Oral health knowledge, perceptions and attitudes of pregnant women in Sub-Saharan Africa: a systematic review

Abstract

Background: This systematic review aimed to assess pregnant women's knowledge, perceptions, and attitudes toward oral health changes in sub-Saharan Africa (SSA) and examine their oral health-seeking behavior during pregnancy.

Methods: A comprehensive search was conducted across PubMed, Google Scholar, African Journals Online (AJOL), the Directory of Open Access Journals (DOAJ), and the Cochrane Library. Both Medical Subject Headings (MeSH) and free-text terms related to oral health, knowledge, attitudes, perceptions, antenatal care, pregnancy, and Africa were used. Boolean operators ("AND," "NOT," and "OR") refined the search strategy. Two independent reviewers screened studies and extracted data using Rayyan software, with a third reviewer resolving conflicts. The Robins-E tool assessed the risk of bias.

Results: Fifteen of seventy-five studies initially identified met the inclusion criteria after full-text screening. Most employed a cross-sectional design. Findings revealed low oral health-seeking behavior among pregnant women in Africa, attributed to factors such as negative dental experiences, concerns about harm to the unborn child, and the belief that dental care is unnecessary. Many women visited dental clinics only when they noticed significant oral health changes.

Conclusions: The reviewed studies demonstrated a low risk of bias and consistent findings. Pregnancy is a critical period, and poor oral health can adversely affect birth outcomes. Insufficient knowledge and misconceptions deter women from seeking dental care during pregnancy. To address this, targeted oral health education must improve awareness and overcome barriers to seeking care.

Keywords: Africa; Attitude; Knowledge; Oral health; Perception; Pregnancy; Women.

Fig. 1

Risk of bias assessment

Fig. 2

Prisma flow chart of included studies