Purpose <p>To assess whether caries-preventive clinical interventions targeted exclusively to expectant mothers reduce caries experience or various surrogate parameters associated with caries activity in their children.</p> Method <p>Seven databases were searched for randomised clinical trials until November 2024. Studies assessing clinical caries-preventive measures in healthy expectant mothers and comparing them to placebo, other, or no interventions. Outcomes measured in children included caries experience and surrogate parameters (e.g., <i>S. mutans</i> levels), patient-reported, and socioeconomic data. Non-randomized studies as well as, behavioural and educational interventions were excluded. Risk of bias was assessed using the Cochrane Collaboration’s RoB 2 tool.</p> Results <p>Out of the 2149 studies identified, only 5 studies were included. Two of them presented with low risk of bias, whereas there were some concerns for the other three. The assessed outcomes included either caries experience directly (percentage of caries active children, DMFT, DMFS, dmft, dmfs) or the <i>Streptococcus mutans</i> levels. Children in the experimental groups showed significantly lower <i>S. mutans</i> levels compared to controls. Regarding caries levels, the results were contradictory. The supplementation of calcium in expectant mothers resulted in caries reductions in their offsprings, while sodium fluoride with potassium iodine topical applications or vitamin D supplementation were not shown to be effective.</p> Conclusion <p>Clinical caries-preventive interventions applied to expectant mothers might result in reduced <i>S. mutans</i> levels in their children. Further studies are warranted to provide additional evidence, especially with regards to caries experience.</p> Registration <p>Research Registry:&#xa0;reviewregistry1047.</p>