Evaluation of an oral health promotion program at the time of birth on dental caries in 5-year-old children in Vorarlberg, Austria

Abstract

Objectives: The aim of this study was to evaluate the effect of an early oral health promotion program (OHPP) on oral health of 5-year-old children in Austria by providing new mothers with dental health counseling.

Methods: Qualified dental health educators visited all mothers at time after birth in regional hospitals in Vorarlberg and counseled them regarding the oral health of their children as a one-off intervention. Mothers were given comprehensive oral hygiene instructions for their children and themselves (daily use of fluoride toothpaste, restoration of own caries lesions), which included practical tooth brush training and dietary counseling by the use of brief motivational interviewing and anticipatory guidance approaches. After 5 years, a case-cohort study was conducted to evaluate the program with annual dental check-ups of 471 children and a parent survey. Dental caries was scored using WHO diagnostic criteria at dentine level without radiography. To compare oral health parameters (dmfs/dmft, care index), children were allocated to intervention and control group and matched on basis of age, sex, ethnicity, and socio-economic status (SES) and analyzed statistically.

Results: Children whose mothers participated in the OHPP showed significantly lower caries prevalence and experience (33.2%; 3.2 ± 7.4 d3-4 mfs/1.5 ± 2.5 d3-4 mft) than children whose mothers did not participate (42.6%; 5.2 ± 6.4 d3-4 mfs/2.4 ± 4.1 d3-4 mft). Bivariate analysis showed that ethnicity, SES, age at which toothbrushing started, supervision of toothbrushing, use of fluoride salt, and use of fluoride toothpaste were significantly related to d3-4 mft.

Conclusions: The OHPP was an effective community-based preventive approach for improving oral health in preschool children.

Keywords: caries; children; dental health promotion; oral health; program evaluation; public health.