Pregnancy brings hormonal and behavioural changes that heighten vulnerability to gingival inflammation and dental caries, yet preventive oral care is frequently overlooked during antenatal care. This narrative review synthesises recent literature (2023–2026, supplemented by one earlier India-focused review) on pregnant women’s awareness of oral health, their preventive practices, and the effectiveness of interventions designed to improve both. A scoping review of 67 studies and recent surveys from Saudi Arabia and northern India show that knowledge is often limited, especially regarding the link between oral health and pregnancy outcomes and the safety and timing of dental treatment. Once-daily brushing and problem-driven dental visits predominate, and education and income consistently predict better behaviour. Prenatal care providers generally acknowledge the importance of oral health but seldom translate this into clinical action. Educational and primary-care interventions improve knowledge, behaviours, and some clinical indicators, although evidence of effects on birth outcomes remains inconclusive and many studies carry a high risk of bias. Cost, fear, misconceptions, and weak collaboration between obstetric and dental services are the main barriers. Integrating oral health screening and tailored, theory-based counselling into routine antenatal visits is recommended.