewing sticks and toothbrushes during pregnancy, calling for further investigation.

Conclusions

This scoping review underscores significant disparities in oral hygiene practices among pregnant women in Nigeria. Many pregnant women rely on self-care methods such as tooth cleaning, while a smaller proportion seek out dental services. However, both the frequency of toothbrushing and the utilization of dental services fall short of optimal levels. Identified individual, structural, and behavioral factors deter pregnant women from accessing dental services. Future studies are needed to enhance our understanding of the oral health practices among pregnant women, and more studies are needed from Northern Nigeria.

Data availability

The data provided in this research can be freely accessed on PubMed, Science Direct, Web of Science, EBSCOHOST, Sabinet, African Index Medicus, and Scopus.

Abbreviations

PRISMA:

Preferred Reporting Items for Systematic Review and Meta- Analysis

References

  1. Kandan PM, Menaga V, Kumar RRR. Oral health in pregnancy (guidelines to gynaecologists, general physicians and oral health care providers). JPMA-J. Pak. Med. Assoc; 2011. 61. 1009.

  2. Nuriel-Ohayon M, Neuman H, Koren O. Microbial changes during pregnancy, birth, and Infancy. Front Microbiol. 2016;7:1031.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Silva de Araujo Figueiredo C, Gonçalves Carvalho Rosalem C, Costa Cantanhede AL, Abreu Fonseca Thomaz ÉB. Fontoura Nogueira Da Cruz MC. Systemic alterations and their oral manifestations in pregnant women. J Obstet Gynaecol Res. 2017;43:16–22.

    Article  PubMed  Google Scholar 

  4. Ressler-Maerlender J, Krishna R, Robison V. Oral health during pregnancy: current research. J Women’s Health. 2005;14:880–2.

    Article  Google Scholar 

  5. Rahman B, Kawas S. The relationship between dental health behavior, oral hygiene and gingival status of dental students in the United Arab Emirates. Eur J Dent. 2013;7:22–7.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Nithila A, Bourgeois D, Barmes DE, Murtomaa H. WHO Global Oral Data Bank, 1986–1996: An overview of oral health surveys at 12 years of age. Bull World Health Organ; 1998. 76. 237.

  7. Turton MS, Henkel RR, Africa CWJ. A simple point of Care Test can indicate the need for Periodontal Therapy to reduce the risk for adverse pregnancy outcomes in mothers attending Antenatal clinics. Volume 22. Biomarkers; 2017. pp. 740–6.

  8. Mumghamba EGS, Manji KP. Maternal oral Health Status and Preterm Low Birth Weight at Muhimbili National Hospital, Tanzania: a case-control study. 7 ed. BMC Oral Health; 2007. p. 1.

  9. Gesase N, Miranda-Rius J, Brunet-Llobet L, Lahor-Soler E, Mahande MJ, Masenga G. The Association between Periodontal Disease and adverse pregnancy outcomes in Northern Tanzania: a cross-sectional study. Afr Health Sci. 2018;18(3):601–11.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Corbella S, Taschieri S, del Fabbro M, Francetti L, Weinstein R, Ferrazzi E. Adverse pregnancy outcomes and periodontitis: a systematic review and meta-analysis exploring potential association. Quintessence Int (Berl). 2016;2. 47(3).

  11. Azadbakht K, Baharvand P, Artemes P, Niazi M, Mahmoudvand H. Prevalence and risk factors of oral cavity parasites in pregnant women in Western Iran. Parasite Epidemiol Control; 2022. 19. e00275.

  12. Adesina KT, Ernest MA, Tobin AO, Isiaka-Lawal SA, Adeyemi MF, Olarinoye AO, Ezeoke GG. Oral health status of pregnant women in Ilorin, Nigeria. J Obstet Gynaecol. 2018;38(8):1093–8.

    Article  PubMed  Google Scholar 

  13. CDC Pregnancy and Oral Health Feature. cdc.gov/oralhealth/publications/features/pregnancy-and-oral-health.html

  14. Umoh AO, Savage KO, Ojehanon PI. Association between maternal Gingivitis, Low Birth Weight and Preterm Delivery. JMBR. 2013;12(1):65–75.

    Google Scholar 

  15. Soroye M, Bello K. Dental Service utilization, oral Hygiene practices, and Periodontal Treatment needs of pregnant women in Nigeria. LASU J Med Sci. 2022;5(1).

  16. Miranda-Rius J, Brunet‐Llobet L, Blanc V, Álvarez G, Moncunill‐Mira J, Mashala EI, Kasebele Y, Masenga G, Nadal A, León R. Microbial Profile of Placentas from Tanzanian mothers with adverse pregnancy outcomes and Periodontitis. Oral Dis. 2021;29(2):772–85.

    Article  PubMed  Google Scholar 

  17. Cissé DF, Diouf M, Faye A, Diadhiou M, Tal-Dia A. Periodontal Disease of pregnant women and Low Weight Newborn in Senegal: a case-control study. Open J Epidem. 2015;5:1–8.

    Article  Google Scholar 

  18. Wanjohi R. Preterm low birth weight and maternal periodontal status among mothers attending Puwani Maternity Hospital Nairobi, Kenya. Master’s Thesis, University of Nairobi; 2020.

  19. Harjunmaa U, Järnstedt J, Alho L, Dewey KG, Cheung YB, Deitchler M, Ashorn U, Maleta K, Klein NJ, Ashorn P. Association between maternal dental periapical infections and pregnancy outcomes: results from a cross-sectional study in Malawi. Trop Med Int Health. 2015;20(11):1549–58.

    Article  PubMed  Google Scholar 

  20. Uwambaye P, Munyanshongore C, Rulisa S, Shiau H, Nuhu A, Kerr MS. Assessing the Association between Periodontitis and premature birth: a case-control study. BMC Pregnancy Childbirth; 2021. p. 21.

  21. Rahman MM, Abe SK, Rahman MS, Kanda M, Narita S, Bilano V, Ota E, Gilmour S, Shibuya K. Maternal anemia and risk of adverse birth and health outcomes in low-and middle-income countries: systematic review and meta-analysis, 2. Am J Clin Nutr. 2016;103(2):495–504.

    Article  CAS  PubMed  Google Scholar 

  22. Tsegaye B, Kassa A. Prevalence of adverse birth outcome and associated factors among women who delivered in Hawassa town governmental health institutions, South Ethiopia, in 2017. Reprod Health. 2018;15(1):193.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Bashiru BO, Anthony IN. Oral health awareness and experience among pregnant women in a Nigerian tertiary health institution. J Dent Res Rev. 2014;1(2):66–9.

    Article  Google Scholar 

  24. Adeniyi A, Donnelly L, Janssen P, Jevitt C, von Bergman H, Brondani M. A qualitative study of Health Care Providers’ views on integrating oral health into prenatal care. JDR Clin Trans Res. 2021;6(4):409–19.

    CAS  PubMed  Google Scholar 

  25. Onwuka C, Onwuka CI, Iloghalu EI, Udealor PC, Ezugwu EC, Menuba IE, Ugwu EO, Ututu C. Pregnant women utilization of dental services: still a challenge in low resource setting. BMC Oral Health. 2021;21(1):384.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Petersen PE. World Health Organization global policy for improvement of oral health—World Health Assembly 2007. Int Dent J. 2008;58:115–21.

    Article  PubMed  Google Scholar 

  27. Sajjan P, Pattanshetti JI, Padmini C, Nagathan VM, Sajjanar M, Siddiqui T. Oral Health Related Awareness and practices among pregnant women in Bagalkot District, Karnataka, India. J Int Oral Health. 2015;7(2):1–5.

    PubMed  PubMed Central  Google Scholar 

  28. Arksey H, O’Malley L. Scoping studies: towards a Methodological Framework. Int J Soc Res Methodol. 2005;8(1):19–32.

    Article  Google Scholar 

  29. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, Moher D, Peters MDJ, Horsley T, Weeks L, Hempel S, Akl EA, Chang C, McGowan J, Stewart L, Hartling L, Aldcroft A, Wilson MG, Garritty C, Lewin S, Godfrey CM, Macdonald MT, Langlois EV, Soares-Weiser K, Moriarty J, Clifford T, Tunçalp Ö, Straus SE. PRISMA Extension for scoping reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169:467–73.

    Article  PubMed  Google Scholar 

  30. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ; 2021. 372. 71.

  31. Ishaq Z, Faiz Rasul AA. Oral health seeking behaviour among pregnant Women-A cross sectional survey. Cell. 2018;343:8430485.

    Google Scholar 

  32. Lubon AJ, Erchick DJ, Khatry SK, LeClerq SC, Agrawal NK, Reynolds MA, Katz J, Mullany LC. Oral health knowledge, behavior, and care seeking among pregnant and recently-delivered women in rural Nepal: a qualitative study. BMC Oral Health. 2018;18:1–7.

    Article  Google Scholar 

  33. Ligali TO, Uti OG, Sofola OO. A survey of self-reported oral health practices, behaviour and oral health status of pregnant women attending TBA ante-natal clinics in a Nigerian rural community. Afr J Oral Health. 2017;7(1):17–23.

    Article  Google Scholar 

  34. Bassey GO, Anyanechi CE, Ekabua KJ, Ekabua JE. Oral health among antenatal care attendees in Calabar, Nigeria. J Obstet Gynaecol. 2010;30(2):143–6.

    Article  CAS  PubMed  Google Scholar 

  35. Abiola A, Olayinka A, Mathilda B, Ogunbiyi O, Modupe S, Olubunmi OA. Survey of the oral health knowledge and practices of pregnant women in a Nigerian teaching hospital. Afr J Reprod Health. 2011;15(4):14–9.

    PubMed  Google Scholar 

  36. Chinenye-Julius AE, Omeonu PE, Akinsola K. Knowledge, attitude and practices of oral Hygiene among pregnant women attending Antenatal Clinics in Nigeria: evidence from Ogun State. Afr J Health Sci. 2021;34(1):44–54.

    Google Scholar 

  37. Adeniyi AA, Ogunbanjo BO, Sorunke ME, Onigbinde OO, Agbaje MO, Braimoh M. Dental attendance in a sample of Nigerian pregnant women. Nig Q J Hosp Med. 2010;20(4):186–91.

    CAS  PubMed  Google Scholar 

  38. Afolabi AO, Adedigba MA, Adekanmbi V. Evaluation of oral health among pregnant women in a Nigerian population. East Afr J Public Health. 2014;18(11):630–340.

    Google Scholar 

  39. Ifesanya JU, Ifesanya AO, Asuzu MC, Oke GA. Determinants of good oral hygiene among pregnant women in Ibadan, South-Western Nigeria. Ann med Health sci res. 2010;8:95–100.

    Google Scholar 

  40. Bukar M, Audu BM, Adesina OA, Marupa JY. Oral health practices among pregnant women in North Eastern Nigeria. Niger J Clin Pract. 2012;15:302–5.

    Article  CAS  PubMed  Google Scholar 

  41. Okeigbemen SA, Adam VY. Factors influencing the oral hygiene practices of pregnant women attending public secondary health facilities in Benin City. Nigeria. HemaSphere; 2019. p. 502.

  42. Adam VY, Okeigbemen SA, Osagie O, Oseghale E. Knowledge, attitude towards and practice of oral hygiene among antenatal clinic attendees in public secondary health facilities in Benin City, Nigeria. Nigerian Health J. 2017;17:301.

    Google Scholar 

  43. Onigbinde OO, Sorunke ME, Braimoh MO, Adeniyi AO. Periodontal status and some variables among pregnant women in a Nigeria tertiary institution. Ann med Health sci res; 2014. 4. 852–7.

  44. Omisakin O, Mohammed D, Fomete B. Oral health knowledge and practices among pregnant women in a teaching hospital in north-west, Nigeria. Nig J Med Dent Edu; 2012. 17. 45–9.

  45. Azodo CC, Omuemu VO. Perceived oral health, oral self-care habits and dental attendance among pregnant women in Benin-City, Nigeria. Tanzan Dent J; 2012. 17. 45–9.

  46. Lasisi TJ, Abdus-Salam RA. Pattern of oral Health among a Population of pregnant women in Southwestern Nigeria. Arch Basic Appl Med. 2018;6:99–103.

    CAS  PubMed  PubMed Central  Google Scholar 

  47. Soroye MO, Onigbinde OO. Oral hygiene status, interdental cleaning and perception of gingival bleeding among a group of pregnant women in Nigeria. Nigerian J Dent Res. 2022;7:75–82.

    Article  Google Scholar 

  48. Onwuka CI, Udealor PC, Iloghalu EI, Onwuka CI, Ezugwu EC, Menuba IE. Oral Health Awareness and practices among pregnant women receiving Antenatal Care in a low resource setting: a cross-sectional study of Antenatal attendees in Enugu, Southeastern Nigeria. J Clin Diagn Res. 2021;15:13–6.

    Google Scholar 

  49. Kimhasawad W, Punyanirun K, Somkotra T, Detsomboonrat P, Trairatvorakul C, Songsiripradubboon S. Comparing protection-motivation theory‐based intervention with routine public dental health care. Int J Dent Hyg. 2021;19:279–86.

    Article  PubMed  Google Scholar 

  50. Mazhari F, Boskabady M, Moeintaghavi A, Habibi A. The effect of toothbrushing and flossing sequence on interdental plaque reduction and fluoride retention: a randomized controlled clinical trial. J Periodontol. 2018;89:824–32.

    Article  CAS  PubMed  Google Scholar 

  51. Rotella K, Bosma ML, McGuire JA, Sunkara A, DelSasso A, Gaff M, Milleman K, Milleman J. Habits, practices and beliefs regarding Floss and Mouthrinse among Habitual and Non-habitual users. Volume 96. American Dental Hygienists’ Association; 2022. pp. 46–58.

  52. Shah AH, El Haddad SA. Oral hygiene behavior, smoking, and perceived oral health problems among university students. J Int Soc Prev Community Dent. 2015;5:327.

    Article  PubMed  PubMed Central  Google Scholar 

  53. An R, Li S, Li Q, Luo Y, Wu Z, Liu M, Chen W. Oral health behaviors and oral health-related quality of life among dental patients in China: a cross-sectional study. Patient Prefer Adherence; 2022. 1. 3045–58.

  54. Giacaman RA, Fernández CE, Muñoz-Sandoval C, León S, García-Manríquez N, Echeverría C, Valdés S, Castro RJ, Gambetta-Tessini K. Understanding dental caries as a non-communicable and behavioral disease: management implications. Front oral Health. 2022;3:764479.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Rode SD, Gimenez X, Montoya VC, Gómez M, Blanc SL, Medina M, Salinas E, Pedroza J, Zaldivar-Chiapa RM, Pannuti CM, Cortelli JR. Daily biofilm control and oral health: consensus on the epidemiological challenge-latin American Advisory Panel. Braz Oral Res. 2012;26:133–43.

  56. Tiwari RV, Megalamanegowdru J, Gupta A, Agrawal A, Parakh A, Pagaria S, Sahu A. Knowledge, attitude and practice of tobacco use and its impact on the oral health status of 12 and 15-year-old school children of Chhattisgarh, India. Asian Pac J Cancer Prev. 2014;15:10129–35.

    Article  PubMed  Google Scholar 

  57. Miller PM, Ravenel MC, Mauldin MP, Sulkowski S, Lowndes A, Thomas SE. An online alcohol and oral health curriculum for dental students. J Dent Educ. 2014;78:16–23.

    Article  PubMed  Google Scholar 

  58. Tamirat KS, Sisay MM, Tesema GA, Tessema ZT. Determinants of adverse birth outcome in Sub-saharan Africa: analysis of recent demographic and health surveys. BMC Public Health. 2021;21:1–10.

    Article  Google Scholar 

  59. Adebayo ET, Abodunrin OR, Adewole IE, Salako AO, Lusher J, Akinsolu FT, El Tantawi M, Alade OT, Eleje GU, Ezechi OC et al. Oral Diseases and Adverse Pregnancy Outcomes in Sub-Saharan Africa: A Scoping Review. BioMed. 2024;4(1): 1–18. https://doi.org/10.3390/biomed4010001

  60. Davies RM. The prevention of dental caries and periodontal disease from the cradle to the grave: what is the best available evidence? Volume 30. Dental Update; 2003. pp. 170–9.

  61. Batra M, Shah AF, Virtanen JI. Integration of oral health in primary health care through motivational interviewing for mothers of young children: a pilot study. J Indian Soc Pedod Prev Dent. 2018;36:86–92.

    Article  PubMed  Google Scholar 

  62. Okoli C, Hajizadeh M, Rahman MM, Khanam R. Geographical and socioeconomic inequalities in the utilization of maternal healthcare services in Nigeria: 2003–2017. BMC Health Serv Res. 2020;20:1–4.

    Article  Google Scholar 

  63. Uguru N, Onwujekwe O, Uguru CC, Ogu UU. Achieving universal health coverage in Nigeria: the dilemma of accessing dental care in Enugu state, Nigeria, a mixed methods study. Heliyon; 2021. 7. e05977.

  64. Abraham C, Michie S. A taxonomy of behavior change techniques used in interventions. Health Psychol. 2008;27:379–87.

    Article  PubMed  Google Scholar 

  65. Aspinall SR, Parker JK, Khutoryanskiy VV. Oral care product formulations, properties and challenges. Colloids Surf B. 2021;1:200:111567.

    Article  Google Scholar 

  66. Malik AS, Shaukat MS, Qureshi AA, Abdur R. Comparative effectiveness of chewing stick and toothbrush: a randomized clinical trial. N Am J Med Sci. 2014;6:333–7.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Magaji F, Ali MJ, Golit WB, Ogwuche J, Anzaku SA, Ocheke AN, Sagay SA, Imade GE, Oyebode TA, Pam VC, Zoakah AI. National Health Insurance Scheme Coverage for pregnant women in Jos, Nigeria: implications for SDG-3: National Health Insurance Coverage in pregnancy. J Health sci Pract. 2022;1:25–31.

    Google Scholar 

  68. Ikpeme BM, Oyo-Ita AE, Akpet O. Work profile of Community Health Extension workers in Cross River State and implications for achieving MDG 4 and 5. J prim care amp; Community Health. 2013;25:76–9.

  69. Olaniran A, Smith H, Unkels R, Bar-Zeev S, vd Broek N. Who is a community health worker?- a systematic review of definitions. Glob Health Action. 2017;10:1.

    Article  Google Scholar 

  70. Olaniran A, Madaj B, Bar-Zev S, van den Broek N. The roles of community health workers who provide maternal and newborn health services: case studies from Africa and Asia. BMJ Global Health. 2019;4:e001388.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Ibama AS, Dennis P. The role of community health practitioners in National development: the Nigeria situation. Int J Clin Med. 2016;07:511–8.

    Article  Google Scholar 

  72. Community Health Influencers, Promoters, and Services (CHIPS). https://nphcda.gov.ng/chips/#:~:text=The%20Community%20Health%20Influencers%2C%20Promoters%20and%20Services%20%28CHIPS%29,improve%20on%20the%20Village%20Health%20Worker%20%28VHW%29%20concept. [Accessed 23rd September, 2023].

  73. Adegboyega A. Buhari approves 159 new radio, television stations. Premium Times September 28, 2021. https://www.premiumtimesng.com/news/top-news/487197-buhari-approves-159-new-radio-television-stations.html?tztc=1. [Accessed 23rd September, 2023].

  74. Lim M, Riggs E, Shankumar R, Marwaha P, Kilpatrick N. Midwives’ and women’s views on accessing dental care during pregnancy: an Australian qualitative study. Aust Dent J. 2018;63:320–8.

    Article  Google Scholar 

  75. George A, Johnson M, Duff M, Ajwani S, Bhole S, linkhorn A, Ellis S. Midwives and oral health care during pregnancy: perceptions of pregnant women in south-western Sydney, Australia. J Clin Nurs. 2012;21:1087–96.

    Article  PubMed  Google Scholar 

  76. Dhalla N, Patil S, Chaubey KK, Narula IS. The detection of BANA micro-organisms in adult periodontitis before and after scaling and root planing by BANA-Enzymatic™ test kit: an in vivo study. J Indian Soc Periodontol. 2015;19:401–5.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors express their gratitude to the Faculty of Health Sciences Librarian at Nelson Mandela University, South Africa, for granting access to the information and scholarly resources utilized in this research. The authors also thank the Nigerian Institute for Medical Research for supporting the study.

Funding

This study received financial support from the Oral Health Initiative, Nigeria Institute of Medical Research, Nigeria, under grant number [OHI/COH2023/0003].

Author information

Authors and Affiliations

Authors

Contributions

Conceptualization: L.B.A.; Methodology: L.B.A., and A.O.E.; Software: L.B.A., A.O.E., and O.S.I. Validation: L.B.A., A.O.E., and O.S.I.; Formal Analysis: L.B.A., A.O.E., and M.O.F. investigation, L.B.A., A.O.E., O.S.I.; resources: L.B.A., and A.O.E., G.U.E. and M.O.F.; Data Curation: L.B.A., A.O.E., M.O.F., G.U.E., Writing—original draft preparation, L.B.A.; writing—review, A.O.E., G.U.E, and M.O.F.; Visualization, L.B.A., A.O.E., G.U.E. and M.O.F, supervision, G.U.E. and M.O.F. All authors reviewed and approved the final published manuscript.

Corresponding author

Correspondence to Love Bukola Ayamolowo.

Ethics declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ayamolowo, L.B., Esan, A.O., Ibitoye, O.S. et al. Oral health behavior of pregnant women in Nigeria: a scoping review. BMC Oral Health 24, 971 (2024). https://doi.org/10.1186/s12903-024-04728-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12903-024-04728-2

Keywords