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As the primary point of contact for healthcare providers, gynecologists can play a crucial role in promoting oral healthcare during pregnancy. This study aimed to assess the perspectives and adherence to oral healthcare promotion among Iranian gynecologists for pregnant women. This cross-sectional study was conducted in 2022 on a random sample of gynecologists working in both private and public settings in Tehran, Iran. The addresses and telephone numbers of participants’ workplaces, including offices, hospitals, and clinics, were obtained from the Association of Obstetricians and Gynecologists. Tehran University of Medical Sciences granted ethics approval. A hundred and forty-six gynecologists received a researcher-designed questionnaire consisting of seven main sections: oral health care knowledge, attitude, performance, and oral self-care of gynecologists, backgrounds, patients' self-reported oral health, and oral self-care and oral health training resources for gynecologists. Data were analyzed using linear regression in SPSS version 26. The significance level was P < 0.05. The average overall knowledge score for participants was 9.5 ± 3.1 (out of 17), and the average performance score was 3.2 ± 1.7 (out of 11). The average was 23.2 ± 6.2 (out of 32 points) for attitude and 7.6 ± 2.1 (out of 12 points) for oral self-care in gynecologists. The knowledge (P < 0.001) and attitude (P = 0.01) of gynecologists were significantly and directly related to the number of patients per day. Likewise, their oral self-care was significantly and directly related to their age (P < 0.001). Participants' performance in oral health care for pregnant women was not significantly associated with any of the background factors. The adherence of Iranian gynecologists to the oral health of pregnant women was insufficient and in need of improvement. The results revealed that increased engagement with oral health problems among participants improved their perspectives and led them to feel the need for more education among the general public. It is highly recommended that oral health care topics be reinforced in medical curricula and continuing education programs to facilitate a multidisciplinary approach to oral health promotion for pregnant women.