Background There is evidence to show that immigrants have poorer oral health status than their local counterparts, and low-skilled migrant workers may also be more prone to poor oral health. This study aims to evaluate the oral health status and oral health behaviors of pregnant migrant workers compared to those of local pregnant women. Methods A hospital-based cross-sectional study was conducted in a public general hospital in Bangkok. Pregnant migrant workers who attended the antenatal clinic were randomly enrolled at their first antenatal booking; local pregnant women were also randomly included to form a comparison group. Oral health status of all eligible pregnant women was evaluated according to the World Health Organization (WHO) protocol, and their oral health behaviors were assessed using a structured questionnaire. Oral health status and behaviors of the two pregnant groups were compared using Chi-Square test, Student’s t test, Mann–Whitney U test, Fisher’s exact test and multiple logistic regression analysis. Results A total of 208 pregnant migrant workers and 210 local pregnant women were included. Pregnant migrant workers had significantly more dental disease than local pregnant women (DMFT mean (SD) = 5.8 (4.4) vs 4.8 (4.0), p = 0.014) with significant more dental decay (D mean (SD) = 5.5 (3.6) vs 3.8 (2.9), p < 0.001; adjusted OR 3.56 (95%CI 1.74–7.27)). Pregnant migrant workers suffered greater periodontal disease with mean (SD) CPI of 2.9 (0.6) vs 2.2 (0.5), p < 0.001. CPI = 3 or 4 occurred in 74.5% of migrants compared to only 22.4% of local pregnant women (adjusted OR 6.39: 95%CI 3.53–11.58). A significant greater percentage of pregnant migrants had a CPI of 4 (11.1% vs 0.5%). Pregnant migrant workers tended not to use fluoride toothpaste or dental floss and despite having 76.0% healthcare coverage, they made significantly fewer dental visits compared to local women; furthermore, the majority of them (74.5%) were under the misconception that dental treatment was prohibited during pregnancy. Conclusion Pregnant migrant workers experienced more dental caries and periodontal disease, had less access to oral health facilities, had less knowledge of healthy oral hygiene, and had poorer oral health practices than local pregnant women. Comprehensive oral health screening and treatment during antenatal visits, together with appropriate systematic antenatal health education, could play a crucial role in improving their oral health.

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