A Study to Assess the Impact of a Nurse-Led Educational Intervention on Knowledge Regarding Oral Health Among Primigravida in Selected Hospitals of Navi Mumbai

Pregnancy produces hormonal changes that heighten susceptibility to gingivitis, periodontal disease, and other oral conditions, which have been associated with adverse pregnancy outcomes such as preterm birth, low birth weight, and pre-eclampsia. Despite this, oral health is rarely prioritized within routine antenatal care, particularly in low- and middle-income settings such as India, and nurses are well positioned to close this gap through structured education.
Objectives: To assess knowledge regarding oral health among primigravida before and after a nurse-led educational intervention, to evaluate the impact of the intervention, and to determine the association between pre-intervention knowledge and selected demographic variables.
Methods: A pre-experimental one-group pretest-posttest design was used. Two hundred and twenty primigravida in the first trimester of pregnancy were recruited from five private hospitals in Navi Mumbai using non-probability convenient sampling. Oral health knowledge was measured using a self-structured, expert-validated 35-item questionnaire (content validated by 21 experts; test-retest reliability, r = 0.85) administered before and eight days after a nurse-led educational session delivered through a presentation, charts, and flashcards. Data were analyzed using descriptive statistics, the paired t-test, and the chi-square test of association.
Results: Mean knowledge scores increased significantly from 13.10 (SD = 2.21) before the intervention to 26.04 (SD = 2.35) afterward (t(219) = -74.129, p < .001). Before the intervention, 80.0% of participants had poor knowledge and none had good knowledge; afterward, 84.5% had good knowledge and 11.8% had very good knowledge. Pre-intervention knowledge was significantly associated with age (χ² = 19.23, p = .023) and occupation (χ² = 18.43, p = .031) but not with education, family income, religion, or prior dental visits (all p > .05).
Conclusion: A brief, nurse-led educational intervention produced a substantial and statistically significant improvement in oral health knowledge among primigravida. Embedding such interventions in routine antenatal nursing care may help address a widely neglected component of maternal health in India.

oral health; primigravida; nurse-led education; antenatal care; knowledge; pregnancy

1. American Academy of Pediatric Dentistry, Clinical Affairs Committee–Infant Oral Health Subcommittee. (2015). Guideline on infant oral health care. Pediatric Dentistry, 34, 148–152. [Google Scholar] [Crossref]

2. Bansal, K., Goyal, M., & Dhingra, R. (2015). Effect of an educational intervention on oral health knowledge and attitude among antenatal women. [Journal article — original source details incomplete]. [Google Scholar] [Crossref]

3. Boggess, K. A., & Edelstein, B. L. (2006). Oral health in women during preconception and pregnancy: Implications for birth outcomes and infant oral health. Maternal and Child Health Journal, 10(S1), 169–174. [Google Scholar] [Crossref]

4. Carrillo-de-Albornoz, A., Figuero, E., Herrera, D., & Bascones-Martínez, A. (2015). Gingival changes during pregnancy: II. Influence of hormonal variations on the subgingival biofilm. Journal of Clinical Periodontology, 37(3), 230–240. [Google Scholar] [Crossref]

5. Cengiz, S. B. (2017). The pregnant patient: Considerations for dental management and drug use. Quintessence International, 38, e133–e142. [Google Scholar] [Crossref]

6. Gaffield, M. L., Gilbert, B. J., Malvitz, D. M., & Romaguera, R. (2015). Oral health during pregnancy: An analysis of information collected by the Pregnancy Risk Assessment Monitoring System. Journal of the American Dental Association, 132(7), 1009–1016. [Google Scholar] [Crossref]

7. George, A., Shamim, S., Johnson, M., Ajwani, S., Bhole, S., Blinkhorn, A., & Yeo, A. E. (2019). Periodontal treatment during pregnancy and birth outcomes: A meta-analysis of randomized trials. International Journal of Evidence-Based Healthcare, 121–147. [Google Scholar] [Crossref]

8. Giglio, J. A., Lanni, S. M., Laskin, D. M., & Giglio, N. W. (2019). Oral health care for the pregnant patient. Journal of the Canadian Dental Association, 75, 43–48. [Google Scholar] [Crossref]

9. Hullah, E., Turok, Y., Nauta, M., & Yoong, W. (2018). Self-reported oral hygiene habits, dental attendance and attitudes to dentistry during pregnancy in a sample of immigrant women in north London. Archives of Gynecology and Obstetrics, 277(5), 405–409. [Google Scholar] [Crossref]

10. Hwang, S. S., Smith, V. C., McCormick, M. C., & Barfield, W. D. (2015). Racial/ethnic disparities in maternal oral health experiences in 10 states, Pregnancy Risk Assessment Monitoring System, 2004–2006. Maternal and Child Health Journal, 15(6), 722–729. [Google Scholar] [Crossref]

11. Kavungal, T. (2019). Effectiveness of a structured teaching programme on knowledge regarding prevention of dental caries among pregnant mothers in a selected hospital, Kollam district. European Journal of Pharmaceutical and Medical Research. [Google Scholar] [Crossref]

12. Kloetzel, M. K., Huebner, C. E., Milgrom, P., Littell, C. T., & Eggertsson, H. (2018). Oral health in pregnancy: Educational needs of dental professionals and office staff. Journal of Public Health Dentistry, 72(4), 279–286. [Google Scholar] [Crossref]

13. Laine, M. A. (2015). Effect of pregnancy on periodontal and dental health. Acta Odontologica Scandinavica, 60(5), 257–264. [Google Scholar] [Crossref]

14. Leelavati, R. (2018). Knowledge, attitude and practices related to oral health among pregnant women attending a government hospital, Chennai [Study report — original source details incomplete]. [Google Scholar] [Crossref]

15. López, N. J., Smith, P. C., & Gutierrez, J. (2016). Higher risk of preterm birth and low birth weight in women with periodontal disease. Journal of Dental Research, 81(1), 58–63. [Google Scholar] [Crossref]

16. Lydon-Rochelle, M. T., Krakowiak, P., Hujoel, P. P., & Peters, R. M. (2014). Dental care use and self-reported dental problems in relation to pregnancy. American Journal of Public Health, 94(5), 765–771. [Google Scholar] [Crossref]

17. Martinez Abreu, J. (2015). Effects of an oral health education program for pregnant women. [Journal article — original source details incomplete]. [Google Scholar] [Crossref]

18. Michalowicz, B. S., Hodges, J. S., DiAngelis, A. J., Lupo, V. R., Novak, M. J., Ferguson, J. E., Buchanan, W., Bofill, J., Papapanou, P. N., Mitchell, D. A., Matseoane, S., & Tschida, P. A. (2016). Treatment of periodontal disease and the risk of preterm birth. New England Journal of Medicine, 355(18), 1885–1894. [Google Scholar] [Crossref]

19. Offenbacher, S., Lieff, S., Boggess, K. A., Murtha, A. P., Madianos, P. N., Champagne, C. M., McKaig, R. G., Jared, H. L., Mauriello, S. M., Auten, R. L., Herbert, W. N., & Beck, J. D. (2001). Maternal periodontitis and prematurity. Part I: Obstetric outcome of prematurity and growth restriction. Annals of Periodontology, 6(1), 164–174. [Google Scholar] [Crossref]

20. Osman, S. R. (2018). Knowledge, attitude and practice regarding oral healthcare among pregnant women in Assiut, Egypt [Study report — original source details incomplete]. [Google Scholar] [Crossref]

21. Patil, S. N., Kalburgi, N. B., Koregol, A. C., Warad, S. B., Patil, S., & Ugale, M. S. (2018). Female sex hormones and periodontal health awareness among gynecologists: A questionnaire survey. Saudi Dental Journal, 24(2), 99–104. [Google Scholar] [Crossref]

22. Sood, M. (2017). Oral health knowledge, attitude, and associated factors among pregnant women in India [Study report — original source details incomplete]. [Google Scholar] [Crossref]

23. Taani, D. Q., Habashneh, R., Hammad, M. M., & Batieha, A. (2015). The periodontal status of pregnant women and its relationship with socio-demographic and clinical variables. Journal of Oral Rehabilitation, 30(4), 440–445. [Google Scholar] [Crossref]

24. Thalla, M. (2016). Women have a right to safe motherhood. Plan Parenthood Challenge, 1, 1–2. [Google Scholar] [Crossref]

25. Thomas, N. J., Middleton, P. F., & Crowther, C. A. (2018). Oral and dental health care practices in pregnant women in Australia: A postnatal survey. BMC Pregnancy and Childbirth, 8, Article 13. [Google Scholar] [Crossref]

26. Tilakaratne, A., Soory, M., Ranasinghe, A. W., Corea, S. M., Ekanayake, S. L., & de Silva, M. (2017). Periodontal disease status during pregnancy and 3 months post-partum, in a rural population of Sri-Lankan women. Journal of Clinical Periodontology, 27(10), 787–792. [Google Scholar] [Crossref]

27. Vogt, M., Sallum, A. W., Cecatti, J. G., & Morais, S. S. (2019). Factors associated with the prevalence of periodontal disease in low-risk pregnant women. Reproductive Health, 9(3). [Google Scholar] [Crossref]

28. Wagh, S. (2018). Knowledge, attitude and practice of oral health and adverse pregnancy outcomes among rural and urban pregnant women of Moradabad, Uttar Pradesh [Study report — original source details incomplete]. [Google Scholar] [Crossref]

29. Xiong, X., Buekens, P., Fraser, W. D., Beck, J., & Offenbacher, S. (2016). Periodontal disease and adverse pregnancy outcomes: A systematic review. BJOG: An International Journal of Obstetrics & Gynaecology, 113(2), 135–143. [Google Scholar] [Crossref]