CC BY-NC-ND 4.0 · European Dental Research and Biomaterials Journal
DOI: 10.1055/s-0045-1806956
Review Article

The Role of Interprofessional Education in Oral Health Promotion from Pregnancy to Early Childhood: Narrative Review

Ebtehal Ghazal
1   Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
,
2   Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
,
Gajanan Kulkarni
3   Pediatric Dentistry Department, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
› Author Affiliations
Funding None.
 

Abstract

Oral health is integral to general health and vice versa and should be viewed as such. Therefore, interprofessional collaboration in oral health is essential for enhancing overall systemic health, preventing dental diseases, and promoting oral health awareness among expectant families and young children. This narrative review provides an overview of critical aspects of interprofessional collaboration in promoting oral health from pregnancy to early childhood. A comprehensive search using electronic databases was conducted for publications from 2014 to 2024. The authors included studies that assessed the role of interprofessional education (IPE) and practices in oral health care and recommended the best IPE practices to achieve optimal oral health in children. Several oral health conditions may occur during pregnancy. Yet, many pregnant women are unaware of the importance of prenatal and postnatal oral care and that seeking regular or emergency dental care is safe. Interprofessional collaboration in oral health promotion needs to be improved in many ways to help increase awareness and address dental problems for pregnant women and young children. IPE and practice can enable effective communication between health care professionals and critically contribute to optimal oral health in children and overall well-being in pregnancy and early childhood.


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Introduction

Oral health is a significant component of overall health and well-being. The World Health Organization (WHO) considers oral health an essential aspect of health.[1] Oral microorganisms play a role in common diseases affecting general health. Maintaining oral health for pregnant women is necessary as maternal health and behaviors significantly impact coral health outcomes later in life.[2] [3] The first stage of primary tooth development begins around 6 weeks of pregnancy (gestation), and any disturbance during the development process can affect the tooth morphology and composition.[4] The hormonal changes during pregnancy may affect oral tissues, causing gingival sensitivity or inflammation, decreasing the saliva flow and increasing the bacterial plaque.[5] These factors make many pregnant women avoid brushing their teeth properly and taking good oral care, negatively affecting their own and their babies' oral health.[6] Thus, prenatal and postnatal health care is essential for the mother and baby. Studies have shown a strong association between untreated caries and high level of salivary Streptococcus mutans during pregnancy and increased risk of early childhood caries (ECC).[3] [7] According to the American Academy of Pediatric Dentistry, the disease of ECC is the presence of one or more decayed (noncavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in a child aged ≤71 months.[8] Children who experience ECC are at higher risk of having new caries in both primary and permanent dentition.[3] [9] Moreover, maternal dietary habits, oral hygiene practices, and maternal-infant feeding patterns can significantly influence the oral microbial environment within the child's mouth, further contributing to caries susceptibility.[10] These findings emphasize the importance of maternal oral health and caries experience as crucial factors in assessing and preventing childhood dental caries.

Public health interventions upstream of disease onset are successful in preventing disease, and those downstream of disease onset are helpful in mitigating the more deleterious health outcomes. Upstream approaches address the root causes of disease and tooth morbidity, while downstream approaches focus on early disease detection and management.[11] Health promotion is a cost-effective upstream approach that aims to prevent people from acquiring a disease or significantly delaying its onset.[12] Health promotion comprises health education and the implementation of health policies to empower people to control and improve their own or their children's health.

Health education encompasses a variety of learning experiences intended to promote voluntary actions that support good health. These actions or behaviors may involve individuals, families, institutions, or communities and can include educational interventions for children, parents, policymakers, or health care providers. The goal of oral health education is to enhance knowledge, potentially resulting in the adoption of positive oral health behaviors that contribute to improved oral health.[13] The knowledge gained should serve to empower population groups with accurate information about health and health care technologies, enabling them to take action to protect their health or avoid practices that can be detrimental.

Collaboration between health care providers has become a practical approach to achieving a well-functioning health care system. This cooperation can improve care delivery and patient outcomes since teamwork among professionals would ensure that patient needs are met.[14] Health care professionals can promote the importance of obtaining good oral health during pregnancy and early childhood.[2] Medical teams, including family physicians, pediatricians, nurses, nurse practitioners, and midwives, are encouraged to practice oral health assessment during routine prenatal and child checkup appointments. In addition, some simple preventive measures can be learned and addressed for patients. Collaboration between medical and dental teams effectively delivers quality oral health care to pregnant women and young children.

Current health care practices can be improved in managing different oral lesions and proper oral diagnosis and assessment.[15] [16] Delayed patient referrals or improper diagnosis may worsen oral health. Therefore, undergraduate and postgraduate medical training should implement oral health promotion curricula.

The main objectives of this review were to summarize the role of interprofessional education (IPE) in oral health promotion, and demonstrate how the collaboration between dentists and other health care providers could improve the oral outcomes of pregnant women and young children.


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Methods

The systematic search comprised seven electronic databases: PubMed, MEDLINE, EMBASE, Cochrane Library, Google Scholar, Scopus, and Web of Science. These databases encompass a broad international range of literature. Including a larger number of studies is essential to ensure the validity of the review. The search was limited by date (2014–2024, the last 10 years), and to English-language publications, using the Boolean method to combine search terms. The gray literature search was also conducted, which included clinical trial registries, the International Prospective Register of Systematic Reviews (PROSPERO) and dissertation databases.

Four search queries were used to ensure comprehensive coverage of the topic, focusing on pregnancy and childhood.

  • Detailed query 1: (“interprofessional education”[MeSH Terms] OR (“interprofessional”[All Fields] AND “education”[All Fields]) OR “interprofessional education”[All Fields]) AND ((“oral health”[MeSH Terms] OR (“oral”[All Fields] AND “health”[All Fields]) OR “oral health”[All Fields]) AND (“promote”[All Fields] OR “promoted”[All Fields] OR “promotes”[All Fields] OR “promoting”[All Fields] OR “promotion”[All Fields] OR “promotional”[All Fields] OR “promotions”[All Fields] OR “promotive”[All Fields])) AND (“pregnancy”[MeSH Terms] OR “pregnancy”[All Fields] OR “pregnancies”[All Fields] OR “pregnancy's”[All Fields])) AND ((y_10[Filter]) AND (english[Filter]))

  • Detailed query 2: (“interprofessional education”[MeSH Terms] OR (“interprofessional”[All Fields] AND “education”[All Fields]) OR “interprofessional education”[All Fields]) AND ((“oral health”[MeSH Terms] OR (“oral”[All Fields] AND “health”[All Fields]) OR “oral health”[All Fields]) AND (“promote”[All Fields] OR “promoted”[All Fields] OR “promotes”[All Fields] OR “promoting”[All Fields] OR “promotion”[All Fields] OR “promotional”[All Fields] OR “promotions”[All Fields] OR “promotive”[All Fields])) AND (“childhood”[All Fields] OR “childhoods”[All Fields])) AND ((y_10[Filter]) AND (english[Filter]))

  • Detailed query 3: ((“Pregnant Women”[MeSH Terms] OR “Pregnancy”[MeSH Terms] OR “Expectant Mothers”[Title/Abstract]) AND (“Oral Health”[MeSH Terms] OR “Dental Health”[Title/Abstract] OR “Oral Hygiene”[MeSH Terms]) AND (“Knowledge”[MeSH Terms] OR “Attitude”[MeSH Terms] OR “Awareness”[Title/Abstract] OR “Perception”[Title/Abstract])) AND ((english[Filter]) AND (2014:2024[pdat]))

  • Detailed query 4: ((“Maternal Health”[MeSH Terms] OR “Maternal Behavior”[MeSH Terms] OR “Mothers”[MeSH Terms] OR “Pregnancy”[MeSH Terms]) AND (“Child Development”[MeSH Terms] OR “Child Health”[MeSH Terms] OR “Infant Health”[MeSH Terms] OR “Pediatric Health”[Title/Abstract]) AND (“Health Behavior”[MeSH Terms] OR “Parental Influence”[Title/Abstract] OR “Risk Factors”[MeSH Terms]) AND (“english”[Language] AND 2014/01/01:2024/12/31[Date - Publication])) AND (english[Filter])

This review included English-language, peer-reviewed articles and gray literature published within the last 10 years. Eligible studies examined IPE approaches to oral health promotion in pregnancy and early childhood contexts. Articles that focused solely on clinical interventions without educational aspects or involved populations outside of pregnancy and early childhood were excluded. Additionally, we included studies on maternal general health and maternal knowledge of oral health and child health to ensure a comprehensive understanding of the topic from its foundations.

The research yielded 37 research articles that met the inclusion criteria. Titles and abstracts were independently screened by E.G. and M.A. for relevance. Relevant articles were included in this review, and reference lists were manually searched to identify sources not captured in the database search. The review process was conducted by E.G. and M.A. Conflicts and uncertainties related to study selection were resolved through discussion with the third reviewer (G.K.).

As this is a narrative review, no formal quality assessment tools were applied to evaluate the included studies. The review aimed to provide an overarching synthesis of the available literature, rather than assess the methodological rigor of each study.


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Results

Effect of Maternal Health and Behaviors on Children

Some maternal habits could significantly affect the mother and her infant's general and oral health. For instance, smoking during pregnancy reported several general and dental adverse long-term outcomes for children born to smoking mothers. Some pregnant women consume heated tobacco products (HTP), a form of nicotine delivery, assuming they have less harmful effects than traditional cigarettes. Zaitsu et al found that HTP could increase the risk of gestational hypertension and low birth weight.[17] Akinkugbe et al assessed the association between prenatal smoking and the caries experience of offspring. The results showed that children born to smoking mothers had 1.42 (95% confidence interval [CI]: 1.08–1.86) the adjusted hazard ratio of the first caries experience compared to offspring of nonsmokers.[18]

In addition to smoking, overconsumption of alcohol during pregnancy may cause fetal alcohol syndrome (FAS), a developmental disorder that may cause several defects with lifelong consequences for a child. FAS symptoms include abnormal facial features and behavioral and dental abnormalities. Concerning dental problems, Blanck-Lubarsch et al examined 30 children prospectively diagnosed with FAS to investigate the associated dental anomalies and habits.[19] They found significant differences in mouth breathing, breastfeeding, DMFT (decayed, missing, filled teeth), and modified DDE (developmental defects of enamel) indexes as they were high compared to the control group.[19] Another recent study by Blanck-Lubarsch et al observed the relationship between FAS and dental malocclusion among 30 patients with FAS using the peer assessment rating (PAR) index.[20] The examination was done during the mixed dentition period. Compared to the healthy control group, there was a significant increase in malocclusion (crowding, spacing, crossbite, and edge-to-edge bite) in FAS patients, according to the PAR examination.[20] Therefore, early multidisciplinary assessment and treatment are required for children with FAS as it can prevent or mitigate further complications.

The unnecessary use of medications during pregnancy is another factor that could negatively affect a mother and her child. For example, overuse and misuse of antibiotics cause antibiotic resistance among pathogenic bacteria and DDE.[21] [22] Molar incisor hypomineralization (MIH) is a significant dental problem that could result from antibiotic overuse in pregnancy and early childhood.[23] MIH leads to many complications affecting a child's oral health and quality of life. Teeth discoloration is another negative effect of using antibiotics such as the tetracycline group during pregnancy.[24] Tetracycline has the ability to bind to calcium ions during tooth mineralization and calcification, resulting in discoloration of both primary and permanent dentitions. In some cases, medications with lower risk profile can be selected to limit dental adverse effects.


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Knowledge and Attitude of Pregnant Women about Oral Health

Practicing good oral health care during pregnancy significantly impacts the general and oral health of expectant mothers and their babies. Liu et al evaluated the behaviors and information of pregnant women regarding oral health and dental visits.[16] The common theme among some study participants was avoiding dental visits during pregnancy would be better for their overall health.[16] Some patients thought nutrition supplements could help prevent dental problems.[16] A study by Togoo et al assessed the knowledge level of 251 pregnant women about pregnancy gingivitis.[25] They found most participants did not know about the condition, its cause, outcomes, and prevention measures.[25] Many women were also unaware of the effect of untreated pregnancy gingivitis on their newborns' oral health, and even when they had inflamed gum, they did not seek dental treatment.[25]

Wassihun et al assessed knowledge of 384 pregnant women at South Omo Zone public hospitals in Southern Ethiopia about oral health and related factors.[26] Most participants (n = 251, 65.9%) had a low level of knowledge of oral health.[26] One of the principal factors that impacted their dental knowledge during pregnancy was getting counseling and information on oral care at the prenatal clinic.[26] Therefore, exploring barriers to dental services among pregnant women, such as lack of knowledge, cost, fear, cultural issues, and other reported factors, is essential to address these barriers and work on improving dental care utilization during pregnancy.[27]

Raising awareness of oral health as part of prenatal care is necessary, especially since pregnant women are usually willing to develop good behaviors to improve their health and the infant's well-being. Implementing a prenatal oral health program as an educational intervention in dental and medical curricula and residency programs that see pregnant women regularly is a valuable step in health care. These programs would help standard clinical guidelines that support interprofessional collaboration between dental and medical health providers to deliver comprehensive clinical care to pregnant women.[28] [29] [30] Promoting and providing oral health information and dental services during the prenatal period positively impacts pregnant women's behaviors toward their own and their infants' oral and general health.[31]


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Importance of Interprofessional Education and Interprofessional Practice in Oral Health Promotion

According to the WHO, the definition of IPE is “when two or more professions learn with, about and from each other to enable effective collaboration and improve health outcomes,” and it defines interprofessional collaborative practice as “when multiple health workers from different professional backgrounds provide comprehensive services by working with patients, their families, careers and communities to deliver the highest quality of care across settings.”[32] Enhancing multidisciplinary preventive oral health practice is necessary as oral health is integral to general health. IPE and collaboration would help achieve good oral health in pregnant women and young children.

Sheiham and Watt introduced the concept of the “common risk factor approach” in dentistry, where oral diseases share common risk factors with other noncommunicable diseases.[33] For example, smoking and sugary foods might not only cause dental decay but also cause obesity and cardiovascular diseases. Focusing on these common risk factors will significantly impact many diseases at a lower cost and with greater efficiency and effectiveness than disease-specific approaches. Hence, interprofessional collaboration is needed to tackle many risk factors at once and reduce the incidence of multiple diseases.

Lacking interprofessional cooperation is a significant problem in health care settings. The common barriers to effective communication between health care professionals were lack of experience and confidence, accessibility to patients' electronic health records, personal values and expectations, no formal communication between health care teams, and time restrictions.[34]

Integrating IPE into the academic curriculum and training is essential to improving dental care. These learning opportunities encourage students to work with colleagues in other health professions and improve their knowledge and skills to work effectively and collaboratively.[35] Haresaku et al conducted a study in a Japanese nursing school to examine the effect of oral assessment educational programs in the academic curriculum on first-year nursing students.[36] The course includes lectures and training on the importance of interprofessional health care and how to perform oral assessment.[36] The study found that students' attitudes, confidence, and performance in oral assessment improved after the program compared to baseline.[36] Similarly, Khanbodaghi et al tested the influence of oral health educational programs on pediatric nurse practitioners' dental knowledge and behaviors at Northeastern University, United States.[37] After the test, the authors reported significant improvement in all participants' understanding of dental issues, confidence, and behavior scores.[37]

Collaboration between health care teams has improved patient-centered care, decreased complications, and increased patient satisfaction.[35] Several educational programs have been developed to support IPE and collaborative practice between dental and medical teams. One of the critical programs in pediatric dentistry is the Strategic Partnership for Interprofessional Collaborative Education in Pediatric Dentistry (SPICE-PD) program 2015–2020 at the UCLA School of Dentistry.[38] As a young child could visit primary care centers several times a year, this program aimed to improve knowledge, confidence, and skills in oral health care among primary health care providers.[38] In addition, the program aimed to encourage primary health care providers to perform early management and intervention of oral health problems by applying some preventive measures for children, such as fluoride varnish.[38] Ramos-Gomez et al found that the SPICE-PD program has significantly helped most dental, medical, and pediatric nurse participants work effectively with their colleagues and enhance their clinical performance.[38]

Good investments from dental grant programs in supporting oral health education and practice in medical schools improve oral health promotion and drive positive health outcomes among the population. It also builds good communication between medical and oral health care professionals. The College of Medicine-Phoenix and Delta Dental of Arizona at the University of Arizona announced the creation of the Oral Health in Medicine Initiative (OHMI) program. The OHMI program is designed to offer oral health knowledge and hands-on training for medical students, providing real experience with patients in a clinical dental setting. This cooperation was made through a valued investment by the Delta Dental of Arizona Foundation.[39]

IP Conceptual Model

The conceptual model ([Fig. 1]) is derived from the authors' perspectives on the role of interprofessional collaboration in oral health promotion. The anticipated outcomes are to increase awareness of the importance of oral health, enhance understanding of each other's roles, and improve the oral health status and general health of pregnant women and children.

Zoom Image
Fig. 1 Conceptual framework of the role of interprofessional collaboration in oral health promotion.

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Role of Health Care Professionals and Policymakers in Oral Health Promotion

Prevention is critical to good oral health. Dental diseases such as tooth decay are widespread, yet easily preventable if proper oral hygiene care and regular dental checkups are maintained. Health care professionals, especially those who usually counsel pregnant women and young children, should improve basic oral health knowledge among their patients and perform routine oral examinations. Teamwork and effective communication between health care members can ensure optimal care for patients.

Obstetrician gynecologists and midwives can significantly establish good oral health care behaviors in expectant mothers. This can be achieved by offering oral health education and counseling visits to pregnant women before and after childbirth in collaboration with dentists. Oral screening and risk assessment are essential to identify at-risk cases for early referral and dental management. George et al presented the great impact of midwives' oral health interventions (education, screening, dental access, and referrals) on pregnant women attending antenatal clinics in Sydney, Australia.[40] Interestingly, there was a remarkable improvement in oral health status, including teeth and gum conditions, among the group who accessed dental services. All groups reported significant changes in oral health knowledge after the study intervention.[40] Maternal health care providers can also advise women about breastfeeding's positive effect on the baby's oral health. It was found that breastfeeding for more than 9 months decreased the prevalence of malocclusion among preterm infants, compared to the less than 3 months breastfed group.[41] Additionally, it is vital to provide informative free resources to help pregnant women learn how to practice proper oral hygiene and the importance of dental care for mothers and their children.

Pediatricians and pediatric nurses' knowledge and skills concerning oral health play a major role in managing children's oral health problems. Incorporating proper oral examination steps in the routine child wellness assessment would enhance the prevention and early detection of caries and other oral conditions during infancy and early childhood. They can also apply some preventive measures for children, such as fluoride varnish. Reddy et al investigated the role of 200 pediatricians in oral health in the Hyderabad district, India.[42] Most participants (>85%) believed they should do oral screening and early referrals to dentists, although less than 50% of participants had performed oral health screening.[42] A study conducted among pediatricians in Southern Saudi Arabia showed that more than 90% of the participants were aware of dental caries and its adverse effect on teeth.[43] They also agreed about their significant role in oral health promotion and prevention in young children.[43] However, almost half of the study respondents disagreed with the information that bacteria causing caries can be transmitted from a mother to her child.[43] This highlights opportunities to improve basic oral health among primary physicians. Encouraging oral health education/practice among pediatric health professionals is required since they see children regularly.

As family members worldwide could visit primary care centers multiple times, family physicians and pediatric primary care providers can play an expanded role in oral health care, especially for infants and young children. Primary care practitioners can discuss and check oral health before, during, and after pregnancy. They can encourage pregnant women to do regular dental cleaning and checkups throughout pregnancy and after childbirth. For newborns, they may recognize congenital abnormalities in the mouth, such as cleft lips and cleft palate, and do referrals when required.[44] They can also screen young children's dentition status, discuss and reinforce proper dental care and food habits with their families, and do early referrals when needed.[45] Since primary health care providers significantly impact early childhood health and antibiotic prescription, it is imperative to be cautious when prescribing antibiotics and counsel parents about their improper use and their consequences on a child's dental and overall health. Early and frequent use of antibiotics has been reported among the critical risk factors of MIH.[46] MIH strongly negatively affects children's oral health–related quality of life (OHRQoL).[47]

Oral health professionals are in an ideal position to increase awareness of the importance of dental care and its positive consequences on maternal and infant health. In the Eastern province of Saudi Arabia, Albasry et al recruited pregnant women from hospitals and health care centers to assess dental care utilization during pregnancy and related factors.[48] From the results of 270 collected questionnaires, 52.6% of the study sample avoided dental treatment during pregnancy and thought it unsafe, while 43.7% visited a dental clinic when they had dental problems only.[48] In collaboration with their colleagues in maternal and primary care clinics, dentists can assure pregnant women about the safety of most dental procedures during pregnancy and how they improve oral health.[48] They can also encourage mothers and young children to practice proper oral health care and train them to do it efficiently. Interprofessional communication between dental and medical health care providers in oral health will reduce the number of pregnant women and young children without dental care.

Oral health is a critical aspect of overall well-being. According to the WHO Global Oral Health Status Report in 2022, oral diseases affect almost 3.5 billion persons worldwide.[49] Effective oral health promotion among the community targeting all age groups, particularly young children, requires cooperation between policymakers, health organizations, health care professionals, and society. It is critical to ensure the availability of resources that support and foster oral health care in the community, such as early and easy access to dental services, water fluoridation, and preventive oral procedures like pit and fissure sealant and topical fluoride.[50] In addition, integrating oral health education and activities in primary schools would motivate children to gain good oral care habits and have long-lasting benefits.[51] Supporting dental coverage for all population levels would reduce dental disparities and improve oral health behaviors and outcomes.[52] Zivkovic et al investigated the marginal effects (ME) of having dental insurance among 42,553 individuals aged ≥12 years in Ontario, Canada.[52] They found dental coverage positively affected the proportion of people who visited the dentist (56.6–79.4%; ME: 22.8) and those who reported good to excellent oral health (48.3–7.9%, ME: 9.6).[52] The authors suggested establishing universal dental coverage to eliminate financial barriers to dental care. Moreover, providing financial support to health care professionals and individuals in the health sector who can play a vital role in oral health promotion is required. It would ensure effective expansion and delivery of oral health awareness and preventive care among the population.


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Role of Parents and Community in Oral Health Promotion

Parents can play a fundamental role in preventing oral diseases in children and affecting their oral health habits by establishing good dental hygiene routines early in their lives. Parents are the primary role models for their kids; it is imperative to model good oral health behaviors and attitudes in front of them as children learn by observation and active participation. Pregnant women, in particular, should pay careful attention to prenatal and postnatal oral care, which is essential for promoting good oral health and overall well-being for the mother and baby. Daily practices to avoid dental diseases include brushing the teeth regularly, flossing, maintaining a healthy diet, limiting sugary food and drinks, and having regular dental checkups with the application of fluoride varnish. Public health is critical in providing educational programs to promote oral health in communities. Implementing school-based oral hygiene programs starting from preschools is a significant way to increase oral health awareness.[53] These programs teach children about oral health and its association with general health and provide preventive oral health services, such as screening, cleaning, simple treatments, and fluoride application.[53] In addition, parental engagement in oral health promotion programs should be encouraged to produce better oral health outcomes.[54] [55] Besides the education these programs offer, they can serve as a platform for open discussion and exchange of ideas between families guided by teachers and health professionals. This healthy communication helps improve awareness and understanding of each other's oral health needs and tackle barriers to dental care services. Since prevention is always better than cure, it is very important to invest in oral health education for parents and children in their early life years to improve general oral health in future generations.


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Recommendations for Enhancing Oral Health Promotion during Pregnancy and Childhood

Enhancing oral health during pregnancy and childhood requires a multifaceted approach involving health care professionals, policymakers, parents, and the community. By implementing these recommendations, we can improve oral health outcomes and foster a lifetime of healthy smiles for children. However, more research is needed to evaluate the long-term impact of these recommendations.

Recommendations for promoting better oral health during these critical stages are outlined incorporating findings from previous studies in [Table 1] and the authors' recommendations in [Table 2].

Table 1

Findings from previous studies on oral health promotion

Study

Recommendations

Deghatipour et al[56]

• Conduct educational interventions by different health specialties for pregnant women, such as lectures and group discussions about mothers' and infants' oral health behaviors

• Establish dental training sessions for primary health care practitioners to educate mothers and children during routine maternal and wellness visits

GeethaPriya et al[51]

Integrate school-based oral health care programs in children's schools that include interactive sessions. For instance, traditional games and flashcards can introduce information about good and bad oral health habits and their consequences on their health

Vamos et al[57]

Use eHealth applications to implement prenatal oral health guidelines about dental history taking, oral assessment, care, and referral for health care providers. This method would aid clinical interventions, health care delivery, and patient–clinician communication

Rasmus et al[58]

Develop and install mobile applications that target young children to promote oral health. It can be a motivating tool to learn and improve the quality of daily oral health practices and eating habits

Table 2

Recommendations from the authors on oral health promotion

During pregnancy

1. Offer comprehensive oral health education during prenatal care visits, emphasizing its importance for pregnancy and the developing baby

2. Incorporate oral health assessments into routine prenatal care to promptly identify and address any existing dental issues to prevent complications

3. Emphasizing the importance of treating gingivitis and periodontal disease during pregnancy, as these conditions might lead to adverse pregnancy outcomes

4. Provide dietary recommendations to expectant mothers, encouraging a balanced diet low in sugary and acidic foods, which could help prevent dental issues. Emphasize the importance of calcium and vitamin D for the development of the baby's teeth and bones

During childhood

1. Conduct caries risk assessment during well-baby and well-child visits, and provide referrals to a dental home

2. Encourage parents to schedule their child's first dental visit within the first 6 mo of the first tooth eruption or by their first birthday. Early visits help establish good oral health habits

3. Teach parents how to clean their infant's gums even before teeth appear and provide instructions on proper toothbrushing techniques. Encourage the use of age-appropriate fluoride toothpaste

4. Promote the application of fluoride varnish for infants and young children as a preventive measure against early childhood caries (ECC). Fluoride varnish has a preventive fraction between 40 and 60%, is cost-effective, and can be used in nondental environments such as health-promoting schools and primary care settings, even by nondental professionals

5. Educate parents about the diet's impact on oral health, emphasizing the importance of limiting sugary snacks and drinks in terms of both frequency and quantity

6. Address common oral habits, such as thumb-sucking or pacifier use, which can impact dental development

General recommendations

1. Launch public health campaigns to raise awareness about the significance of oral health during pregnancy and early childhood

2. Advocate for and support policies that promote oral health during pregnancy and childhood, including mandates for oral health screenings and water fluoridation

3. Advocate for comprehensive dental care coverage for pregnant women and children

4. Collaborate with community organizations, local health departments, and schools to expand efforts in promoting oral health

5. Encourage oral care product companies to partner with prenatal health centers in providing essential oral health care products for newborns and infants, such as a postpartum gift set containing baby's tooth and gum xylitol wipes, gauze, a soft toothbrush, and toothpaste, along with informative CDs about proper oral hygiene practices for young children. Establishing this system would benefit participating companies and enhance oral health promotion. Mothers will be encouraged to start cleaning and caring for their baby's gums and mouth even before the first tooth appears

6. Implement a multidisciplinary system for approving medication orders that may negatively affect a child's teeth. In this system, if a health practitioner enters an incorrect duration of a drug or repeats prescriptions of the same type of antibiotic for the same patient, the system will not proceed without obtaining clearance from a pharmacist

7. Provide training and educational resources to health care professionals and community workers to ensure they are well equipped to offer oral health guidance and support

8. Invest in research to better understand the specific oral health needs and challenges during pregnancy and early childhood. Having scientific evidence will help inform policymakers about the issues and potential solutions

9. Ensure that oral health promotion materials and interventions are culturally sensitive and accessible to diverse communities, by either using their language or delivering the messages through community workers who share the same culture

It is important to note that medical–dental integration has been promoted as a means to enhance health care quality, accessibility, and cost-effectiveness. At the very least, all health care providers should possess a fundamental understanding of one another's fields. For example, medical providers should recognize the intrinsic significance of oral health and its connections to overall well-being and vice versa

In addition to mutual understanding, medical–dental integration can be achieved by implementing a shared electronic health record system that includes a core dataset encompassing both medical and dental information. This would facilitate the seamless exchange of health information among providers and streamline the referral process

To make this integration successful, collaboration is essential among governments, regulatory bodies, professional associations, educators, and office software vendors[59]

To sum up, the combined efforts of health care professionals and policymakers are vital in promoting oral health from pregnancy to early childhood. These efforts encompass education, prevention, regulation, access to care, and research, all to ensure that children start life with robust oral health and maintain it throughout their formative years


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Study Limitations

The review is limited by its focus on English-language studies published within the last 10 years, which may have excluded relevant findings from older or non-English research. Furthermore, the moderate number of studies included reflects the niche nature of the topic and limits the generalizability of the findings. Additionally, the article focuses on studies conducted in specific regions or countries without discussing how findings might vary in different cultural, socioeconomic, or health care settings.

Despite these limitations, the review provides valuable insights into the role of IPE in oral health promotion and provides a foundation for future research and practice in this area.


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Conclusion

IPE and interprofessional practice, combined with maternal health promotion, can significantly contribute to children's oral health. Health care providers involved in prenatal and pediatric care have a crucial role in educating and guiding parents on best practices for maintaining good oral health from infancy, which can also positively impact overall health in early childhood. By fostering collaboration among health care professionals, these efforts can help reduce the burden of oral diseases and enhance overall health outcomes for children.


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Conflict of Interest

None declared.

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  • 10 Anil S, Anand PS. Early childhood caries: prevalence, risk factors, and prevention. Front Pediatr 2017; 5: 157
  • 11 Williams DR, Costa MV, Odunlami AO, Mohammed SA. Moving upstream: how interventions that address the social determinants of health can improve health and reduce disparities. J Public Health Manag Pract 2008; 14 (Suppl): S8-S17
  • 12 Fraihat N, Madae'en S, Bencze Z, Herczeg A, Varga O. Clinical effectiveness and cost-effectiveness of oral-health promotion in dental caries prevention among children: systematic review and meta-analysis. Int J Environ Res Public Health 2019; 16 (15) 2668
  • 13 Nakre PD, Harikiran AG. Effectiveness of oral health education programs: a systematic review. J Int Soc Prev Community Dent 2013; 3 (02) 103-115
  • 14 Karam M, Brault I, Van Durme T, Macq J. Comparing interprofessional and interorganizational collaboration in healthcare: a systematic review of the qualitative research. Int J Nurs Stud 2018; 79: 70-83
  • 15 Lyu J, Zhang X, Nie X, Wei L, He H. A cross-sectional study of the knowledge, attitudes, and behaviors of obstetricians, gynecologists, and dentists regarding oral health care during pregnancy. Ann Palliat Med 2021; 10 (04) 4242-4251
  • 16 Liu PP, Wen W, Yu KF, Gao X, Wong MCM. Dental care-seeking and information acquisition during pregnancy: a qualitative study. Int J Environ Res Public Health 2019; 16 (14) 2621
  • 17 Zaitsu M, Hosokawa Y, Okawa S, Hori A, Kobashi G, Tabuchi T. Heated tobacco product use and hypertensive disorders of pregnancy and low birth weight: analysis of a cross-sectional, web-based survey in Japan. BMJ Open 2021; 11 (09) e052976
  • 18 Akinkugbe AA, Brickhouse TH, Nascimento MM, Slade GD. Prenatal smoking and the risk of early childhood caries: a prospective cohort study. Prev Med Rep 2020; 20: 101201
  • 19 Blanck-Lubarsch M, Dirksen D, Feldmann R, Sauerland C, Hohoff A. Tooth malformations, DMFT index, speech impairment and oral habits in patients with fetal alcohol syndrome. Int J Environ Res Public Health 2019; 16 (22) 4401
  • 20 Blanck-Lubarsch M, Flieger S, Feldmann R, Kirschneck C, Sauerland C, Hohoff A. Malocclusion can give additional hints for diagnosis of fetal alcohol spectrum disorder. Alcohol 2019; 54 (01) 56-61
  • 21 Mancuso G, Midiri A, Gerace E, Biondo C. Bacterial antibiotic resistance: the most critical pathogens. Pathogens 2021; 10 (10) 1310
  • 22 Popescu M, Ionescu M, Scrieciu M. et al. Etiology study of acquired developmental defects of enamel and their association with dental caries in children between 3 and 19 years old from Dolj County, Romania. Children (Basel) 2022; 9 (09) 1386
  • 23 Schmalfuss AJ, Sehic A, Brusevold IJ. Effects of antibiotics on the developing enamel in neonatal mice. Eur Arch Paediatr Dent 2022; 23 (01) 159-168
  • 24 Vennila V, Madhu V, Rajesh R, Ealla KK, Velidandla SR, Santoshi S. Tetracycline-induced discoloration of deciduous teeth: case series. J Int Oral Health 2014; 6 (03) 115-119
  • 25 Togoo RA, Al-Almai B, Al-Hamdi F, Huaylah SH, Althobati M, Alqarni S. Knowledge of pregnant women about pregnancy gingivitis and children oral health. Eur J Dent 2019; 13 (02) 261-270
  • 26 Wassihun B, Ayinalem A, Beyene K. Knowledge of oral health during pregnancy and associated factors among pregnant mothers attending antenatal care at South Omo Zone public hospitals, Southern Ethiopia, 2021. PLoS One 2022; 17 (08) e0273795
  • 27 Bahramian H, Mohebbi SZ, Khami MR, Quinonez RB. Qualitative exploration of barriers and facilitators of dental service utilization of pregnant women: a triangulation approach. BMC Pregnancy Childbirth 2018; 18 (01) 153
  • 28 Jackson JT, Quinonez RB, Kerns AK. et al. Implementing a prenatal oral health program through interprofessional collaboration. J Dent Educ 2015; 79 (03) 241-248
  • 29 Brame JL, Quinonez RB, Ciszek BP, Weintraub JA. Implementing a prenatal oral health program for dental students: lessons learned. Health Promot Pract 2023; 10.1177/15248399231207070.
  • 30 Leone SM, Quinonez RB, Chuang A. et al. Introduction of prenatal oral health into medical students' obstetrics training. J Dent Educ 2017; 81 (12) 1405-1412
  • 31 Byrd MG, Quinonez RB, Lipp K, Chuang A, Phillips C, Weintraub JA. Translating prenatal oral health clinical standards into dental education: results and policy implications. J Public Health Dent 2019; 79 (01) 25-33
  • 32 Prasad M, Manjunath C, Murthy AK, Sampath A, Jaiswal S, Mohapatra A. Integration of oral health into primary health care: a systematic review. J Family Med Prim Care 2019; 8 (06) 1838-1845
  • 33 Sheiham A, Watt RG. The common risk factor approach: a rational basis for promoting oral health. Community Dent Oral Epidemiol 2000; 28 (06) 399-406
  • 34 Laniado N, Cloidt M, Altonen B, Badner V. Interprofessional Oral Health Collaboration. Interprofessional oral health collaboration: a survey of knowledge and practice behaviors of hospital-based primary care medical providers in New York City. Adv Med Educ Pract 2021; 12: 1211-1218
  • 35 Mohammed CA, Anand R, Saleena Ummer V. Interprofessional education (IPE): a framework for introducing teamwork and collaboration in health professions curriculum. Med J Armed Forces India 2021; 77 (Suppl. 01) S16-S21
  • 36 Haresaku S, Miyoshi M, Kubota K. et al. Effect of interprofessional education on oral assessment performance of nursing students. Clin Exp Dent Res 2020; 6 (01) 51-58
  • 37 Khanbodaghi A, Natto ZS, Forero M, Loo CY. Effectiveness of interprofessional oral health program for pediatric nurse practitioner students at Northeastern University, United States. BMC Oral Health 2019; 19 (01) 170
  • 38 Ramos-Gomez F, Kinsler JJ, Askaryar H, Verzemnieks I, Garell C. Evaluation of an interprofessional education program in pediatric dentistry, medicine, and nursing. J Dent Educ 2021; 85 (07) 1228-1237
  • 39 Smith B. Delta Dental of Arizona, University of Arizona Announce Creation of Oral Health Medical Initiative at the College of Medicine – Phoenix. The University of Arizona - Newsroom2023. 2024 . Accessed March 12, 2025 at: https://phoenixmed.arizona.edu/news/delta-dental-grant
  • 40 George A, Dahlen HG, Blinkhorn A. et al. 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. Int J Nurs Stud 2018; 82: 49-57
  • 41 da Rosa DP, Bonow MLM, Goettems ML. et al. The influence of breastfeeding and pacifier use on the association between preterm birth and primary-dentition malocclusion: a population-based birth cohort study. Am J Orthod Dentofacial Orthop 2020; 157 (06) 754-763
  • 42 Reddy SM, Shaik N, Pudi S, Yennavaram VK, Kotha A, Avidapu R. Assessing the pediatricians' role in improving young children's oral health in Telangana state: a cross-sectional study. Int J Clin Pediatr Dent 2022; 15 (05) 591-595
  • 43 Tikare S, Eroje A, Togoo R, Marzoq S. Pediatrician's knowledge and practice of early childhood caries and infant oral health in southern Saudi Arabia. Journal of Dental Research and Review. 2019;6(02):
  • 44 Frederick R, Hogan AC, Seabolt N, Stocks RMS. An ideal multidisciplinary cleft lip and cleft palate care team. Oral Dis 2022; 28 (05) 1412-1417
  • 45 Nelson JD, Spencer SM, Blake CE, Moore JB, Martin AB. Elevating oral health interprofessional practice among pediatricians through a statewide quality improvement learning collaborative. J Public Health Manag Pract 2018; 24 (03) e19-e24
  • 46 Kameli S, Moradi-Kor N, Tafaroji R, Ghorbani R, Farzadmnesh H, Sameni H. Effects of amoxicillin on the structure and mineralization of dental enamel and dentin in Wistar rats. Front Dent 2019; 16 (02) 130-135
  • 47 Joshi T, Rahman A, Rienhoff S, Rienhoff J, Stamm T, Bekes K. Impact of molar incisor hypomineralization on oral health-related quality of life in 8-10-year-old children. Clin Oral Investig 2022; 26 (02) 1753-1759
  • 48 Albasry Z, Alhaddad B, Benrashed MA, Al-Ansari A, Nazir MA. A cross-sectional analysis of dental care utilization among pregnant women in Saudi Arabia. Open Access Maced J Med Sci 2019; 7 (23) 4131-4136
  • 49 World Health Organization (WHO). Global oral health status report: Towards universal health coverage for oral health by 2030. 2022 . Accessed March 12, 2025 at: https://www.who.int/publications/i/item/9789240061484
  • 50 Ghanbarzadegan A, Balasubramanian M, Luzzi L, Brennan D, Bastani P. Inequality in dental services: a scoping review on the role of access toward achieving universal health coverage in oral health. BMC Oral Health 2021; 21 (01) 404
  • 51 GeethaPriya PR, Asokan S, Kandaswamy D, Shyam S. Impact of different modes of school dental health education on oral health-related knowledge, attitude and practice behaviour: an interventional study. Eur Arch Paediatr Dent 2020; 21 (03) 347-354
  • 52 Zivkovic N, Aldossri M, Gomaa N. et al. Providing dental insurance can positively impact oral health outcomes in Ontario. BMC Health Serv Res 2020; 20 (01) 124
  • 53 Bramantoro T, Santoso CMA, Hariyani N. et al. Effectiveness of the school-based oral health promotion programmes from preschool to high school: a systematic review. PLoS One 2021; 16 (08) e0256007
  • 54 Menoncin BLV, Crema AFA, Ferreira FM, Zandoná AF, Menezes JVNB, Fraiz FC. Parental oral health literacy influences preschool children's utilization of dental services. Braz Oral Res 2023; 37: e090
  • 55 Deghatipour M, Ghorbani Z, Mokhlesi AH, Ghanbari S, Namdari M. Community-based interventions to reduce dental caries among 24-month old children: a pilot study of a field trial. BMC Oral Health 2021; 21 (01) 637
  • 56 Deghatipour M, Ghorbani Z, Mokhlesi AH, Ghanbari S, Namdari M. Effect of oral health promotion interventions on pregnant women dental caries: a field trial. BMC Oral Health 2022; 22 (01) 280
  • 57 Vamos CA, Green SM, Griner S. et al. Identifying implementation science characteristics for a prenatal oral health eHealth application. Health Promot Pract 2020; 21 (02) 246-258
  • 58 Rasmus K, Toratti A, Karki S, Pesonen P, Laitala ML, Anttonen V. Acceptability of a mobile application in children's oral health promotion: a pilot study. Int J Environ Res Public Health 2021; 18 (06) 3256
  • 59 Quiñonez C. The politics of dental care in Canada. Canadian Scholars' Press; 2021

Address for correspondence

Ebtehal Ghazal, BDS, MSc
124 Edward St, Toronto, ON M5G 1G6
Canada   

Publication History

Article published online:
10 April 2025

© 2025. European Dental Research and Biomaterials Journal. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • 11 Williams DR, Costa MV, Odunlami AO, Mohammed SA. Moving upstream: how interventions that address the social determinants of health can improve health and reduce disparities. J Public Health Manag Pract 2008; 14 (Suppl): S8-S17
  • 12 Fraihat N, Madae'en S, Bencze Z, Herczeg A, Varga O. Clinical effectiveness and cost-effectiveness of oral-health promotion in dental caries prevention among children: systematic review and meta-analysis. Int J Environ Res Public Health 2019; 16 (15) 2668
  • 13 Nakre PD, Harikiran AG. Effectiveness of oral health education programs: a systematic review. J Int Soc Prev Community Dent 2013; 3 (02) 103-115
  • 14 Karam M, Brault I, Van Durme T, Macq J. Comparing interprofessional and interorganizational collaboration in healthcare: a systematic review of the qualitative research. Int J Nurs Stud 2018; 79: 70-83
  • 15 Lyu J, Zhang X, Nie X, Wei L, He H. A cross-sectional study of the knowledge, attitudes, and behaviors of obstetricians, gynecologists, and dentists regarding oral health care during pregnancy. Ann Palliat Med 2021; 10 (04) 4242-4251
  • 16 Liu PP, Wen W, Yu KF, Gao X, Wong MCM. Dental care-seeking and information acquisition during pregnancy: a qualitative study. Int J Environ Res Public Health 2019; 16 (14) 2621
  • 17 Zaitsu M, Hosokawa Y, Okawa S, Hori A, Kobashi G, Tabuchi T. Heated tobacco product use and hypertensive disorders of pregnancy and low birth weight: analysis of a cross-sectional, web-based survey in Japan. BMJ Open 2021; 11 (09) e052976
  • 18 Akinkugbe AA, Brickhouse TH, Nascimento MM, Slade GD. Prenatal smoking and the risk of early childhood caries: a prospective cohort study. Prev Med Rep 2020; 20: 101201
  • 19 Blanck-Lubarsch M, Dirksen D, Feldmann R, Sauerland C, Hohoff A. Tooth malformations, DMFT index, speech impairment and oral habits in patients with fetal alcohol syndrome. Int J Environ Res Public Health 2019; 16 (22) 4401
  • 20 Blanck-Lubarsch M, Flieger S, Feldmann R, Kirschneck C, Sauerland C, Hohoff A. Malocclusion can give additional hints for diagnosis of fetal alcohol spectrum disorder. Alcohol 2019; 54 (01) 56-61
  • 21 Mancuso G, Midiri A, Gerace E, Biondo C. Bacterial antibiotic resistance: the most critical pathogens. Pathogens 2021; 10 (10) 1310
  • 22 Popescu M, Ionescu M, Scrieciu M. et al. Etiology study of acquired developmental defects of enamel and their association with dental caries in children between 3 and 19 years old from Dolj County, Romania. Children (Basel) 2022; 9 (09) 1386
  • 23 Schmalfuss AJ, Sehic A, Brusevold IJ. Effects of antibiotics on the developing enamel in neonatal mice. Eur Arch Paediatr Dent 2022; 23 (01) 159-168
  • 24 Vennila V, Madhu V, Rajesh R, Ealla KK, Velidandla SR, Santoshi S. Tetracycline-induced discoloration of deciduous teeth: case series. J Int Oral Health 2014; 6 (03) 115-119
  • 25 Togoo RA, Al-Almai B, Al-Hamdi F, Huaylah SH, Althobati M, Alqarni S. Knowledge of pregnant women about pregnancy gingivitis and children oral health. Eur J Dent 2019; 13 (02) 261-270
  • 26 Wassihun B, Ayinalem A, Beyene K. Knowledge of oral health during pregnancy and associated factors among pregnant mothers attending antenatal care at South Omo Zone public hospitals, Southern Ethiopia, 2021. PLoS One 2022; 17 (08) e0273795
  • 27 Bahramian H, Mohebbi SZ, Khami MR, Quinonez RB. Qualitative exploration of barriers and facilitators of dental service utilization of pregnant women: a triangulation approach. BMC Pregnancy Childbirth 2018; 18 (01) 153
  • 28 Jackson JT, Quinonez RB, Kerns AK. et al. Implementing a prenatal oral health program through interprofessional collaboration. J Dent Educ 2015; 79 (03) 241-248
  • 29 Brame JL, Quinonez RB, Ciszek BP, Weintraub JA. Implementing a prenatal oral health program for dental students: lessons learned. Health Promot Pract 2023; 10.1177/15248399231207070.
  • 30 Leone SM, Quinonez RB, Chuang A. et al. Introduction of prenatal oral health into medical students' obstetrics training. J Dent Educ 2017; 81 (12) 1405-1412
  • 31 Byrd MG, Quinonez RB, Lipp K, Chuang A, Phillips C, Weintraub JA. Translating prenatal oral health clinical standards into dental education: results and policy implications. J Public Health Dent 2019; 79 (01) 25-33
  • 32 Prasad M, Manjunath C, Murthy AK, Sampath A, Jaiswal S, Mohapatra A. Integration of oral health into primary health care: a systematic review. J Family Med Prim Care 2019; 8 (06) 1838-1845
  • 33 Sheiham A, Watt RG. The common risk factor approach: a rational basis for promoting oral health. Community Dent Oral Epidemiol 2000; 28 (06) 399-406
  • 34 Laniado N, Cloidt M, Altonen B, Badner V. Interprofessional Oral Health Collaboration. Interprofessional oral health collaboration: a survey of knowledge and practice behaviors of hospital-based primary care medical providers in New York City. Adv Med Educ Pract 2021; 12: 1211-1218
  • 35 Mohammed CA, Anand R, Saleena Ummer V. Interprofessional education (IPE): a framework for introducing teamwork and collaboration in health professions curriculum. Med J Armed Forces India 2021; 77 (Suppl. 01) S16-S21
  • 36 Haresaku S, Miyoshi M, Kubota K. et al. Effect of interprofessional education on oral assessment performance of nursing students. Clin Exp Dent Res 2020; 6 (01) 51-58
  • 37 Khanbodaghi A, Natto ZS, Forero M, Loo CY. Effectiveness of interprofessional oral health program for pediatric nurse practitioner students at Northeastern University, United States. BMC Oral Health 2019; 19 (01) 170
  • 38 Ramos-Gomez F, Kinsler JJ, Askaryar H, Verzemnieks I, Garell C. Evaluation of an interprofessional education program in pediatric dentistry, medicine, and nursing. J Dent Educ 2021; 85 (07) 1228-1237
  • 39 Smith B. Delta Dental of Arizona, University of Arizona Announce Creation of Oral Health Medical Initiative at the College of Medicine – Phoenix. The University of Arizona - Newsroom2023. 2024 . Accessed March 12, 2025 at: https://phoenixmed.arizona.edu/news/delta-dental-grant
  • 40 George A, Dahlen HG, Blinkhorn A. et al. 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. Int J Nurs Stud 2018; 82: 49-57
  • 41 da Rosa DP, Bonow MLM, Goettems ML. et al. The influence of breastfeeding and pacifier use on the association between preterm birth and primary-dentition malocclusion: a population-based birth cohort study. Am J Orthod Dentofacial Orthop 2020; 157 (06) 754-763
  • 42 Reddy SM, Shaik N, Pudi S, Yennavaram VK, Kotha A, Avidapu R. Assessing the pediatricians' role in improving young children's oral health in Telangana state: a cross-sectional study. Int J Clin Pediatr Dent 2022; 15 (05) 591-595
  • 43 Tikare S, Eroje A, Togoo R, Marzoq S. Pediatrician's knowledge and practice of early childhood caries and infant oral health in southern Saudi Arabia. Journal of Dental Research and Review. 2019;6(02):
  • 44 Frederick R, Hogan AC, Seabolt N, Stocks RMS. An ideal multidisciplinary cleft lip and cleft palate care team. Oral Dis 2022; 28 (05) 1412-1417
  • 45 Nelson JD, Spencer SM, Blake CE, Moore JB, Martin AB. Elevating oral health interprofessional practice among pediatricians through a statewide quality improvement learning collaborative. J Public Health Manag Pract 2018; 24 (03) e19-e24
  • 46 Kameli S, Moradi-Kor N, Tafaroji R, Ghorbani R, Farzadmnesh H, Sameni H. Effects of amoxicillin on the structure and mineralization of dental enamel and dentin in Wistar rats. Front Dent 2019; 16 (02) 130-135
  • 47 Joshi T, Rahman A, Rienhoff S, Rienhoff J, Stamm T, Bekes K. Impact of molar incisor hypomineralization on oral health-related quality of life in 8-10-year-old children. Clin Oral Investig 2022; 26 (02) 1753-1759
  • 48 Albasry Z, Alhaddad B, Benrashed MA, Al-Ansari A, Nazir MA. A cross-sectional analysis of dental care utilization among pregnant women in Saudi Arabia. Open Access Maced J Med Sci 2019; 7 (23) 4131-4136
  • 49 World Health Organization (WHO). Global oral health status report: Towards universal health coverage for oral health by 2030. 2022 . Accessed March 12, 2025 at: https://www.who.int/publications/i/item/9789240061484
  • 50 Ghanbarzadegan A, Balasubramanian M, Luzzi L, Brennan D, Bastani P. Inequality in dental services: a scoping review on the role of access toward achieving universal health coverage in oral health. BMC Oral Health 2021; 21 (01) 404
  • 51 GeethaPriya PR, Asokan S, Kandaswamy D, Shyam S. Impact of different modes of school dental health education on oral health-related knowledge, attitude and practice behaviour: an interventional study. Eur Arch Paediatr Dent 2020; 21 (03) 347-354
  • 52 Zivkovic N, Aldossri M, Gomaa N. et al. Providing dental insurance can positively impact oral health outcomes in Ontario. BMC Health Serv Res 2020; 20 (01) 124
  • 53 Bramantoro T, Santoso CMA, Hariyani N. et al. Effectiveness of the school-based oral health promotion programmes from preschool to high school: a systematic review. PLoS One 2021; 16 (08) e0256007
  • 54 Menoncin BLV, Crema AFA, Ferreira FM, Zandoná AF, Menezes JVNB, Fraiz FC. Parental oral health literacy influences preschool children's utilization of dental services. Braz Oral Res 2023; 37: e090
  • 55 Deghatipour M, Ghorbani Z, Mokhlesi AH, Ghanbari S, Namdari M. Community-based interventions to reduce dental caries among 24-month old children: a pilot study of a field trial. BMC Oral Health 2021; 21 (01) 637
  • 56 Deghatipour M, Ghorbani Z, Mokhlesi AH, Ghanbari S, Namdari M. Effect of oral health promotion interventions on pregnant women dental caries: a field trial. BMC Oral Health 2022; 22 (01) 280
  • 57 Vamos CA, Green SM, Griner S. et al. Identifying implementation science characteristics for a prenatal oral health eHealth application. Health Promot Pract 2020; 21 (02) 246-258
  • 58 Rasmus K, Toratti A, Karki S, Pesonen P, Laitala ML, Anttonen V. Acceptability of a mobile application in children's oral health promotion: a pilot study. Int J Environ Res Public Health 2021; 18 (06) 3256
  • 59 Quiñonez C. The politics of dental care in Canada. Canadian Scholars' Press; 2021

Zoom Image
Fig. 1 Conceptual framework of the role of interprofessional collaboration in oral health promotion.