Prenatal Dental Attendance in Fuzhou, China: A Cross-Sectional Study on the Role of Obstetrician Advice

Introduction and aims To evaluate oral health knowledge, attitudes, and practices among pregnant women in Fuzhou, China, and test the hypothesis that receiving obstetrician advice is independently associated with higher prenatal dental attendance. Methods A cross-sectional survey of pregnant women was conducted using consecutive trimester-stratified quota sampling at the Department of Obstetrics of a tertiary public hospital in Fuzhou, China. Questionnaire reliability and validity were assessed. Gestational age was determined via last menstrual period and confirmed by early pregnancy ultrasound scan (<14 weeks). Factors associated with dental visits were evaluated using multivariable logistic regression after collapsing sparse variable categories to ensure model stability (Study Registration Filing No.: MR-35-25-062116). Results Of 500 approached women, 452 were analysed (96.0% response rate; 18 excluded for failing attention checks). Only 13.1% (59/452) reported a prenatal dental visit, with 91.5% (54/59) driven by acute toothache. Mean knowledge, attitude, and practice scores (4.29 ± 1.25, 24.87 ± 2.09, and 2.92 ± 1.73) highlighted a significant attitude–practice gap. Lacking obstetrician advice was the primary barrier for nonattenders (53.2%). Multivariable logistic regression revealed obstetrician advice was the strongest independent factor associated with attendance (adjusted odds ratio [aOR] 6.32; 95% CI 3.38-11.84; P < .001). Late pregnancy (aOR 3.58; P = .002), higher income (aOR 4.23; P = .029), and recent prepregnancy dental checks (aOR 2.10; P = .018) were also independently associated with higher utilization. Conclusion Dental service utilization during pregnancy is low, predominantly symptom-driven, and marked by an attitude–practice gap. Receiving obstetrician advice is strongly associated with attendance. Establishing institutionalized ‘Ask-Advise-Refer’ pathways within routine antenatal care is a practical strategy to optimize maternal oral healthcare utilization. Clinical relevance Integrating brief oral health counselling and streamlined cross-referral pathways into standard antenatal visits could significantly reduce missed opportunities for preventive dental care during pregnancy.