In Bangladesh, over 95% of pregnant women suffer from gum disease (gingivitis or periodontitis), yet oral health is rarely included in standard pregnancy check-ups. This study tests a new "Integrated Oral Health Promotion Package" to see if teaching oral hygiene during routine prenatal visits can improve the health of mothers. Pregnant women (ages 18-45) will be divided into two groups. The intervention group will receive two face-to-face education sessions with a dental assistant, learn a specific tooth-brushing technique, and receive weekly SMS text reminders to brush their teeth. The control group will receive the standard pregnancy care currently offered in Bangladesh. Researchers will track the participants for 12 weeks to see if the education and reminders lead to better brushing habits (twice-daily) and cleaner teeth and gums compared to the standard care group.
Pregnant women attending ANC services at participating UHCs
Gestational age ≤24 weeks at enrolment to allow follow-up
Age 18 years or older
Willing and able to provide informed consent
Presence of severe medical or obstetric complications requiring immediate referral
Current participation in another behavioural or oral health intervention study
Conditions preventing participation in oral examination procedures
Parallel
Integrated Oral Health Promotion Package (IOHPP)
BehavioralThe Integrated Oral Health Promotion Package (IOHPP) is an education-based intervention embedded within routine Antenatal Care (ANC). It consists of 1) Two 20-30 minute face-to-face education sessions on maternal/child oral health; 2) Practical demonstrations of modified Bass brushing and flossing techniques; 3) Weekly SMS reminders to reinforce twice-daily brushing and healthy dietary habits; and 4) Distribution of pictorial leaflets and guidelines. ANC providers are trained to provide basic oral health counseling and facilitate referrals to dental services. The model uses the PRECEDE-PROCEED framework to address social and behavioral determinants of health in a low-resource setting.
Change in Oral Hygiene Index-Simplified (OHI-S) score
The OHI-S assesses oral hygiene through two components: Debris Index (DI-S) and Calculus Index (CI-S). Six tooth surfaces are examined. The total score ranges from 0 to 6. A score of 0.0-1.2 is Good; 1.3-3.0 is Fair; 3.1-6.0 is Poor
Change in oral health knowledge scores
Measured using a structured composite scale assessing knowledge of maternal oral health, hygiene practices, and disease prevention. The scale ranges from 0 to \[Insert your Max Score\], where higher scores indicate better knowledge.
Proportion of women brushing twice daily
Calculated as the percentage of participants who self-report brushing their teeth at least twice per day over the previous 7 days using an interviewer-administered questionnaire.
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