Oral healthcare in maternal health services: a cross-country comparative analysis in 10 European countries

Abstract

Introduction and aim: Despite associations between oral and systemic health, little attention has been paid to oral care during pregnancy across Europe. This study aims to map the coverage and delivery of maternal oral healthcare across different European countries. Materials and methods: This qualitative, cross-country comparative study examines how ten European health systems–Denmark, England, Estonia, France, Hungary, Ireland, the Netherlands, Norway, Portugal, and Sweden–govern, finance, and deliver maternal oral healthcare. Using a template created by the authors, data were collected between September 2024 and January 2025, from members of the EU-funded PRUDENT and DELIVER consortia. After comparative analysis, the data were sent to all participants for validation. Results: Thematic analysis of participant answers revealed the following findings: (1) England provides more ample oral healthcare coverage for pregnant women; Estonia, France, Ireland, and Portugal offer partial reimbursement; and Denmark, the Netherlands, Norway, and Sweden don’t have a specific maternal coverage. (2) Geographic and socioeconomic disparities persist. (3) Only England and Estonia were identified as having quality evaluation tools, and England, France, Hungary, Ireland, and Portugal have targeted oral health promotion initiatives for pregnant or postpartum women. Discussion: The findings of this study suggest a missed opportunity for oral health prevention. Reconsideration of financing models, integration of oral screenings into prenatal care, expansion of training for healthcare professionals, and establishment of quality assurance frameworks are needed.