Early maternal exposure to children's oral health may be correlated with lower early childhood caries prevalence in their children

Abstract

Subjects: In 2002, women (n = 649) expecting their first child were enrolled in a study to prevent severe early childhood caries (S-ECC). Women were randomized into an intervention group (n = 327) and a control group (n = 322), and both groups were followed for 20 months. Results from this early follow-up period have been published elsewhere.(1) In 2008, 625 of the women were approached for long-term follow-up (n = 312 from the initial intervention group and 313 from the initial control group). An additional 641 women with children born in 2002 were approached to serve as a comparative cohort. After enrollment, there were 141 women in the intervention group, 136 in the control group, and 277 in the external comparison group. In 2010, there were 96 remaining in the intervention group, 91 in the control group, and 262 in the external comparison group. In 2009, the study group completed a "Child Oral Health Survey" questionnaire, and in 2010, dental records of South Australian School of Dental Services were retrieved. Nearly 80% of parents have their children enrolled in the School Dental Services program.

Key risk/study factor: The key study factor was evaluating the impact of oral health education for new mothers on the prevalence of early childhood caries (ECC) in their children. Intervention was based on a series of oral promotion activities and was designed to encourage mothers to take a proactive approach to their children's oral health.

Main outcome measure: Decayed, missing, or filled tooth surfaces or teeth (dmfs or dmft) in the primary dentition.

Main results: At age 6 to 7 years, children participating in the trial were less likely to have dental caries compared with children in the external comparison group (33% vs 42%). All measures of caries severity were lower in the intervention group compared with the control group, but the differences were not statistically significant. Twenty-nine percent of mothers from the comparison group reported that their children suffered from toothache versus 11% in the intervention group (P <.001) and 17% in the control group (P <.001). For the caries severity index SiC30, the difference between the intervention group and the external comparison group was significant (P > .001). None of the logistic regression models showed a significant association between the intervention group and either of the 2 types of control groups.

Conclusions: Exploring methods of engaging all new mothers in preventive strategies may help to stem early childhood caries and its ill effects on children, families, and society. Providing adequate information and guidance is good practice and is relatively inexpensive. Effective ECC Prevention strategies would provide disease management benefits that are cost-effective and can be sustainable for several years.