Beliefs about Oral Health and the Occurrence of Dental Caries in Pregnant Women: Cross-Sectional Study Nested in a Prospective Cohort

Campos, Magda Lyce Rodrigues; Azevedo, Talyta Cristina Santos de; Martins, Rafiza Félix Marão; Costa, Elisa Miranda; Azevedo, Juliana Aires Paiva de; Alves, Claudia Maria Coelho; Thomaz, Erika Barbara Abreu Fonseca

doi:10.1590/pboci.2026.029

person Magda Lyce Rodrigues Campos

Conceptualization · Investigation · Resources · Data Curation · Writing - Original Draft · and Writing - Review · Editing. · declare that they contributed to critical review of intellectual content · approval of the final version to be published

schoolPost-Graduate Program in Dentistry, Federal University of Maranhão, São Luís, MA, Brazil

0000-0001-6868-3686

person Talyta Cristina Santos de Azevedo

Investigation · and Writing - Original Draft. · declare that they contributed to critical review of intellectual content · approval of the final version to be published

schoolFaculty of Dentistry, Federal University of Maranhão, São Luís, MA, Brazil

0000-0002-6767-729X

person Rafiza Félix Marão Martins

Investigation · and Visualization. · declare that they contributed to critical review of intellectual content · approval of the final version to be published

schoolCeuma University, São Luís, MA, Brazil

0000-0002-9676-435X

person Elisa Miranda Costa

Investigation. · declare that they contributed to critical review of intellectual content · approval of the final version to be published

schoolDepartment of Dentistry, Federal University of Alagoas, Maceió, AL, BrazilschoolPost-Graduate Program in Public Health, Federal University of Maranhão, São Luís, MA, Brazil

0000-0001-5364-0384

person Juliana Aires Paiva de Azevedo

Investigation. · declare that they contributed to critical review of intellectual content · approval of the final version to be published

schoolPost-Graduate Program in Dentistry, Faculty São Leopoldo Mandic, Campinas, SP, Brazil

0000-0002-4278-9279

person Claudia Maria Coelho Alves

Methodology · Investigation · and Supervision. · declare that they contributed to critical review of intellectual content · approval of the final version to be published

schoolPost-Graduate Program in Dentistry, Federal University of Maranhão, São Luís, MA, BrazilschoolPost-Graduate Program in Public Health, Federal University of Maranhão, São Luís, MA, Brazil

0000-0003-4705-4914

person Erika Barbara Abreu Fonseca Thomaz

Formal Analysis · Writing - Review · Editing · Supervision · Project Administration · and Funding Acquisition. · declare that they contributed to critical review of intellectual content · approval of the final version to be published

schoolPost-Graduate Program in Dentistry, Federal University of Maranhão, São Luís, MA, BrazilschoolPost-Graduate Program in Public Health, Federal University of Maranhão, São Luís, MA, Brazil

0000-0003-4156-4067

personCorresponding author: Erika Bárbara Abreu Fonseca Thomaz
E-mail:erika.barbara@ufma.br

Academic Editor:

Wilton Wilney Nascimento Padilha

Conflict of Interest

The authors declare no conflicts of interest.

Variables	Mean ± SD	Minimum-Maximum
Age of Pregnant Women (years)	26.3 ± 6.2	14-43
Gestational Age (months)	2.7 ± 0.9	0.1-3.8
Household Income (minimum wages)1	3.5 ± 3.1	0.3-22.5
Number of Prenatal Consultations	3.1 ± 2.2	1-15
Number of Prenatal Dental Consultations	0.2 ± 0.7	0-4
Brushing Frequency (per day)	3.0 ± 0.9	1-6
Visible Plaque Index (VPI, %)	14.4 ± 14.0	0-38.0

Variables	N	%
Economic Class (ABEP Criterion)1
Class A-B	60	28.9
Class C	119	57.2
Class D-E	15	7.2
No information	14	6.7
Years of Schooling
<5 years	8	3.8
5-8 years	48	23.1
9-11 years	136	65.4
>11 years	16	7.7
Living with a Partner
No	47	22.6
Yes	161	77.4
Head of Household
Partner	27	13.0
Pregnant woman	120	57.7
Others	57	27.4
No information	4	1.9
Access to Running Water
No	84	40.4
Yes	124	59.6
Access to Garbage Collection
No	12	5.8
Yes	196	94.2
Access to Sanitation Services
No	68	32.7
Yes	132	63.5
No information	8	3.8
Self-Reported Oral Health
Very good	9	4.3
Good	19	9.1
Fair	80	38.5
Poor	83	39.9
Very poor	13	6.3
No information	4	1.9

ICDAS-II Criteria	Mean ± SD	Min.-Max.
(0) Sound tooth surface: no evidence of caries after 5 s air drying	22.8 ± 4.7	7-32
(1) First visual change in enamel: opacity or discoloration (white or brown) is visible at the entrance to the pit or fissure seen after prolonged air drying	0.3 ± 0.8	0-4
(2) Distinct visual change in enamel visible when wet, lesion must be visible when dry	1.9 ± 2.3	0-12
(3) Localized enamel breakdown (without clinical visual signs of dentinal involvement) seen when wet and after prolonged drying	1.2 ± 1.9	0-12
(4) Underlying dark shadow from dentine (enamel apparently intact or with small fractures)	0.8 ± 1.7	0-11
(5) Distinct enamel cavity (opaque and pigmented) with visible dentine	0.4 ± 0.8	0-5
(6) Extensive (more than half the surface) distinct cavity with visible dentine	0.5 ± 1.1	0-6

Beliefs	N	%	95% CI
Pregnant women cannot have teeth extracted.	116	76.82	60.1-83.6
Pregnant women cannot receive dental anesthesia.	102	75.56	683-82.8
Regardless of care, some pregnant women have more cavities than others.	116	70.30	63.3-77.3
Pregnant women cannot undergo dental X-ray examination.	94	64.83	56.5-72.6
Regardless of care, some pregnant women have more gum problems than others.	105	61.40	54.1-68.7
The baby absorbs calcium from the mother's teeth and bones.	64	50.79	41.4-59.4
It is normal to develop cavities during pregnancy.	73	47.71	39.8-55.6
Having more children leads to more cavities during pregnancy.	37	25.87	18.7-33.1
Having more children leads to more gum problems during pregnancy.	35	25.36	18.1-32.6
Pregnant women cannot undergo DT during pregnancy.	35	21.08	15.2-27.8
It is normal to have gum problems during pregnancy.	27	16.98	11.1-22.8
It is not possible to prevent gum disease during pregnancy.	13	7.88	3.8-12.0
Pregnant women cannot use fluoride during pregnancy.	11	7.05	3.0-11.1
It is not possible to prevent cavities during pregnancy.	12	6.19	2.8-9.6
One tooth is lost with each pregnancy.	9	5.56	2.0-9.1

Beliefs	I Agree		Disagree		p-value
	Mean (SD)	Median (IQR)	Mean (SD)	Median (IQR)
It is normal to develop cavities during pregnancy.	4.5 (4.9)	3.0 (2.0)	6.6 (5.4)	5.0 (6.0)	0.157
It is normal to have gum problems during pregnancy.	6.0 (4.9)	4.5 (9.0)	6.1 (5.0)	5.0 (6.0)	0.851
It is not possible to prevent cavities during pregnancy.	6.0 (5.2)	3.0 (9.0)	5.9 (4.9)	5.0 (5.5)	0.698
It is not possible to prevent gum diseases during pregnancy.	6.7 (4.7)	5.0 (9.0)	6.4 (5.3)	5.0 (5.5)	0.698
Having more children leads to more cavities during pregnancy.	4.5 (2.3)	3.0 (2.0)	4.6 (2.9)	5.0 (5.0)	0.952
Having more children leads to more gum problems during pregnancy.	4.2 (2.9)	3.0 (2.0)	5.2 (2.8)	5.0 (4.5)	0.449
Regardless of care, some pregnant women have more cavities than others.	6.1 (6.4)	3.5 (7.0)	5.4 (3.1)	5.0 (5.0)	0.551
Regardless of care, some pregnant women have more gum problems than others.	5.1 (3.6)	4.0 (5.0)	5.7 (5.8)	5.0 (5.0)	0.801
One tooth is lost with each pregnancy.	--	--	5.3 (3.8)	4.0 (5.0)	--
The baby absorbs calcium from the mother's teeth and bones.	4.7 (3.0)	5.0 (5.0)	4.5 (3.7)	3.0 (1.0)	0.606
Pregnant women cannot undergo DT during pregnancy.	3.3 (0.6)	3.0 (10)	6.8 (5.4)	5.0 (6.0)	0.299
Pregnant women cannot receive dental anesthesia.	6.6 (5.4)	5.0 (5.0)	4.7 (3.0)	3.0 (5.0)	0.323
Pregnant women cannot have teeth extracted.	5.4 (3.9)	4.0 (4.0)	4.3 (3.2)	3.0 (6.0)	0.479
Pregnant women cannot use fluoride during pregnancy.	--	--	6.3 (5.2)	4.5 (6.0)	--
Pregnant women cannot undergo dental X-ray examination.	6.7 (4.4)	5.0 (7.0)	3.8 (2.9)	4.0 (4.0)	0.177

[TFN1] ¹
The minimum wage at the time was R$622.00.

Beliefs about Oral Health and the Occurrence of Dental Caries in Pregnant Women: Cross-Sectional Study Nested in a Prospective Cohort

ABSTRACT