Obstetrician Advice as a Key Determinant of Dental Visits During Pregnancy: A Cross-Sectional Study in China

Objectives To assess oral health knowledge, attitudes, and practices (KAP) among pregnant women in Fuzhou, China, and to identify factors associated with dental visits during pregnancy. Materials and Methods A cross-sectional survey was conducted from 10 September to 31 October 2025 at a tertiary obstetrics clinic in Fuzhou, China. Participants were recruited at Fuzhou University Affiliated Provincial Hospital. Using consecutive recruitment with trimester quota sampling (DEFF ≈ 1), 452 pregnant women completed a structured questionnaire covering demographics, oral health knowledge (7 items), attitudes (6 items), behaviors, barriers, and information needs. Internal consistency was assessed (Attitudes: Cronbach’s α; Knowledge: KR-20), and construct validity of the attitude scale was examined (KMO and Bartlett’s test). Spearman correlation and multivariable logistic regression were performed. Results Mean Knowledge, Attitude, and Practice scores were 4.29 ± 1.79 (0–7), 24.35 ± 4.38 (6–30), and 2.96 ± 1.88 (0–10), respectively. Overall, 13.1% (59/452) reported a dental visit during pregnancy, increasing by trimester (7.3% ≤12 weeks; 11.8% 13–27 weeks; 20.0% ≥28 weeks). While 68.6% brushed at least twice daily, only 14.4% used dental floss. Knowledge and attitudes correlated positively with practice (Spearman r = 0.248 and r = 0.178; both p < 0.001). Among non-attenders, the most common primary barrier was lack of obstetrician advice or referral information (53.2%, 209/393). In adjusted analyses, obstetrician advice/referral was the strongest predictor of dental visits during pregnancy (aOR 6.30; 95% CI 3.22–12.32). Higher household income was also associated with dental attendance (15,000–24,999 RMB: aOR 3.32, 95% CI 1.02–10.75; ≥25,000 RMB: aOR 6.09, 95% CI 1.61–23.04, vs. <8,000 RMB), as was having a dental check within 6 months prior to pregnancy (aOR 2.19; 95% CI 1.18–4.07). Late pregnancy (≥ 28 weeks) showed a borderline association with utilization (aOR 2.22; 95% CI 0.99–4.99; p = 0.054). Education was not independently associated after adjustment. Conclusions Despite generally positive attitudes, dental service utilization and several preventive behaviors remained low. Integrating obstetrician-delivered counseling/referral into routine antenatal care and addressing pregnancy-specific safety misconceptions may improve timely dental attendance. Clinical Relevance: Embedding oral health counseling and a streamlined referral pathway within antenatal visits could reduce missed opportunities for dental care during pregnancy. Trial Registration: This study was registered in the China National Medical Research Registration System with the registration number: MR-35-25-062116. Registered on September 8, 2025.