The changes in the knowledge, attitudes and behaviors of obstetrics and gynecology and dentistry staff in a suburb of Beijing regarding periodontal disease in pregnant women (2019 - 2025)
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Abstract Objective Periodontal infection not only affects the local oral cavity but also has a significant impact on the overall health of pregnant women and their fetuses. Obstetricians are the health care providers for pregnant women throughout their pregnancy. This study aimed to assess the changes of attitudes, and clinical behaviors of dentists, obstetricians, and gynecologists regarding periodontal disease in pregnant women in Mentougou district, a suburb of Beijing, China, from 2019 to 2025. Methods This cross-sectional study included Mentougou dentists/obstetricians/gynecologists healthcare professionals in 2019 and 2025, and the questions in the questionnaire were statistically processed using SPSS software. Results In 2019 and 2025, 153 and 124 questionnaires were distributed. Our study found that participants (97.4% vs. 93.5%) were aware of the inflammatory and infectious nature of periodontal disease. Regarding the prevalence of periodontitis in China and in pregnant women, the awareness among doctors in 2025 has increased significantly compared to 2019 (P < 0.05). In addition, the overall level of periodontal disease knowledge in relation to adverse pregnancy effects was elevated compared with the previous, preterm labor (64.1% VS. 80.6%), very low birth weight (48.4% VS. 66.1%), spontaneous abortion (40.5% VS. 58.9%), gestational diabetes mellitus (33.3% VS. 46.0%), preeclampsia (15.7% VS. 21.0%), reproductive tract infections (15.7% VS.25.8%), and no effect (13.1% VS. 4.8%). Regarding the attitudes and behaviors of healthcare workers, oral examination pre-, during and post-pregnancy improved significantly in 2025 compared to 2019 (85.6% VS. 100%, 82.4 VS. 95.2%, and 86.3% VS. 100%, respectively, P < 0.05). Conclusions Our study suggests that, from 2019 to 2025, the knowledge and attitudes about the relationship between periodontal disease and pregnancy outcomes of dentists/obstetricians/gynecologists in suburban hospitals in Beijing have improved significantly.
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The changes in the knowledge, attitudes and behaviors of obstetrics and gynecology and dentistry staff in a suburb of Beijing regarding periodontal disease in pregnant women (2019 - 2025) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article The changes in the knowledge, attitudes and behaviors of obstetrics and gynecology and dentistry staff in a suburb of Beijing regarding periodontal disease in pregnant women (2019 - 2025) Jing Qiao, Yixin Wu, Liyun Sun, Fei Li, Xiaoli Wu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7217085/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective Periodontal infection not only affects the local oral cavity but also has a significant impact on the overall health of pregnant women and their fetuses. Obstetricians are the health care providers for pregnant women throughout their pregnancy. This study aimed to assess the changes of attitudes, and clinical behaviors of dentists, obstetricians, and gynecologists regarding periodontal disease in pregnant women in Mentougou district, a suburb of Beijing, China, from 2019 to 2025. Methods This cross-sectional study included Mentougou dentists/obstetricians/gynecologists healthcare professionals in 2019 and 2025, and the questions in the questionnaire were statistically processed using SPSS software. Results In 2019 and 2025, 153 and 124 questionnaires were distributed. Our study found that participants (97.4% vs. 93.5%) were aware of the inflammatory and infectious nature of periodontal disease. Regarding the prevalence of periodontitis in China and in pregnant women, the awareness among doctors in 2025 has increased significantly compared to 2019 (P < 0.05). In addition, the overall level of periodontal disease knowledge in relation to adverse pregnancy effects was elevated compared with the previous, preterm labor (64.1% VS. 80.6%), very low birth weight (48.4% VS. 66.1%), spontaneous abortion (40.5% VS. 58.9%), gestational diabetes mellitus (33.3% VS. 46.0%), preeclampsia (15.7% VS. 21.0%), reproductive tract infections (15.7% VS.25.8%), and no effect (13.1% VS. 4.8%). Regarding the attitudes and behaviors of healthcare workers, oral examination pre-, during and post-pregnancy improved significantly in 2025 compared to 2019 (85.6% VS. 100%, 82.4 VS. 95.2%, and 86.3% VS. 100%, respectively, P < 0.05). Conclusions Our study suggests that, from 2019 to 2025, the knowledge and attitudes about the relationship between periodontal disease and pregnancy outcomes of dentists/obstetricians/gynecologists in suburban hospitals in Beijing have improved significantly. Health sciences/Diseases Health sciences/Health care Health sciences/Medical research Periodontal diseases pregnant woman adverse pregnancy outcomes preterm birth knowledge attitudes and behaviors INTRODUCTION The human mouth contains more than 700 species of microorganisms, which form a community with the human body, and many oral and systemic diseases are related to various microorganisms in the mouth. [ 1 ] Currently, periodontal disease has been found to be strongly associated with microorganisms in the oral cavity. Periodontal disease (PD) is an infectious chronic inflammatory disease that affects the supporting tissues of the teeth. [ 2 ] Periodontal diseases include periodontitis and gingivitis. Periodontitis was transformed into untreated gingivitis. The global prevalence of periodontal disease is reported to–20–50%. [ 3 ] The prevalence in pregnant women is approximately 40%. [ 4 ] During pregnancy, due to the high levels of estrogen and progesterone in women, 50–70% develop gingivitis and are more likely to develop periodontal disease than their non-pregnant counterparts. Varshhey and Gautam [ 5 ] found that women with pre-eclampsia were 4.33 times more likely to develop periodontal disease than those with normal pregnancies. Thomas et al. demonstrated that almost half of pregnant women in early pregnancy Thomas et al [ 6 ] demonstrated that almost half of all pregnant women exhibit poor periodontal health early in pregnancy, and those with periodontitis were more likely to develop diabetes during pregnancy. Periodontitis has been linked to various adverse pregnancy outcomes, including preterm birth, low birth weight, preeclampsia, diabetes, and spontaneous abortion. Even today, preterm birth of low-birth-weight babies remains a significant public health problem. [ 7 ] Approximately 15 million premature babies are born globally each year. [ 8 ] In the United States, premature birth is the leading cause of neonatal deaths. Currently, oral healthcare awareness and behaviors among pregnant women worldwide are weak. Obstetricians and gynecologists are healthcare maintainers of pregnant women throughout pregnancy, and their awareness of the importance of periodontics can be a great catalyst for promoting oral health and facilitating pregnancy outcomes in pregnant women. Considering the relationship between oral health and pregnancy outcomes, prenatal care practitioners worldwide have begun to actively promote preventive oral healthcare services for pregnant women. In 2014, the American College of Obstetricians and Gynecologists was the first to publish guidelines on the oral health of pregnant women. However, there are currently very little data on the relationship between periodontal or oral health and pregnancy, as perceived by obstetricians and gynecologists globally. This study aimed to assess the knowledge, attitudes, and clinical behaviors of dentists, obstetricians, and gynecologists in Mentougou district, a suburb of Beijing, regarding periodontal disease in pregnant women and to evaluate the factors influencing them; furthermore, to evaluate the change of the knowledge, attitudes, and clinical behaviors of dentists, obstetricians, and gynecologists between 2019 and 2025. MATERIALS AND METHODS Human ethics and Consent to participate The study protocol was approved by the Ethical Committee of Peking University School and Hospital of Stomatology (PKUSSIRB-201949139 and PKUSSIRB-202532004). Questionnaire Materials We reviewed the relevant literature and consulted obstetricians and gynecologists with extensive clinical experience. Under the guidance of a statistician, we completed the first draft of the questionnaire and conducted a pilot survey to determine whether there were any deficiencies or excessive difficulties in the questionnaire entries. Based on the results of the pilot survey and the opinions of the participants, appropriate modifications were made to the questionnaire entries that were cumbersome, difficult, and ambiguous. The modified questionnaire consisted of three main sections: the first section included the participants' socio-demographic characteristics (e.g., department, occupation, sex, etc.) and self-periodontal health status; the second section assessed the participants' knowledge about the etiology of periodontal disease and its impact on adverse outcomes during pregnancy; and the third section assessed whether the participants' perceptions and attitudes were related to clinical behaviors. The questionnaires took almost 20 minutes to complete. All questionnaires informed the investigator of the purpose, and informed consent was obtained. The surveyed population consisted of dentists and obstetricians and gynecologists working in the District Hospital, Traditional Chinese Medicine Hospital and Maternal and Child Health Hospital of Mentougou District. Mentougou District is located slightly to the south of due west of the urban area of Beijing. It administers 9 towns and 4 sub - districts, and has a permanent resident population of approximately 396,000 people. This district is an ecological conservation area of Beijing. As a remote mountainous suburban areas, Mentougou District has a medical workforce predominantly composed of local individuals. Consequently, the medical staff in this district exhibits a relatively high level of stability and the surveyed population was relatively stable. Methodology of the investigation We conducted two questionnaire surveys. The survey population was all obstetricians and gynecologists and dentists in Mentougou district, and we adopted a face-to-face approach to questionnaire completion, and both papers were filled out using uniform criteria with uniform training for questionnaire reviewers. The questionnaires were recovered after completion, incomplete answers were eliminated, and finally, trainers conducted the final review of the surveyed questionnaires, and only those who met the criteria were included in the valid questionnaires. Statistical Analysis We used SPSS version 27 for statistical analysis. Qualitative information was expressed as a percentage using the chi-square and Fisher’s tests. Quantitative data are described as mean and standard deviation and analyzed by ANOVA (conforming to a normal distribution). RESULTS Sociological Characteristics of Participants in 2019 and 2025 In 2019 and 2025, 175 and 143 questionnaires were distributed, respectively, and after excluding incomplete questionnaires, 153 and 124 questionnaires were returned, with response rates of 87.4% and 86.7% in both years. We analyzed relevant studies. There were 175 dentists and 102 obstetricians and gynecologists. Of the two-year total doctors (dentists and obstetricians and gynecologists), 110 had been working for more than 10 years and 167 for less than 10 years, 89 were male and 188 were female, 176 (63.3%) felt good about their own mouths, 112 (40.4%) had not seen their teeth for more than a year, and 192 (69.3%) had never been diagnosed as periodontitis (Table 1). The data from 2019 and 2025 show that the distribution pattern of doctors' years of practice was similar. Most dentists and gynecologists have been in practice for less than ten years. The number of doctors who visited the dentist within one year increased in 2025 compared to 2019 (59.4% vs 66.2% in dentists, and 53.8% vs 56.0% in obstetricians/gynecologists). In 2019, there were 69.3% of obstetricians/gynecologists had never been diagnosed as periodontitis; while in 2025, the percent decreased to 50%. Periodontal Awareness In the periodontal knowledge survey in the past six years, most healthcare workers chose periodontal disease (97.4% VS. 93.5%) as a chronic inflammatory infectious disease but also chose the immune system (39.9% VS. 33.0%), hereditary (49.0% VS. 50.8%), degenerative (37.9% VS. 35.5%), other factors (unifactorial, not genetic, etc.) (Table 2). Healthcare professionals’ knowledge of periodontal disease symptoms, bleeding gums (96.1% VS. 95.2%), loose tooth (85.6% VS. 83.9%), gingival recession (89.5% VS. 89.5%), dental caries (27.5% VS. 17.7%), and alveolar bone resorption (75.2% VS. 82.3%) (Table 2). In addition, we also focused on healthcare professionals' knowledge of gingival treatment, oral hygiene instructions (96.7% VS. 95.2%), supragingival scaling (95.4% VS. 100%), subgingival scaling and root planing (82.4% VS. 89.5%), and regular maintenance (88.9% VS. 97.6%) (Table 2). In the above-mentioned perceptions, the data from 2019 and 2025 showed no statistically significant differences. While it can still be noticed that, the periodontal knowledge of healthcare workers improved in 2025 compared to that in 2019. Table 2 Periodontal awareness. Responders were allowed to check more than one answer. Dentists/obstetricians/gynecologists’ periodontal knowledge 2019 (N = 153) 2025 (N = 124) p -value Definition of periodontal diseases 0.315 Inflammation and multi-infection 149 (97.4%) 116 (93.5%) Auto immunity 61 (39.9%) 41 (33.0%) Hereditary disease 75 (49.0%) 63 (50.8%) Degenerative process 58 (37.9%) 44 (35.5%) Other 28 (18.3%) 7 (5.6%) Clinical signs associated with periodontal diseases 0.734 Gingival bleeding 147 (96.1%) 118 (95.2%) Tooth loss 131 (85.6%) 104 (83.9%) gum recession 137 (89.5%) 111 (89.5%) Caries 42 (27.5%) 22 (17.7%) Alveolar bone destruction 115 (75.2%) 102 (82.3%) Prevalence of adult periodontal disease in China 0.027 < 50% 65 (42.4%) 44 (35.5%) 90%以上 82 (53.6%) 78 (62.9%) Other 6 (3.9%) 2 (1.6%) Treatment of periodontal diseases 0.958 Oral hygiene instruction 148 (96.7%) 118 (95.2%) Supragingival scaling 146 (95.4%) 124 (100%) Subgingival scaling and root planing 126 (82.4%) 111 (89.5%) maintenance 136 (88.9%) 121 (97.6%) Prevalence of periodontitis in pregnant women 0.004 ≤ 30% 81 (52.9%) 26 (21.0%) 30–100% 72 (47.1%) 98 (79.0%) Regarding the prevalence of adult periodontal disease in China, the understandings of doctors in 2019 and 2025 were as follows: a prevalence rate 90% (53.6% VS. 62.9%), other (3.9% VS. 1.6%). Regarding the perception of the prevalence of periodontitis, compared to 2019, the awareness among doctors in 2025 has increased significantly (P < 0.05). A similar trend was also observed in the perception of the prevalence of periodontitis in pregnant women. In 2025, doctors’ awareness was significantly higher than that in 2019: a prevalence rate of 30%~100% (47.1% VS. 79.0%, P < 0.05). We did a total population statistical analysis about periodontal awareness of all dentists or obstetricians/gynecologists. Regard to knowledge about periodontal disease, the data of dentists in 2019 and 2025 showed no significant difference (P > 0.05) (Table 5). While the knowledge about prevalence of adult periodontal disease in China improved in 2025 compared to 2019. And the knowledge about prevalence of periodontitis in pregnant women also improved in 2025 compared to 2019. Table 5 Periodontal awareness of dentist in 2019 and 2025. Responders were allowed to check more than one answer. Dentists 2019 (N = 101) 2025 (N = 74) p -value Definition of periodontal diseases 0.733 Inflammation and multi-infection 99 (98.0%) 70 (94.6%) Auto immunity 36 (35.6%) 23 (31.1%) Hereditary disease 67 (66.3%) 36 (48.7%) Degenerative process 30 (29.7%) 24 (32.4%) Other 16 (15.8%) 5 (6.8%) Clinical signs associated with periodontal diseases 0.534 Gingival bleeding 99 (98.0%) 72 (97.3%) Tooth loss 96 (95.1%) 71 (96.0%) gum recession 97 (96.0%) 71 (96.0%) Caries 9 (8.9%) 5 (6.8%) Alveolar bone destruction 98 (97.0%) 72 (97.3%) Prevalence of adult periodontal disease in China 0.365 50% 21 (20.8%) 13 (17.6%) 90%以上 75 (74.3%) 60 (81.1%) Other 5 (5.0%) 1 (1.4%) Treatment of periodontal diseases 0.704 Oral hygiene instruction 101 (100%) 74 (100%) Supragingival scaling 101 (100.0%) 74 (100.0%) Subgingival scaling and root planing 98 (97.0%) 73 (98.7%) maintenance 101 (100%) 74 (100%) Prevalence of periodontitis in pregnant women 0.141 ≤ 30% 34 (33.7%) 5 (6.8%) 30–100% 67 (66.3%) 69 (93.2%) Table 6 shows the periodontal awareness of obstetricians/gynecologists. Regard to knowledge about definition of periodontal diseases and clinical signs associated with periodontal disease, the data in 2019 and 2025 showed no significant difference (P > 0.05). While on the awareness of whether caries belonging to clinical signs associated with periodontal diseases, the percentage of incorrect answer decreased from 63.5% (2019) to 34.0% (2025). And on the assessment of periodontal knowledge, for example, prevalence of adult periodontal disease in China, treatment of periodontal diseases, and prevalence of periodontitis in pregnant women significantly improved from 2019 to 2025 (P < 0.05). Table 6 Periodontal awareness of obstetricians/gynecologists in 2019 and 2025. Responders were allowed to check more than one answer. Obstetricians/gynecologists 2019 (n = 52) 2025 (n = 50) P -value Definition of periodontal diseases 0.062 Inflammation and multi-infection 50 (96.2%) 44 (88.5%) Auto immunity 25 (48.1%) 18 (36.0%) Hereditary disease 8 (15.5%) 18 (54.0%) Degenerative process 28 (53.9%) 20 (40.0%) Other 12 (23.2%) 2 (4%) Clinical signs associated with periodontal diseases 0.074 Gingival bleeding 48 (92.3%) 46 (92.0%) Tooth loss 35 (67.3%) 33 (66.0%) gum recession 40 (76.9%) 40 (80.0%) Caries 33 (63.5%) 17 (34.0%) Alveolar bone destruction 17 (32.7%) 30 (60%) Prevalence of adult periodontal disease in China 0.015 50% 44 (84.6%) 31 (62.0%) 90%以上 7 (13.5%) 18 (54.0%) Other 1 (1.9%) 1 (2.0%) Treatment of periodontal diseases 0.007 Oral hygiene instruction 47 (90.4%) 44 (88.0%) Supragingival scaling 45 (86.5%) 50 (100.0%) Subgingival scaling and root planing 28 (53.9%) 38 (76.0%) maintenance 35 (67.3%) 47 (94.0%) Prevalence of periodontitis in pregnant women 0.001 ≤ 30% 47 (90.4%) 21 (42.0%) 30–100% 5 (9.6%) 29 (58.0%) Common Periodontal Disease Symptoms and Adverse Effects in Pregnant Women The performance of healthcare professionals in the area of oral symptoms often described in pregnant women in 2019 and 2025 (Table 3): gingival bleeding (94.8% VS. 95.2%), swollen gums (81.7% VS. 84.7%), tooth loss (32.7% VS. 35.5%), caries (31.4% VS. 25.0%), gum tumor (33.3% VS. 15.3%), gingival overgrowth (36.6% VS. 40.3%). Although there was no statistical significant (P > 0.05), the overall level of knowledge of healthcare professionals in 2025 improved compared to those in 2019. The performance of healthcare professionals in the area of perception of adverse effects of pregnancy in pregnant women in 2019 and 2025 (Table 3): preterm birth (64.1% VS. 80.6%), low weight newborn (48.4% VS. 66.1%), spontaneous abortion (40.5% VS. 58.9%), gestational diabetes mellitus (33.3% VS. 46.0%), pre-eclampsia (15.7% VS. 21.0%), low genital tract infection (15.7% VS.25.8%), and no effect (13.1% VS 4.8%). On the oral and systemic effects of periodontal disease in pregnancy, the overall level of knowledge of healthcare professionals in 2025 is better than that in 2019 (P < 0.05). Table 3 Common Periodontal Disease Symptoms and Adverse Effects in Pregnant Women dentists/obstetricians/gynecologists’ periodontal knowledge 2019 (N = 153) 2025 (N = 124) p -value Oral symptoms often described in pregnant women 0.072 Gingival bleeding 145 (94.8%) 118 (95.2%) Swollen gums 125 (81.7%) 105 (84.7%) Tooth loss 50 (32.7%) 44 (35.5%) Caries 48 (31.4%) 31 (25.0%) Gum tumor 51 (33.3%) 19 (15.3%) Gingival overgrowth 56 (36.6%) 50 (40.3%) Influence of periodontal diseases on pregnancy 0.043 Preterm birth 98 (64.1%) 100 (80.6%) Low weight newborn 74 (48.4%) 82 (66.1%) Spontaneous abortion 62 (40.5%) 73 (58.9%) gestational diabetes 51 (33.3%) 57 (46.0%) Pre-eclampsia 24 (15.7%) 26 (21.0%) Low genital tract infection 24 (15.7%) 32 (25.8%) No influence 20 (13.1%) 6 (4.8%) We also did a total population statistical analysis about common periodontal disease symptoms and adverse effects in pregnant women of dentists or obstetricians/gynecologists. For dentists, oral symptoms often described in pregnant women showed no significant difference between the data in 2019 and 2025 (P > 0.05) (Table 7). In dentists, the awareness of influence of periodontal diseases on pregnancy improved in 2025 compared to that in 2019, although without statistical significance (P > 0.05) (Table 7). Table 7 Awareness of Common Periodontal Disease Symptoms and Adverse Effects in Pregnant Women of Dentists Dentists 2019 (N = 101) 2025 (N = 74) p -value Oral symptoms often described in pregnant women 0.058 Gingival bleeding 94 (93.1%) 69 (93.2%) swollen gums 84 (83.2%) 69 (93.2%) Tooth loss 37 (36.6%) 27 (36.5%) Caries 32 (31.7%) 17 (23.0%) gum tumor 40 (39.6%) 10 (13.5%) Gingival overgrowth 40 (39.6%) 34 (45.9%) Influence of periodontal diseases on pregnancy 0.303 Preterm birth 75 (74.3%) 66 (89.2%) Low weight newborn 56 (55.4%) 64 (86.5%) Spontaneous abortion 44 (43.6%) 44 (59.5%) gestational diabetes 47 (46.5%) 39 (52.7%) Pre-eclampsia 21 (20.8%) 20 (27%) Low genital tract infection 23 (22.8%) 44 (59.5%) No influence 8 (7.9%) 0 (0.00%) For obstetricians/gynecologists, oral symptoms often described in pregnant women showed no significant difference between the data in 2019 and 2025 (P > 0.05) (Table 8). In obstetricians/gynecologists, the awareness of influence of periodontal diseases on pregnancy improved significantly in 2025 compared to that in 2019 (P < 0.05) (Table 8). Table 8 Awareness of Common Periodontal Disease Symptoms and Adverse Effects in Pregnant Women of Obstetricians/gynecologists Obstetricians/gynecologists 2019 (N = 52) 2025 (N = 50) p -value Oral symptoms often described in pregnant women 0.066 Gingival bleeding 51 (98.1%) 49 (98.0%) swollen gums 41 (78.8%) 36 (72.0%) Tooth loss 13 (25.0%) 17 (34.0%) Caries 16 (30.8%) 14 (28.0%) gum tumor 11 (21.1%) 9 (18.0%) Gingival overgrowth 16 (30.8%) 16 (32.0%) Influence of periodontal diseases on pregnancy 0.008 Preterm birth 24 (46.2%) 25 (50.0%) Low weight newborn 17 (32.7%) 26 (52.0%) Spontaneous abortion 13 (25.0%) 29 (58.0%) gestational diabetes 13 (25.0%) 10 (20.0%) Pre-eclampsia 6 (11.5%) 5 (10.0%) Low genital tract infection 5 (9.6%) 9 (18.0%) No influence 13 (25.0%) 6 (12.0%) Healthcare workers’ attitude and behavior In terms of healthcare workers’ perceptions and attitudes, we found that of healthcare workers in 2025 significantly improved compared to that in 2019 referring to periodontal disease affects pregnancy, pre-pregnancy oral examination, oral examination during pregnancy, post-delivery oral examination, periodontal treatment effective for pregnant women and periodicity of periodontal treatment for pregnant women (P < 0.05) (Table 4). Table 4 Healthcare workers’ attitude and behavior 2019 (N = 153) 2025 (N = 124) P value Periodontal disease affects pregnancy 0.005 Yes 126 (82.4%) 118 (95.2%) No 27 (17.6%) 6 (4.8%) Pre-pregnancy oral examination 0.004 Yes 131 (85.6%) 124 (100.0%) No 22 (14.4%) 0 (0.0%) Oral examination during pregnancy 0.009 Yes 126 (82.4%) 118 (95.2%) No 27 (17.6%) 6 (4.8%) Post-delivery oral examination 0.041 Yes 132 (86.3%) 124 (100.0%) No 21 (13.7%) 0 (0.0%) Periodontal treatment effective for pregnant women 0.016 Yes 126 (82.4%) 122 (98.4%) No 27 (17.6%) 2 (1.6%) Periodicity of periodontal treatment for pregnant women 0.032 No 31 (20.3%) 13 (10.5%) early pregnancy 19 (12.4%) 7 (5.6%) mid-pregnancy 95 (62.1%) 101 (81.5%) late pregnancy 8 (5.2%) 3 (2.4%) We also did a total population statistical analysis. The results showed that both dentists and obstetricians/gynecologists the perceptions and attitudes improved significantly in 2025 compared to that in 2019 (P < 0.05) (Table 9 and Table 10). Table 9 Dentists’ attitude and behavior 2019 (N = 101) 2025(N = 74) p -value Periodontal disease affects pregnancy 0.035 Yes 93 (92.1%) 74 (100%) No 8 (7.9%) 0 (0%) Pre-pregnancy oral examination 0.022 Yes 91 (90.1%) 74 (100.0%) No 10 (9.9%) 0 (0.0%) Oral examination during pregnancy 0.018 Yes 92 (91.1%) 73 (98.6%) No 9 (8.9%) 1 (1.4%) Post-delivery oral examination 0.049 Yes 92 (91.1%) 74 (100.0%) No 9 (8.9%) 0 (0.0%) Periodontal treatment effective for pregnant women 0.027 Yes 93 (92.1%) 74 (100%) No 8 (7.9%) 0 (0.0%) Periodicity of periodontal treatment for pregnant women 0.043 No 16 (15.8%) 5 (6.8%) early pregnancy 7 (6.9%) 1 (1.4%) mid-pregnancy 66 (65.3%) 67 (90.5%) late pregnancy 12 (12.0%) 1 (1.4%) Table 10 Obstetricians/gynecologists’ attitude and behavior 2019 (N = 52) 2025(N = 50) p -value Periodontal disease affects pregnancy 0.015 Yes 33 (63.4%) 44 (88%) No 19 (36.6%) 6 (12%) Pre-pregnancy oral examination 0.032 Yes 40 (76.9%) 74 (100.0%) No 12 (23.1%) 0 (0.0%) Oral examination during pregnancy 0.018 Yes 34 (65.4%) 45 (90.0%) No 18 (34.6%) 5 (10.0%) Post-delivery oral examination 0.020 Yes 40 (76.9%) 50 (100.0%) No 12 (23.1%) 0 (0.0%) Periodontal treatment effective for pregnant women 0.007 Yes 33 (63.5%) 74 (100%) No 19 (36.5%) 0 (0.0%) Periodicity of periodontal treatment for pregnant women 0.043 No 15 (28.8%) 8 (16.0%) early pregnancy 12 (23.1%) 6 (12.0%) mid-pregnancy 29 (55.8%) 34 (68.0%) late pregnancy 6 (11.5%) 2 (4.0%) DISCUSSION Comparison with other studies Over the years, studies have shown an association between periodontal disease and pregnancy complications. [ 9 ] Periodontitis may increase the risk of adverse pregnancy outcomes (APOs), including preterm labor, preeclampsia, gestational diabetes, low birth weight, and intrauterine growth retardation. [ 10 ] Several studies [ 11 ][ 12 ] have found that the prevalence of periodontal disease is high in pregnant women, with rates as high as 66.7% in some races. However, pregnant women have very limited knowledge about periodontal disease and its potential impact on pregnancy. Factors such as age, education, and marital status may have influenced this knowledge. [ 13 ] Although some women are aware of the relationship between periodontal disease and adverse pregnancy outcomes, only 47% have received an oral health diagnosis or appropriate treatment. [ 14 ] Inflammation plays a propulsive role in periodontal diseases. The intact gingival epithelium of the mouth is an innate physical barrier to systemic spread of oral bacteria. During disease progression, the ulcerated epithelium loses its integrity, and the connecting tissues and capillaries come into direct contact with the plaque biofilm. [ 15 ] When a woman is pregnant, periodontal tissues and expression levels of inflammatory factors such as interleukin-1, tumor necrosis factor alpha, and prostaglandin E2 are significantly elevated in women, and these inflammatory factors play an important role in the normal course of labor and delivery. [ 16 ] Perunovic et al. [ 17 ] demonstrated that preterm women have poorer periodontal parameters and significantly elevated levels of prostaglandins and interleukin 6, both of which may be preterm labor and delivery Triggers. Chronic inflammation of the oral cavity is associated with various diseases. Perunovic et al. [ 17 ] demonstrated that preterm women have poorer periodontal parameters and significantly elevated levels of prostaglandins and interleukin 6, both of which may be preterm labor and delivery Triggers. The results of a study in Serbia showed [ 18 ] that slightly more than half of the doctors (53%) were aware of the main etiologic factors of periodontal disease, which is less compared to the results of our data. Regarding other studies [ 19 – 23 ] , Paquette et al. showed [ 19 ] that 95% of dentists in North Carolina were aware of the etiologic factors of periodontitis, which is similar to the results of our study. Furthermore, in our study, it was found that dentists were 89.2% aware of the impact of periodontal disease on preterm labor during pregnancy (in 2025), while only 46% of dentists [ 18 ] in Servia were aware of the relationship between periodontal disease and preterm labor during pregnancy (in 2023). Comparison in awareness of periodontal knowledge In our study, we performed a yearly comparison between 2019 and 2025 and a comparison of the overall level of periodontal knowledge among dentists and obstetricians/gynecologists. In the 2019 survey, regarding the prevalence of adult periodontal disease in China and the prevalence of periodontal disease in pregnant women, only 41.2% and 47.1% of medical staff could accurately know that it was at a relatively high level, and most medical staff had a vague understanding of the specific proportion of the disease. The survey findings in 2025 indicated that medical professionals’ understanding regarding prevalence of periodontal diseases in China and in pregnant women had witnessed a remarkable enhancement (62.9% and 79.0%, Table 2 ). That means an increasing number of medical professionals were able to accurately recognize that pregnant women have a relatively high incidence of periodontal diseases. Concerning the prevalence of adult periodontal disease in China, the awareness rate significantly improved from 41.2% in 2019 to 62.9% in 2025. As for the impact of periodontal disease on fetal development, in 2019, 13.1% of medical staff were not aware that periodontal disease was associated with adverse pregnancy outcomes such as preterm birth and low birth weight (Table 3 ). And the percentage significantly decreased from 13.1–4.8% in 2025. The findings in Table 3 suggests that medical professionals have developed a more profound comprehension of the association between periodontal disease and adverse pregnancy outcomes. The overall level of periodontal knowledge was better in dentists compared to that in obstetricians/gynecologists in both 2019 and 2025. Nevertheless, it is gratifying to recognize that, the cognitive disparities among medical staff from different departments have been gradually reducing. Medical staff in the field of obstetrics and gynecology have achieved notable advancements in their expertise regarding periodontal diseases. Their awareness rate of knowledge related to the diagnosis and treatment of periodontal diseases has shown a marked increase compared to that in 2019 (Table 6 ). And the awareness of periodontal adverse effects in pregnant women of obstetricians/gynecologists also improved significantly in 2025 compared to that in 2019 (Table 8 ). Likewise, dental medical professionals have also strengthened their understanding of the prevalence of periodontal disease in China and periodontal adverse effects in pregnant women although without statistical significance (Table 5 and Table 7 ). Comparison in healthcare workers’ attitude and behavior It was found that the overall level of periodontal knowledge was better and have good clinical behavior among dentists compared to obstetricians and gynecologists (Tables 9 and 10 ). This emphasize the need for healthcare professionals to treat the body as a whole and to recognize that interdisciplinary referrals and deeper continuing education are necessary. There is a significant influence between knowledge and attitudes and practice, and inadequate knowledge may hinder the translation of positive attitudes into effective clinical practice. The representativeness of Mentougou District As the sole national demonstration zone for ecological civilization construction in Beijing, Mentougou District is celebrated for its mountainous area accounting for 98.5% of the total. It can serve as a representative of the extensive mountainous regions in Beijing and other large Chinese cities. In Mentougou District, there are 178 administrative villages in total. The distribution of medical resources in Mentougou District is characterized by ‘core agglomeration and comprehensive coverage’. In particular, medical personnel in the fields of stomatology, obstetrics, and gynecology are mainly concentrated in several hospitals included in this study. The rate of knowledge renewal, the extent of training coverage and the dissemination of equipment and technology among medical personnel in suburban areas especially in mountainous regions typically lag behind those in urban areas. Furthermore, in contrast to urban areas, the collaborative relationships between the departments of obstetrics and gynecology and dentistry in suburban medical institutions tend to be more fragmented. These can partly explain the results in 2019 of this study. The causes of the improvement in the awareness, attitudes, and practices of medical professionals in Mentougou District from 2019 to 2025 are multifaceted. Between 2019 and 2025, medical institutions and relevant authorities gradually recognized the deficiencies in medical staff's knowledge and skills related to periodontal diseases in pregnant women. Consequently, the intensity of training initiatives has been increased. There has been a growing public concern about periodontal diseases in pregnant women, accompanied by a proliferation of related awareness campaigns. These initiatives not only heightened the self - care awareness of pregnant women but also made medical professionals more acutely aware of their roles and responsibilities in the prevention and management of periodontal diseases in pregnant women. This, in turn, has motivated them to proactively acquire relevant knowledge and enhance their service capabilities. The government and health departments have introduced a series of policies to advance the prevention and treatment of periodontal diseases in pregnant women. By integrating oral health care for pregnant women into the public health service framework and increasing financial investment, these policies have provided both policy support and financial resources for medical institutions to conduct related work. In the context of preventing and treating periodontal diseases in pregnant women, the collaboration between the departments of obstetrics and gynecology and dentistry has been increasingly strengthened. This integrated approach has not only improved the therapeutic outcomes for pregnant women with periodontal diseases but has also facilitated knowledge exchange and sharing among medical professionals. As a result, obstetricians and gynecologists have gained a more in - depth understanding of periodontal disease knowledge, while dental professionals have developed a more comprehensive appreciation of the physiological characteristics and pregnancy - associated risks of pregnant women. Declarations Ethics approval and consent to participate: The study protocol was approved by the Ethical Committee of Peking University School and Hospital of Stomatology (PKUSSIRB-201949139 and PKUSSIRB-202532004). Clinical trial number: Not applicable Author contribution: J.Q: conceived and designed the study; analyzed and interpreted the data; wrote the main manuscript. A.B. and C.D. wrote the main manuscript text and E.F. prepared figures 1-3. All authors reviewed the manuscript. Yixin Wu: contributed to study design; collected and processed the data; wrote the main manuscript. Liyun Sun: collected survey data; verified data accuracy. Fei Li: Assisted in data analysis and interpretation; contributed to the discussion section. Xiaoli Wu: conducted the questionnaire survey; collected survey data; wrote a part of the manuscript. Funding: This work was supported by Peking University Clinical Medicine + X Youth Special Program. Fund Number: PKU2025PKULCXQ007 and Beijing Natural Science Foundation - Haidian Original Innovation Joint Fund. No. L252167. Consent to publish: Not applicable Conflict of interest: The authors report no conflicts of interest related to this study. Data availability: supplemented in the submitting process. References Saadaoui M, Singh P, Al Khodor S. Oral microbiome and pregnancy: A bidirectional relationship. J Reprod Immunol . 2021; 145:103293. Fischer RG, Gomes Filho IS, Cruz SSD, et al. What is the future of Periodontal Medicine? Braz Oral Res . 2021;35(Supp 2): e102. Published 2021 Sep 24. Nazir, M.; Al-Ansari, A.; Al-Khalifa, K.; Alhareky, M.; Gaffar, B.; Almas, K. Global Prevalence of Periodontal Disease and Lack of Its Surveillance. Sci. World J. 2020 , 2020 , 2146160. Salih, Y.; Nasr, A.M.; Ahmed, A.B.A.; Sharif, M.E.; Adam, I. Prevalence of and Risk Factors for Periodontal Disease among Pregnant Women in an Antenatal Care Clinic in Khartoum, Sudan. BMC Res. Notes 2020 , 13 , 147. Varshney, S., and Gautam, A. (2014). Poor periodontal health as a risk factor for development of pre-eclampsia in pregnant women. J. Indian Soc. Periodontol. 18, 321–325. Bostanci N. Periodontal health and pregnancy outcomes: Time to deliver. Acta Obstet Gynecol Scand . 2023;102(6):648-651. doi:10.1111/aogs.14548 AlSharief M, Alabdurubalnabi E. Periodontal Pathogens and Adverse Pregnancy Outcomes: A Narrative Review. Life (Basel) . 2023;13(7):1559. Published 2023 Jul 13. Andonova, I.; Iliev, V.; Živković, N.; Sušič, E.; Bego, I.; Kotevska, V. Can Oral Anaerobic Bacteria Cause Adverse Pregnancy Outcomes? Pril. (Makedon. Akad. Nauk. Umetnostite. Oddel. Med. Nauk.) 2015 , 36 , 137–143. Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G, et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol. 1996;67:1103–1113. Thomas C, Timofeeva I, Bouchoucha E, et al. Oral and periodontal assessment at the first trimester of pregnancy: The PERISCOPE longitudinal study. Acta Obstet Gynecol Scand . 2023;102(6):669-680. Xie, Y.; Xiong, X.; Elkind-Hirsch, K.E.; Pridjian, G.; Maney, P.; Delarosa, R.L.; Buekens, P. Change of periodontal disease status during and after pregnancy. J. Periodontol. 2013 , 84 , 725–731. Raju, K.; Berens, L. Periodontology and pregnancy: An overview of biomedical and epidemiological evidence. Periodontol. 2000 2021 , 87 , 132–142. Tarannum, F.; Prasad, R.K.; Shobha, R.; Kumar, B.B.; Ebenezer, S. Awareness of the association between periodontal disease and adverse pregnancy outcome among the general female population. Indian J. Dent. Res. 2015 , 26 , 21–25. Petit, C.; Benezech, J.; Davideau, J.L.; Hamann, V.; Tuzin, N.; Huck, O. Consideration of Oral Health and Periodontal Diseases During Pregnancy: Knowledge and Behaviour Among French Pregnant Women. Oral Health Prev. Dent. 2021 , 19 , 33–42. Jain P, Hassan N, Khatoon K, et al. Periodontitis and Systemic Disorder-An Overview of Relation and Novel Treatment Modalities. Pharmaceutics . 2021;13(8):1175. Published 2021 Jul 30. Hu W, Wang Y, Chen R, Pan T. Oral Health Status and Literacy/Knowledge Amongst Pregnant Women in Shanghai. Int Dent J . 2023;73(2):212-218. Perunovic, N. D., Rakic, M. M., Nikolic, L. I., Jankovic, S. M., Aleksic, Z. M., Plecas, D. V., et al. (2016). The association between periodontal inflammation and labor triggers (elevated cytokine levels) in preterm birth: a cross-sectional study. J. Periodontol. 87, 248–256. Stojilković M, Gušić I, Prodanović D, et al. Awareness of physicians and dentists in Serbia about the association between periodontitis and systemic diseases: a cross-sectional study. BMC Oral Health . 2023;23(1):449. Published 2023 Jul 5. Paquette DW, Bell KP, Phillips C, Offenbacher S, Wilder RS. Dentists’ knowledge and opinions of oral-systemic disease relationships: relevance to patient care and education. J Dent Educ. 2015;79(6):626–35. Bechina C, Bonvillain G, Rethore G, et al. Knowledge and Practice Behaviours of Obstetricians/Gynecologists and Midwives Concerning Periodontal Health and Pregnancy. Oral Health Prev Dent . 2023;21:383-390. Cohen L, Schaeffer M, Davideau JL, Tenenbaum H, Huck O. Obstetric knowledge, attitude, and behavior concerning periodontal diseases and treatment needs in pregnancy: influencing factors in France. J Periodontol. 2015;86:398–405. Tarannum F, Prasad S, Vivekananda L, Jayanthi D, Faizuddin M. Awareness of the association between periodontal disease and pre-term births among general dentists, general medical practitioners and gynecologists. Indian J Public Health. 2013;57:92–5. Satyanarayana K, Durga Bai Y, Aruna P, Sindhura N, Monisha G, Sreenivasulu G. Awareness on the Association between Periodontal Diseases and Pregnancy Outcomesm Among Gynecologists: a cross-sectional study. J Int Oral Health. 2016;8:579–84. Table 1 Table 1 is available in the Supplementary Files section. Additional Declarations No competing interests reported. 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2025)","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003e The human mouth contains more than 700 species of microorganisms, which form a community with the human body, and many oral and systemic diseases are related to various microorganisms in the mouth.\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e Currently, periodontal disease has been found to be strongly associated with microorganisms in the oral cavity. Periodontal disease (PD) is an infectious chronic inflammatory disease that affects the supporting tissues of the teeth.\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e Periodontal diseases include periodontitis and gingivitis. Periodontitis was transformed into untreated gingivitis. The global prevalence of periodontal disease is reported to\u0026ndash;20\u0026ndash;50%.\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e The prevalence in pregnant women is approximately 40%.\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e During pregnancy, due to the high levels of estrogen and progesterone in women, 50\u0026ndash;70% develop gingivitis and are more likely to develop periodontal disease than their non-pregnant counterparts. Varshhey and Gautam\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e found that women with pre-eclampsia were 4.33 times more likely to develop periodontal disease than those with normal pregnancies. Thomas et al. demonstrated that almost half of pregnant women in early pregnancy Thomas et al\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e demonstrated that almost half of all pregnant women exhibit poor periodontal health early in pregnancy, and those with periodontitis were more likely to develop diabetes during pregnancy.\u003c/p\u003e\u003cp\u003ePeriodontitis has been linked to various adverse pregnancy outcomes, including preterm birth, low birth weight, preeclampsia, diabetes, and spontaneous abortion. Even today, preterm birth of low-birth-weight babies remains a significant public health problem.\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e Approximately 15\u0026nbsp;million premature babies are born globally each year.\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e In the United States, premature birth is the leading cause of neonatal deaths.\u003c/p\u003e\u003cp\u003eCurrently, oral healthcare awareness and behaviors among pregnant women worldwide are weak. Obstetricians and gynecologists are healthcare maintainers of pregnant women throughout pregnancy, and their awareness of the importance of periodontics can be a great catalyst for promoting oral health and facilitating pregnancy outcomes in pregnant women. Considering the relationship between oral health and pregnancy outcomes, prenatal care practitioners worldwide have begun to actively promote preventive oral healthcare services for pregnant women. In 2014, the American College of Obstetricians and Gynecologists was the first to publish guidelines on the oral health of pregnant women. However, there are currently very little data on the relationship between periodontal or oral health and pregnancy, as perceived by obstetricians and gynecologists globally.\u003c/p\u003e\u003cp\u003eThis study aimed to assess the knowledge, attitudes, and clinical behaviors of dentists, obstetricians, and gynecologists in Mentougou district, a suburb of Beijing, regarding periodontal disease in pregnant women and to evaluate the factors influencing them; furthermore, to evaluate the change of the knowledge, attitudes, and clinical behaviors of dentists, obstetricians, and gynecologists between 2019 and 2025.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cp\u003e\u003cb\u003eHuman ethics and Consent to participate\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe study protocol was approved by the Ethical Committee of Peking University School and Hospital of Stomatology (PKUSSIRB-201949139 and PKUSSIRB-202532004).\u003c/p\u003e\u003cp\u003e\u003cb\u003eQuestionnaire Materials\u003c/b\u003e\u003c/p\u003e\u003cp\u003e We reviewed the relevant literature and consulted obstetricians and gynecologists with extensive clinical experience. Under the guidance of a statistician, we completed the first draft of the questionnaire and conducted a pilot survey to determine whether there were any deficiencies or excessive difficulties in the questionnaire entries. Based on the results of the pilot survey and the opinions of the participants, appropriate modifications were made to the questionnaire entries that were cumbersome, difficult, and ambiguous. The modified questionnaire consisted of three main sections: the first section included the participants' socio-demographic characteristics (e.g., department, occupation, sex, etc.) and self-periodontal health status; the second section assessed the participants' knowledge about the etiology of periodontal disease and its impact on adverse outcomes during pregnancy; and the third section assessed whether the participants' perceptions and attitudes were related to clinical behaviors. The questionnaires took almost 20 minutes to complete. All questionnaires informed the investigator of the purpose, and informed consent was obtained.\u003c/p\u003e\u003cp\u003eThe surveyed population consisted of dentists and obstetricians and gynecologists working in the District Hospital, Traditional Chinese Medicine Hospital and Maternal and Child Health Hospital of Mentougou District. Mentougou District is located slightly to the south of due west of the urban area of Beijing. It administers 9 towns and 4 sub - districts, and has a permanent resident population of approximately 396,000 people. This district is an ecological conservation area of Beijing. As a remote mountainous suburban areas, Mentougou District has a medical workforce predominantly composed of local individuals. Consequently, the medical staff in this district exhibits a relatively high level of stability and the surveyed population was relatively stable.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethodology of the investigation\u003c/b\u003e\u003c/p\u003e\u003cp\u003eWe conducted two questionnaire surveys. The survey population was all obstetricians and gynecologists and dentists in Mentougou district, and we adopted a face-to-face approach to questionnaire completion, and both papers were filled out using uniform criteria with uniform training for questionnaire reviewers. The questionnaires were recovered after completion, incomplete answers were eliminated, and finally, trainers conducted the final review of the surveyed questionnaires, and only those who met the criteria were included in the valid questionnaires.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eWe used SPSS version 27 for statistical analysis. Qualitative information was expressed as a percentage using the chi-square and Fisher\u0026rsquo;s tests. Quantitative data are described as mean and standard deviation and analyzed by ANOVA (conforming to a normal distribution).\u003c/p\u003e\u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003eSociological Characteristics of Participants in 2019 and 2025\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn 2019 and 2025, 175 and 143 questionnaires were distributed, respectively, and after excluding incomplete questionnaires, 153 and 124 questionnaires were returned, with response rates of 87.4% and 86.7% in both years. We analyzed relevant studies. There were 175 dentists and 102 obstetricians and gynecologists. Of the two-year total doctors (dentists and obstetricians and gynecologists), 110 had been working for more than 10 years and 167 for less than 10 years, 89 were male and 188 were female, 176 (63.3%) felt good about their own mouths, 112 (40.4%) had not seen their teeth for more than a year, and 192 (69.3%) had never been diagnosed as periodontitis (Table\u0026nbsp;1).\u003c/p\u003e\n\u003cdiv\u003e\n\u003c/div\u003e\n\u003cp\u003eThe data from 2019 and 2025 show that the distribution pattern of doctors' years of practice was similar. Most dentists and gynecologists have been in practice for less than ten years. The number of doctors who visited the dentist within one year increased in 2025 compared to 2019 (59.4% vs 66.2% in dentists, and 53.8% vs 56.0% in obstetricians/gynecologists). In 2019, there were 69.3% of obstetricians/gynecologists had never been diagnosed as periodontitis; while in 2025, the percent decreased to 50%.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePeriodontal Awareness\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the periodontal knowledge survey in the past six years, most healthcare workers chose periodontal disease (97.4% VS. 93.5%) as a chronic inflammatory infectious disease but also chose the immune system (39.9% VS. 33.0%), hereditary (49.0% VS. 50.8%), degenerative (37.9% VS. 35.5%), other factors (unifactorial, not genetic, etc.) (Table\u0026nbsp;2). Healthcare professionals’ knowledge of periodontal disease symptoms, bleeding gums (96.1% VS. 95.2%), loose tooth (85.6% VS. 83.9%), gingival recession (89.5% VS. 89.5%), dental caries (27.5% VS. 17.7%), and alveolar bone resorption (75.2% VS. 82.3%) (Table\u0026nbsp;2). In addition, we also focused on healthcare professionals' knowledge of gingival treatment, oral hygiene instructions (96.7% VS. 95.2%), supragingival scaling (95.4% VS. 100%), subgingival scaling and root planing (82.4% VS. 89.5%), and regular maintenance (88.9% VS. 97.6%) (Table\u0026nbsp;2). In the above-mentioned perceptions, the data from 2019 and 2025 showed no statistically significant differences. While it can still be noticed that, the periodontal knowledge of healthcare workers improved in 2025 compared to that in 2019.\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 2\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003ePeriodontal awareness. Responders were allowed to check more than one answer.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDentists/obstetricians/gynecologists’\u003c/p\u003e\n \u003cp\u003eperiodontal knowledge\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003cp\u003e(N = 153)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2025\u003c/p\u003e\n \u003cp\u003e(N = 124)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDefinition of periodontal diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.315\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInflammation and multi-infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e149\u003c/p\u003e\n \u003cp\u003e(97.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003cp\u003e(93.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAuto immunity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003cp\u003e(39.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003cp\u003e(33.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHereditary disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003cp\u003e(49.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003cp\u003e(50.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDegenerative process\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003cp\u003e(37.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003cp\u003e(35.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003cp\u003e(18.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e(5.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eClinical signs associated with periodontal diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.734\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGingival bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e147\u003c/p\u003e\n \u003cp\u003e(96.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e118\u003c/p\u003e\n \u003cp\u003e(95.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTooth loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e131\u003c/p\u003e\n \u003cp\u003e(85.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003cp\u003e(83.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003egum recession\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e137\u003c/p\u003e\n \u003cp\u003e(89.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e111\u003c/p\u003e\n \u003cp\u003e(89.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCaries\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003cp\u003e(27.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003cp\u003e(17.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAlveolar bone destruction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e115\u003c/p\u003e\n \u003cp\u003e(75.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003cp\u003e(82.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrevalence of adult periodontal disease in China\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.027\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt; 50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003cp\u003e(42.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003cp\u003e(35.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e90%以上\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003cp\u003e(53.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003cp\u003e(62.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003cp\u003e(3.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e(1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTreatment of periodontal diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.958\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOral hygiene instruction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e148\u003c/p\u003e\n \u003cp\u003e(96.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e118\u003c/p\u003e\n \u003cp\u003e(95.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSupragingival scaling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e146\u003c/p\u003e\n \u003cp\u003e(95.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e124\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSubgingival scaling and root planing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003cp\u003e(82.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e111\u003c/p\u003e\n \u003cp\u003e(89.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emaintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003cp\u003e(88.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003cp\u003e(97.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrevalence of periodontitis in pregnant women\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e≤ 30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003cp\u003e(52.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003cp\u003e(21.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30–100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003cp\u003e(47.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003cp\u003e(79.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eRegarding the prevalence of adult periodontal disease in China, the understandings of doctors in 2019 and 2025 were as follows: a prevalence rate \u0026lt; 50% (42.4% VS. 35.5%), a prevalence rate of \u0026gt; 90% (53.6% VS. 62.9%), other (3.9% VS. 1.6%). Regarding the perception of the prevalence of periodontitis, compared to 2019, the awareness among doctors in 2025 has increased significantly (P \u0026lt; 0.05). A similar trend was also observed in the perception of the prevalence of periodontitis in pregnant women. In 2025, doctors’ awareness was significantly higher than that in 2019: a prevalence rate of 30%~100% (47.1% VS. 79.0%, P \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003eWe did a total population statistical analysis about periodontal awareness of all dentists or obstetricians/gynecologists.\u003c/p\u003e\n\u003cp\u003eRegard to knowledge about periodontal disease, the data of dentists in 2019 and 2025 showed no significant difference (P \u0026gt; 0.05) (Table\u0026nbsp;5). While the knowledge about prevalence of adult periodontal disease in China improved in 2025 compared to 2019. And the knowledge about prevalence of periodontitis in pregnant women also improved in 2025 compared to 2019.\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 5\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003ePeriodontal awareness of dentist in 2019 and 2025. Responders were allowed to check more than one answer.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDentists\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2019 (N = 101)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2025 (N = 74)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDefinition of periodontal diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.733\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInflammation and multi-infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003cp\u003e(98.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003cp\u003e(94.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAuto immunity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003cp\u003e(35.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003cp\u003e(31.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHereditary disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003cp\u003e(66.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003cp\u003e(48.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDegenerative process\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003cp\u003e(29.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003cp\u003e(32.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003cp\u003e(15.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003cp\u003e(6.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eClinical signs associated with periodontal diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.534\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGingival bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003cp\u003e(98.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003cp\u003e(97.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTooth loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003cp\u003e(95.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003cp\u003e(96.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003egum recession\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003cp\u003e(96.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003cp\u003e(96.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCaries\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003cp\u003e(8.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003cp\u003e(6.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAlveolar bone destruction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003cp\u003e(97.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003cp\u003e(97.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrevalence of adult periodontal disease in China\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.365\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003cp\u003e(20.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e(17.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e90%以上\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003cp\u003e(74.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003cp\u003e(81.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003cp\u003e(5.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e(1.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTreatment of periodontal diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.704\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOral hygiene instruction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSupragingival scaling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003cp\u003e(100.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003cp\u003e(100.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSubgingival scaling and root planing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003cp\u003e(97.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003cp\u003e(98.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emaintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrevalence of periodontitis in pregnant women\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.141\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e≤ 30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003cp\u003e(33.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003cp\u003e(6.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30–100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003cp\u003e(66.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003cp\u003e(93.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable\u0026nbsp;6 shows the periodontal awareness of obstetricians/gynecologists. Regard to knowledge about definition of periodontal diseases and clinical signs associated with periodontal disease, the data in 2019 and 2025 showed no significant difference (P \u0026gt; 0.05). While on the awareness of whether caries belonging to clinical signs associated with periodontal diseases, the percentage of incorrect answer decreased from 63.5% (2019) to 34.0% (2025). And on the assessment of periodontal knowledge, for example, prevalence of adult periodontal disease in China, treatment of periodontal diseases, and prevalence of periodontitis in pregnant women significantly improved from 2019 to 2025 (P \u0026lt; 0.05).\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab4\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 6\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003ePeriodontal awareness of obstetricians/gynecologists in 2019 and 2025. Responders were allowed to check more than one answer.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eObstetricians/gynecologists\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2019 (n = 52)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2025 (n = 50)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDefinition of periodontal diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.062\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInflammation and multi-infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003cp\u003e(96.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003cp\u003e(88.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAuto immunity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003cp\u003e(48.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003cp\u003e(36.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHereditary disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e(15.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003cp\u003e(54.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDegenerative process\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003cp\u003e(53.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003cp\u003e(40.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003cp\u003e(23.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e(4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eClinical signs associated with periodontal diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.074\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGingival bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003cp\u003e(92.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003cp\u003e(92.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTooth loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003cp\u003e(67.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003cp\u003e(66.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003egum recession\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003cp\u003e(76.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003cp\u003e(80.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCaries\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003cp\u003e(63.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003cp\u003e(34.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAlveolar bone destruction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003cp\u003e(32.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003cp\u003e(60%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrevalence of adult periodontal disease in China\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003cp\u003e(84.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003cp\u003e(62.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e90%以上\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e(13.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003cp\u003e(54.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e(1.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e(2.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTreatment of periodontal diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOral hygiene instruction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003cp\u003e(90.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003cp\u003e(88.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSupragingival scaling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003cp\u003e(86.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003cp\u003e(100.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSubgingival scaling and root planing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003cp\u003e(53.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003cp\u003e(76.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emaintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003cp\u003e(67.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003cp\u003e(94.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrevalence of periodontitis in pregnant women\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e≤ 30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003cp\u003e(90.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003cp\u003e(42.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30–100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003cp\u003e(9.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003cp\u003e(58.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eCommon Periodontal Disease Symptoms and Adverse Effects in Pregnant Women\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe performance of healthcare professionals in the area of oral symptoms often described in pregnant women in 2019 and 2025 (Table\u0026nbsp;3): gingival bleeding (94.8% VS. 95.2%), swollen gums (81.7% VS. 84.7%), tooth loss (32.7% VS. 35.5%), caries (31.4% VS. 25.0%), gum tumor (33.3% VS. 15.3%), gingival overgrowth (36.6% VS. 40.3%). Although there was no statistical significant (P \u0026gt; 0.05), the overall level of knowledge of healthcare professionals in 2025 improved compared to those in 2019. The performance of healthcare professionals in the area of perception of adverse effects of pregnancy in pregnant women in 2019 and 2025 (Table\u0026nbsp;3): preterm birth (64.1% VS. 80.6%), low weight newborn (48.4% VS. 66.1%), spontaneous abortion (40.5% VS. 58.9%), gestational diabetes mellitus (33.3% VS. 46.0%), pre-eclampsia (15.7% VS. 21.0%), low genital tract infection (15.7% VS.25.8%), and no effect (13.1% VS 4.8%). On the oral and systemic effects of periodontal disease in pregnancy, the overall level of knowledge of healthcare professionals in 2025 is better than that in 2019 (P \u0026lt; 0.05).\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab5\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 3\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eCommon Periodontal Disease Symptoms and Adverse Effects in Pregnant Women\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003edentists/obstetricians/gynecologists’\u003c/p\u003e\n \u003cp\u003eperiodontal knowledge\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003cp\u003e(N = 153)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2025\u003c/p\u003e\n \u003cp\u003e(N = 124)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOral symptoms often described in pregnant women\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.072\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGingival bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003cp\u003e(94.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e118\u003c/p\u003e\n \u003cp\u003e(95.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSwollen gums\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003cp\u003e(81.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e105\u003c/p\u003e\n \u003cp\u003e(84.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTooth loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003cp\u003e(32.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003cp\u003e(35.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCaries\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003cp\u003e(31.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003cp\u003e(25.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGum tumor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003cp\u003e(33.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003cp\u003e(15.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGingival overgrowth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003cp\u003e(36.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003cp\u003e(40.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInfluence of periodontal diseases on pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.043\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePreterm birth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003cp\u003e(64.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003cp\u003e(80.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLow weight newborn\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003cp\u003e(48.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003cp\u003e(66.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpontaneous abortion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003cp\u003e(40.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003cp\u003e(58.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003egestational diabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003cp\u003e(33.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003cp\u003e(46.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePre-eclampsia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003cp\u003e(15.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003cp\u003e(21.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLow genital tract infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003cp\u003e(15.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003cp\u003e(25.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo influence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003cp\u003e(13.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003cp\u003e(4.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eWe also did a total population statistical analysis about common periodontal disease symptoms and adverse effects in pregnant women of dentists or obstetricians/gynecologists.\u003c/p\u003e\n\u003cp\u003eFor dentists, oral symptoms often described in pregnant women showed no significant difference between the data in 2019 and 2025 (P \u0026gt; 0.05) (Table\u0026nbsp;7). In dentists, the awareness of influence of periodontal diseases on pregnancy improved in 2025 compared to that in 2019, although without statistical significance (P \u0026gt; 0.05) (Table\u0026nbsp;7).\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab6\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 7\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eAwareness of Common Periodontal Disease Symptoms and Adverse Effects in Pregnant Women of Dentists\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDentists\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2019 (N = 101)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2025 (N = 74)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOral symptoms often described in pregnant women\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.058\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGingival bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e94\u003c/p\u003e\n \u003cp\u003e(93.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003cp\u003e(93.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eswollen gums\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003cp\u003e(83.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003cp\u003e(93.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTooth loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003cp\u003e(36.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003cp\u003e(36.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCaries\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003cp\u003e(31.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003cp\u003e(23.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003egum tumor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003cp\u003e(39.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003cp\u003e(13.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGingival overgrowth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003cp\u003e(39.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003cp\u003e(45.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInfluence of periodontal diseases on pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.303\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePreterm birth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003cp\u003e(74.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003cp\u003e(89.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLow weight newborn\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003cp\u003e(55.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003cp\u003e(86.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpontaneous abortion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003cp\u003e(43.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003cp\u003e(59.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003egestational diabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003cp\u003e(46.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003cp\u003e(52.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePre-eclampsia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003cp\u003e(20.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003cp\u003e(27%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLow genital tract infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003cp\u003e(22.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003cp\u003e(59.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo influence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e(7.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0.00%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eFor obstetricians/gynecologists, oral symptoms often described in pregnant women showed no significant difference between the data in 2019 and 2025 (P \u0026gt; 0.05) (Table\u0026nbsp;8). In obstetricians/gynecologists, the awareness of influence of periodontal diseases on pregnancy improved significantly in 2025 compared to that in 2019 (P \u0026lt; 0.05) (Table\u0026nbsp;8).\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab7\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 8\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eAwareness of Common Periodontal Disease Symptoms and Adverse Effects in Pregnant Women of Obstetricians/gynecologists\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eObstetricians/gynecologists\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2019 (N = 52)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2025 (N = 50)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOral symptoms often described in pregnant women\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.066\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGingival bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003cp\u003e(98.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003cp\u003e(98.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eswollen gums\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003cp\u003e(78.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003cp\u003e(72.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTooth loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e(25.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003cp\u003e(34.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCaries\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003cp\u003e(30.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003cp\u003e(28.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003egum tumor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003cp\u003e(21.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003cp\u003e(18.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGingival overgrowth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003cp\u003e(30.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003cp\u003e(32.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInfluence of periodontal diseases on pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePreterm birth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003cp\u003e(46.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003cp\u003e(50.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLow weight newborn\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003cp\u003e(32.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003cp\u003e(52.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpontaneous abortion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e(25.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003cp\u003e(58.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003egestational diabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e(25.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003cp\u003e(20.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePre-eclampsia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003cp\u003e(11.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003cp\u003e(10.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLow genital tract infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003cp\u003e(9.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003cp\u003e(18.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo influence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e(25.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003cp\u003e(12.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eHealthcare workers’ attitude and behavior\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn terms of healthcare workers’ perceptions and attitudes, we found that of healthcare workers in 2025 significantly improved compared to that in 2019 referring to periodontal disease affects pregnancy, pre-pregnancy oral examination, oral examination during pregnancy, post-delivery oral examination, periodontal treatment effective for pregnant women and periodicity of periodontal treatment for pregnant women (P \u0026lt; 0.05) (Table\u0026nbsp;4).\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab8\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 4\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eHealthcare workers’ attitude and behavior\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2019 (N = 153)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2025 (N = 124)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePeriodontal disease affects pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e126 (82.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e118 (95.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27 (17.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6 (4.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePre-pregnancy oral examination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e131 (85.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e124 (100.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22 (14.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOral examination during pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e126 (82.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e118 (95.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27 (17.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6 (4.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePost-delivery oral examination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.041\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e132 (86.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e124 (100.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21 (13.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePeriodontal treatment effective for pregnant women\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.016\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e126 (82.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e122 (98.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27 (17.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2 (1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePeriodicity of periodontal treatment for pregnant women\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.032\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31 (20.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13 (10.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eearly pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19 (12.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7 (5.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emid-pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95 (62.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e101 (81.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003elate pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8 (5.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3 (2.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eWe also did a total population statistical analysis. The results showed that both dentists and obstetricians/gynecologists the perceptions and attitudes improved significantly in 2025 compared to that in 2019 (P \u0026lt; 0.05) (Table\u0026nbsp;9 and Table\u0026nbsp;10).\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab9\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 9\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eDentists’ attitude and behavior\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2019 (N = 101)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2025(N = 74)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePeriodontal disease affects pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.035\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e93 (92.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e74 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8 (7.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePre-pregnancy oral examination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.022\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e91 (90.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e74 (100.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10 (9.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOral examination during pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.018\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e92 (91.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e73 (98.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9 (8.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1 (1.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePost-delivery oral examination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e92 (91.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e74 (100.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9 (8.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePeriodontal treatment effective for pregnant women\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.027\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e93 (92.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e74 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8 (7.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePeriodicity of periodontal treatment for pregnant women\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.043\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16 (15.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5 (6.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eearly pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7 (6.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1 (1.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emid-pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e66 (65.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e67 (90.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003elate pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12 (12.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1 (1.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab10\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 10\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eObstetricians/gynecologists’ attitude and behavior\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2019 (N = 52)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e2025(N = 50)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePeriodontal disease affects pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33 (63.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44 (88%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19 (36.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6 (12%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePre-pregnancy oral examination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.032\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40 (76.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e74 (100.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12 (23.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOral examination during pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.018\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34 (65.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45 (90.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18 (34.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5 (10.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePost-delivery oral examination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.020\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40 (76.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50 (100.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12 (23.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePeriodontal treatment effective for pregnant women\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33 (63.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e74 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19 (36.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePeriodicity of periodontal treatment for pregnant women\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.043\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15 (28.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8 (16.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eearly pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12 (23.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6 (12.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emid-pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29 (55.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34 (68.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003elate pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6 (11.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2 (4.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003e\u003cb\u003eComparison with other studies\u003c/b\u003e\u003c/p\u003e\u003cp\u003eOver the years, studies have shown an association between periodontal disease and pregnancy complications.\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e Periodontitis may increase the risk of adverse pregnancy outcomes (APOs), including preterm labor, preeclampsia, gestational diabetes, low birth weight, and intrauterine growth retardation.\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e Several studies\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e][\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e have found that the prevalence of periodontal disease is high in pregnant women, with rates as high as 66.7% in some races. However, pregnant women have very limited knowledge about periodontal disease and its potential impact on pregnancy. Factors such as age, education, and marital status may have influenced this knowledge.\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e Although some women are aware of the relationship between periodontal disease and adverse pregnancy outcomes, only 47% have received an oral health diagnosis or appropriate treatment.\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e Inflammation plays a propulsive role in periodontal diseases. The intact gingival epithelium of the mouth is an innate physical barrier to systemic spread of oral bacteria. During disease progression, the ulcerated epithelium loses its integrity, and the connecting tissues and capillaries come into direct contact with the plaque biofilm.\u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e When a woman is pregnant, periodontal tissues and expression levels of inflammatory factors such as interleukin-1, tumor necrosis factor alpha, and prostaglandin E2 are significantly elevated in women, and these inflammatory factors play an important role in the normal course of labor and delivery.\u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e Perunovic et al.\u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e demonstrated that preterm women have poorer periodontal parameters and significantly elevated levels of prostaglandins and interleukin 6, both of which may be preterm labor and delivery Triggers. Chronic inflammation of the oral cavity is associated with various diseases. Perunovic et al.\u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e demonstrated that preterm women have poorer periodontal parameters and significantly elevated levels of prostaglandins and interleukin 6, both of which may be preterm labor and delivery Triggers.\u003c/p\u003e\u003cp\u003eThe results of a study in Serbia showed\u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e that slightly more than half of the doctors (53%) were aware of the main etiologic factors of periodontal disease, which is less compared to the results of our data. Regarding other studies\u003csup\u003e[\u003cspan additionalcitationids=\"CR20 CR21 CR22\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e, Paquette et al. showed\u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e that 95% of dentists in North Carolina were aware of the etiologic factors of periodontitis, which is similar to the results of our study. Furthermore, in our study, it was found that dentists were 89.2% aware of the impact of periodontal disease on preterm labor during pregnancy (in 2025), while only 46% of dentists\u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e in Servia were aware of the relationship between periodontal disease and preterm labor during pregnancy (in 2023).\u003c/p\u003e\u003cp\u003e\u003cb\u003eComparison in awareness of periodontal knowledge\u003c/b\u003e\u003c/p\u003e\u003cp\u003eIn our study, we performed a yearly comparison between 2019 and 2025 and a comparison of the overall level of periodontal knowledge among dentists and obstetricians/gynecologists.\u003c/p\u003e\u003cp\u003eIn the 2019 survey, regarding the prevalence of adult periodontal disease in China and the prevalence of periodontal disease in pregnant women, only 41.2% and 47.1% of medical staff could accurately know that it was at a relatively high level, and most medical staff had a vague understanding of the specific proportion of the disease. The survey findings in 2025 indicated that medical professionals\u0026rsquo; understanding regarding prevalence of periodontal diseases in China and in pregnant women had witnessed a remarkable enhancement (62.9% and 79.0%, Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). That means an increasing number of medical professionals were able to accurately recognize that pregnant women have a relatively high incidence of periodontal diseases. Concerning the prevalence of adult periodontal disease in China, the awareness rate significantly improved from 41.2% in 2019 to 62.9% in 2025.\u003c/p\u003e\u003cp\u003eAs for the impact of periodontal disease on fetal development, in 2019, 13.1% of medical staff were not aware that periodontal disease was associated with adverse pregnancy outcomes such as preterm birth and low birth weight (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e3\u003c/span\u003e). And the percentage significantly decreased from 13.1\u0026ndash;4.8% in 2025. The findings in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e3\u003c/span\u003e suggests that medical professionals have developed a more profound comprehension of the association between periodontal disease and adverse pregnancy outcomes.\u003c/p\u003e\u003cp\u003eThe overall level of periodontal knowledge was better in dentists compared to that in obstetricians/gynecologists in both 2019 and 2025. Nevertheless, it is gratifying to recognize that, the cognitive disparities among medical staff from different departments have been gradually reducing. Medical staff in the field of obstetrics and gynecology have achieved notable advancements in their expertise regarding periodontal diseases. Their awareness rate of knowledge related to the diagnosis and treatment of periodontal diseases has shown a marked increase compared to that in 2019 (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e6\u003c/span\u003e). And the awareness of periodontal adverse effects in pregnant women of obstetricians/gynecologists also improved significantly in 2025 compared to that in 2019 (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e8\u003c/span\u003e). Likewise, dental medical professionals have also strengthened their understanding of the prevalence of periodontal disease in China and periodontal adverse effects in pregnant women although without statistical significance (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e5\u003c/span\u003e and Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cb\u003eComparison in healthcare workers\u0026rsquo; attitude and behavior\u003c/b\u003e\u003c/p\u003e\u003cp\u003eIt was found that the overall level of periodontal knowledge was better and have good clinical behavior among dentists compared to obstetricians and gynecologists (Tables\u0026nbsp;\u003cspan refid=\"Tab9\" class=\"InternalRef\"\u003e9\u003c/span\u003e and \u003cspan refid=\"Tab10\" class=\"InternalRef\"\u003e10\u003c/span\u003e). This emphasize the need for healthcare professionals to treat the body as a whole and to recognize that interdisciplinary referrals and deeper continuing education are necessary. There is a significant influence between knowledge and attitudes and practice, and inadequate knowledge may hinder the translation of positive attitudes into effective clinical practice.\u003c/p\u003e\u003cp\u003e\u003cb\u003eThe representativeness of Mentougou District\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAs the sole national demonstration zone for ecological civilization construction in Beijing, Mentougou District is celebrated for its mountainous area accounting for 98.5% of the total. It can serve as a representative of the extensive mountainous regions in Beijing and other large Chinese cities. In Mentougou District, there are 178 administrative villages in total. The distribution of medical resources in Mentougou District is characterized by \u0026lsquo;core agglomeration and comprehensive coverage\u0026rsquo;. In particular, medical personnel in the fields of stomatology, obstetrics, and gynecology are mainly concentrated in several hospitals included in this study.\u003c/p\u003e\u003cp\u003eThe rate of knowledge renewal, the extent of training coverage and the dissemination of equipment and technology among medical personnel in suburban areas especially in mountainous regions typically lag behind those in urban areas. Furthermore, in contrast to urban areas, the collaborative relationships between the departments of obstetrics and gynecology and dentistry in suburban medical institutions tend to be more fragmented. These can partly explain the results in 2019 of this study.\u003c/p\u003e\u003cp\u003eThe causes of the improvement in the awareness, attitudes, and practices of medical professionals in Mentougou District from 2019 to 2025 are multifaceted. Between 2019 and 2025, medical institutions and relevant authorities gradually recognized the deficiencies in medical staff's knowledge and skills related to periodontal diseases in pregnant women. Consequently, the intensity of training initiatives has been increased. There has been a growing public concern about periodontal diseases in pregnant women, accompanied by a proliferation of related awareness campaigns. These initiatives not only heightened the self - care awareness of pregnant women but also made medical professionals more acutely aware of their roles and responsibilities in the prevention and management of periodontal diseases in pregnant women. This, in turn, has motivated them to proactively acquire relevant knowledge and enhance their service capabilities. The government and health departments have introduced a series of policies to advance the prevention and treatment of periodontal diseases in pregnant women. By integrating oral health care for pregnant women into the public health service framework and increasing financial investment, these policies have provided both policy support and financial resources for medical institutions to conduct related work. In the context of preventing and treating periodontal diseases in pregnant women, the collaboration between the departments of obstetrics and gynecology and dentistry has been increasingly strengthened. This integrated approach has not only improved the therapeutic outcomes for pregnant women with periodontal diseases but has also facilitated knowledge exchange and sharing among medical professionals. As a result, obstetricians and gynecologists have gained a more in - depth understanding of periodontal disease knowledge, while dental professionals have developed a more comprehensive appreciation of the physiological characteristics and pregnancy - associated risks of pregnant women.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate: The study protocol was approved by the Ethical Committee of Peking University School and Hospital of Stomatology (PKUSSIRB-201949139 and PKUSSIRB-202532004).\u003c/p\u003e\n\u003cp\u003eClinical trial number: Not applicable\u003c/p\u003e\n\u003cp\u003eAuthor contribution:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eJ.Q: conceived and designed the study; analyzed and interpreted the data; wrote the main manuscript.\u003c/p\u003e\n\u003cp\u003eA.B. and C.D. wrote the main manuscript text and E.F. prepared figures 1-3. All authors reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003eYixin Wu: contributed to study design; collected and processed the data; wrote the main manuscript.\u003c/p\u003e\n\u003cp\u003eLiyun Sun: collected survey data; verified data accuracy.\u003c/p\u003e\n\u003cp\u003eFei Li: Assisted in data analysis and interpretation; contributed to the discussion section.\u003c/p\u003e\n\u003cp\u003eXiaoli Wu: conducted the questionnaire survey; collected survey data; wrote a part of the manuscript.\u003c/p\u003e\n\u003cp\u003eFunding:\u0026nbsp;This work was supported by Peking University Clinical Medicine + X Youth Special Program. Fund Number: PKU2025PKULCXQ007 and Beijing Natural Science Foundation - Haidian Original Innovation Joint Fund. No. L252167.\u003c/p\u003e\n\u003cp\u003eConsent to publish: Not applicable\u003c/p\u003e\n\u003cp\u003eConflict of interest:\u0026nbsp;The authors report no conflicts of interest related to this study.\u003c/p\u003e\n\u003cp\u003eData availability: supplemented in the submitting process.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSaadaoui M, Singh P, Al Khodor S. Oral microbiome and pregnancy: A bidirectional relationship. \u003cem\u003eJ Reprod Immunol\u003c/em\u003e. 2021; 145:103293.\u003c/li\u003e\n\u003cli\u003eFischer RG, Gomes Filho IS, Cruz SSD, et al. What is the future of Periodontal Medicine? \u003cem\u003eBraz Oral Res\u003c/em\u003e. 2021;35(Supp 2): e102. Published 2021 Sep 24. \u003c/li\u003e\n\u003cli\u003eNazir, M.; Al-Ansari, A.; Al-Khalifa, K.; Alhareky, M.; Gaffar, B.; Almas, K. Global Prevalence of Periodontal Disease and Lack of Its Surveillance. \u003cem\u003eSci. World J.\u003c/em\u003e\u003cstrong\u003e2020\u003c/strong\u003e, \u003cem\u003e2020\u003c/em\u003e, 2146160.\u003c/li\u003e\n\u003cli\u003eSalih, Y.; Nasr, A.M.; Ahmed, A.B.A.; Sharif, M.E.; Adam, I. Prevalence of and Risk Factors for Periodontal Disease among Pregnant Women in an Antenatal Care Clinic in Khartoum, Sudan. \u003cem\u003eBMC Res. Notes\u003c/em\u003e\u003cstrong\u003e2020\u003c/strong\u003e, \u003cem\u003e13\u003c/em\u003e, 147.\u003c/li\u003e\n\u003cli\u003eVarshney, S., and Gautam, A. (2014). Poor periodontal health as a risk factor for development of pre-eclampsia in pregnant women. \u003cem\u003eJ. Indian Soc. Periodontol.\u003c/em\u003e 18, 321\u0026ndash;325. \u003c/li\u003e\n\u003cli\u003eBostanci N. Periodontal health and pregnancy outcomes: Time to deliver. \u003cem\u003eActa Obstet Gynecol Scand\u003c/em\u003e. 2023;102(6):648-651. doi:10.1111/aogs.14548\u003c/li\u003e\n\u003cli\u003eAlSharief M, Alabdurubalnabi E. Periodontal Pathogens and Adverse Pregnancy Outcomes: A Narrative Review. \u003cem\u003eLife (Basel)\u003c/em\u003e. 2023;13(7):1559. Published 2023 Jul 13. \u003c/li\u003e\n\u003cli\u003eAndonova, I.; Iliev, V.; Živković, N.; Su\u0026scaron;ič, E.; Bego, I.; Kotevska, V. Can Oral Anaerobic Bacteria Cause Adverse Pregnancy Outcomes? \u003cem\u003ePril. (Makedon. Akad. Nauk. Umetnostite. Oddel. Med. Nauk.)\u003c/em\u003e\u003cstrong\u003e2015\u003c/strong\u003e, \u003cem\u003e36\u003c/em\u003e, 137\u0026ndash;143.\u003c/li\u003e\n\u003cli\u003eOffenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G, et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol. 1996;67:1103\u0026ndash;1113.\u003c/li\u003e\n\u003cli\u003eThomas C, Timofeeva I, Bouchoucha E, et al. Oral and periodontal assessment at the first trimester of pregnancy: The PERISCOPE longitudinal study. \u003cem\u003eActa Obstet Gynecol Scand\u003c/em\u003e. 2023;102(6):669-680.\u003c/li\u003e\n\u003cli\u003eXie, Y.; Xiong, X.; Elkind-Hirsch, K.E.; Pridjian, G.; Maney, P.; Delarosa, R.L.; Buekens, P. Change of periodontal disease status during and after pregnancy. \u003cem\u003eJ. Periodontol.\u003c/em\u003e\u003cstrong\u003e2013\u003c/strong\u003e, \u003cem\u003e84\u003c/em\u003e, 725\u0026ndash;731.\u003c/li\u003e\n\u003cli\u003eRaju, K.; Berens, L. Periodontology and pregnancy: An overview of biomedical and epidemiological evidence. \u003cem\u003ePeriodontol. 2000\u003c/em\u003e\u003cstrong\u003e2021\u003c/strong\u003e, \u003cem\u003e87\u003c/em\u003e, 132\u0026ndash;142.\u003c/li\u003e\n\u003cli\u003eTarannum, F.; Prasad, R.K.; Shobha, R.; Kumar, B.B.; Ebenezer, S. Awareness of the association between periodontal disease and adverse pregnancy outcome among the general female population. \u003cem\u003eIndian J. Dent. Res.\u003c/em\u003e\u003cstrong\u003e2015\u003c/strong\u003e, \u003cem\u003e26\u003c/em\u003e, 21\u0026ndash;25.\u003c/li\u003e\n\u003cli\u003ePetit, C.; Benezech, J.; Davideau, J.L.; Hamann, V.; Tuzin, N.; Huck, O. Consideration of Oral Health and Periodontal Diseases During Pregnancy: Knowledge and Behaviour Among French Pregnant Women. \u003cem\u003eOral Health Prev. Dent.\u003c/em\u003e\u003cstrong\u003e2021\u003c/strong\u003e, \u003cem\u003e19\u003c/em\u003e, 33\u0026ndash;42.\u003c/li\u003e\n\u003cli\u003eJain P, Hassan N, Khatoon K, et al. Periodontitis and Systemic Disorder-An Overview of Relation and Novel Treatment Modalities. \u003cem\u003ePharmaceutics\u003c/em\u003e. 2021;13(8):1175. Published 2021 Jul 30.\u003c/li\u003e\n\u003cli\u003eHu W, Wang Y, Chen R, Pan T. Oral Health Status and Literacy/Knowledge Amongst Pregnant Women in Shanghai. \u003cem\u003eInt Dent J\u003c/em\u003e. 2023;73(2):212-218. \u003c/li\u003e\n\u003cli\u003ePerunovic, N. D., Rakic, M. M., Nikolic, L. I., Jankovic, S. M., Aleksic, Z. M., Plecas, D. V., et al. (2016). The association between periodontal inflammation and labor triggers (elevated cytokine levels) in preterm birth: a cross-sectional study. \u003cem\u003eJ. Periodontol.\u003c/em\u003e 87, 248\u0026ndash;256.\u003c/li\u003e\n\u003cli\u003eStojilković M, Gu\u0026scaron;ić I, Prodanović D, et al. Awareness of physicians and dentists in Serbia about the association between periodontitis and systemic diseases: a cross-sectional study. \u003cem\u003eBMC Oral Health\u003c/em\u003e. 2023;23(1):449. Published 2023 Jul 5. \u003c/li\u003e\n\u003cli\u003ePaquette DW, Bell KP, Phillips C, Offenbacher S, Wilder RS. Dentists\u0026rsquo; knowledge and opinions of oral-systemic disease relationships: relevance to patient care and education. J Dent Educ. 2015;79(6):626\u0026ndash;35.\u003c/li\u003e\n\u003cli\u003eBechina C, Bonvillain G, Rethore G, et al. Knowledge and Practice Behaviours of Obstetricians/Gynecologists and Midwives Concerning Periodontal Health and Pregnancy. \u003cem\u003eOral Health Prev Dent\u003c/em\u003e. 2023;21:383-390.\u003c/li\u003e\n\u003cli\u003eCohen L, Schaeffer M, Davideau JL, Tenenbaum H, Huck O. Obstetric knowledge, attitude, and behavior concerning periodontal diseases and treatment needs in pregnancy: influencing factors in France. J Periodontol. 2015;86:398\u0026ndash;405.\u003c/li\u003e\n\u003cli\u003eTarannum F, Prasad S, Vivekananda L, Jayanthi D, Faizuddin M. Awareness of the association between periodontal disease and pre-term births among general dentists, general medical practitioners and gynecologists. Indian J Public Health. 2013;57:92\u0026ndash;5.\u003c/li\u003e\n\u003cli\u003eSatyanarayana K, Durga Bai Y, Aruna P, Sindhura N, Monisha G, Sreenivasulu G. Awareness on the Association between Periodontal Diseases and Pregnancy Outcomesm Among Gynecologists: a cross-sectional study. J Int Oral Health. 2016;8:579\u0026ndash;84. \u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Table 1","content":"\u003cp\u003eTable 1 is available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Periodontal diseases, pregnant woman, adverse pregnancy outcomes, preterm birth, knowledge, attitudes and behaviors","lastPublishedDoi":"10.21203/rs.3.rs-7217085/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7217085/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003ePeriodontal infection not only affects the local oral cavity but also has a significant impact on the overall health of pregnant women and their fetuses. Obstetricians are the health care providers for pregnant women throughout their pregnancy. This study aimed to assess the changes of attitudes, and clinical behaviors of dentists, obstetricians, and gynecologists regarding periodontal disease in pregnant women in Mentougou district, a suburb of Beijing, China, from 2019 to 2025.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eThis cross-sectional study included Mentougou dentists/obstetricians/gynecologists healthcare professionals in 2019 and 2025, and the questions in the questionnaire were statistically processed using SPSS software.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eIn 2019 and 2025, 153 and 124 questionnaires were distributed. Our study found that participants (97.4% vs. 93.5%) were aware of the inflammatory and infectious nature of periodontal disease. Regarding the prevalence of periodontitis in China and in pregnant women, the awareness among doctors in 2025 has increased significantly compared to 2019 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). In addition, the overall level of periodontal disease knowledge in relation to adverse pregnancy effects was elevated compared with the previous, preterm labor (64.1% VS. 80.6%), very low birth weight (48.4% VS. 66.1%), spontaneous abortion (40.5% VS. 58.9%), gestational diabetes mellitus (33.3% VS. 46.0%), preeclampsia (15.7% VS. 21.0%), reproductive tract infections (15.7% VS.25.8%), and no effect (13.1% VS. 4.8%). Regarding the attitudes and behaviors of healthcare workers, oral examination pre-, during and post-pregnancy improved significantly in 2025 compared to 2019 (85.6% VS. 100%, 82.4 VS. 95.2%, and 86.3% VS. 100%, respectively, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eOur study suggests that, from 2019 to 2025, the knowledge and attitudes about the relationship between periodontal disease and pregnancy outcomes of dentists/obstetricians/gynecologists in suburban hospitals in Beijing have improved significantly.\u003c/p\u003e","manuscriptTitle":"The changes in the knowledge, attitudes and behaviors of obstetrics and gynecology and dentistry staff in a suburb of Beijing regarding periodontal disease in pregnant women (2019 - 2025)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-24 08:29:47","doi":"10.21203/rs.3.rs-7217085/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c433c73b-6853-49df-8e16-4c828274ab1e","owner":[],"postedDate":"November 24th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":58442118,"name":"Health sciences/Diseases"},{"id":58442119,"name":"Health sciences/Health care"},{"id":58442120,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2026-03-03T06:41:09+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-24 08:29:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7217085","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7217085","identity":"rs-7217085","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}
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