Skip to main content
Top
Published in: BMC Oral Health 1/2019

Open Access 01-12-2019 | Caries | Research article

Effectiveness of preventive dental programs offered to mothers by non-dental professionals to control early childhood dental caries: a review

Authors: Ajesh George, Mariana S. Sousa, Ariana C. Kong, Anthony Blinkhorn, Tiffany Patterson Norrie, Jann Foster, Hannah G. Dahlen, Shilpi Ajwani, Maree Johnson

Published in: BMC Oral Health | Issue 1/2019

Login to get access

Abstract

Background

Early childhood caries is a common chronic childhood disease and maternal oral health is a risk factor. Improving the oral health behaviours of pregnant women/young mothers can positively influence the oral health of children and reduce their caries risk. Such preventative strategies have been undertaken by non-dental professionals producing mixed results encompassing various interventions across the perinatal period. However, no comprehensive review of these studies has been undertaken. The aim of this review was to assess the effectiveness of maternal oral health programs undertaken during the antenatal and/or postnatal period by non-dental health professionals to reduce early childhood caries.

Methods

A systematic search of five databases was undertaken using key search terms. Studies were included if they (a) involved quantitative study designs with a control; (b) were published in English; (c) reported on interventions delivered by non-dental professionals (d) delivered the intervention to expectant mothers or mothers with young infants up to 24 months; (e) measured outcomes when the child was under 5 years; (f) measured changes in oral health outcomes of children clinically and oral health behaviours of mothers or children. No restrictions were placed on the study quality and setting.

Results

Nine studies met the inclusion criteria and involved interventions delivered by diverse non-dental professionals across the antenatal (n = 1), postnatal (n = 6) and perinatal period (n = 2). Most studies were of low methodological quality (n = 6). The interventions focussed on oral health education (n = 8), dental referrals (n = 3) and oral health assessments (n = 1). Interventions conducted in either the postnatal or antenatal periods showed meaningful improvements in children’s clinical and mother’s behavioural oral health outcomes. The outcomes appear to be sustained when a suite of interventions were used along with referral reminders. There were mixed results from interventions across the perinatal period.

Conclusions

Non-dental professionals can promote maternal oral health by providing oral health education, risk assessment and referrals. Combining these interventions could provide a sustained improvement in oral health outcomes for children although current evidence is weak. More high-quality studies are needed to confirm these findings and determine whether the antenatal and/or postnatal period is best suited to deliver these interventions.
Appendix
Available only for authorised users
Literature
1.
go back to reference Kagihara LE, Niederhauser VP, Stark M. Assessment, management, and prevention of early childhood caries. J Am Assoc Nurse Pract. 2009;21(1):1–10.CrossRef Kagihara LE, Niederhauser VP, Stark M. Assessment, management, and prevention of early childhood caries. J Am Assoc Nurse Pract. 2009;21(1):1–10.CrossRef
2.
go back to reference Li Y, Zhang Y, Yang R, Zhang Q, Zou J, Kang D. Associations of social and behavioural factors with early childhood caries in Xiamen city in China. Int J Pediatr Dent. 2011;21(2):103–11.CrossRef Li Y, Zhang Y, Yang R, Zhang Q, Zou J, Kang D. Associations of social and behavioural factors with early childhood caries in Xiamen city in China. Int J Pediatr Dent. 2011;21(2):103–11.CrossRef
3.
go back to reference Veale M, Ajwani S, Johnson M, Nash L, Patterson T, George A. The early childhood oral health program: a qualitative study of the perceptions of child and family health nurses in South Western Sydney, Australia. BMC Oral Health. 2016;16(1):56.CrossRef Veale M, Ajwani S, Johnson M, Nash L, Patterson T, George A. The early childhood oral health program: a qualitative study of the perceptions of child and family health nurses in South Western Sydney, Australia. BMC Oral Health. 2016;16(1):56.CrossRef
4.
go back to reference Çolak H, Dülgergil ÇT, Dalli M, Hamidi MM. Early childhood caries update: a review of causes, diagnoses, and treatments. J Nat Sci Biol Med. 2013;4(1):29–38.CrossRef Çolak H, Dülgergil ÇT, Dalli M, Hamidi MM. Early childhood caries update: a review of causes, diagnoses, and treatments. J Nat Sci Biol Med. 2013;4(1):29–38.CrossRef
5.
go back to reference Kumarihamy SL, Subasinghe LD, Jayasekara P, Kularatna SM, Palipana PD. The prevalence of early childhood caries in 1-2 yrs olds in a semi-urban area of Sri Lanka. BMC Res Notes. 2011;4(1):336.CrossRef Kumarihamy SL, Subasinghe LD, Jayasekara P, Kularatna SM, Palipana PD. The prevalence of early childhood caries in 1-2 yrs olds in a semi-urban area of Sri Lanka. BMC Res Notes. 2011;4(1):336.CrossRef
6.
go back to reference Prowse S, Schroth RJ, Wilson A, Edwards JM, Sarson J, Levi JA, et al. Diversity considerations for promoting early childhood oral health: a pilot study. Int J Dent. 2014;2014:1–10.CrossRef Prowse S, Schroth RJ, Wilson A, Edwards JM, Sarson J, Levi JA, et al. Diversity considerations for promoting early childhood oral health: a pilot study. Int J Dent. 2014;2014:1–10.CrossRef
7.
go back to reference Australian Institute of Health and Welfare. Oral health and dental care in Australia: key facts and figures trends 2015. Cat. No. DEN 229. Canberra: AIHW; 2016. Australian Institute of Health and Welfare. Oral health and dental care in Australia: key facts and figures trends 2015. Cat. No. DEN 229. Canberra: AIHW; 2016.
8.
go back to reference Smith L, Blinkhorn A, Moir R, Brown N, Blinkhorn F. An assessment of dental caries among young aboriginal children in New South Wales, Australia: a cross-sectional study. BMC Public Health. 2015;15(1):1314.CrossRef Smith L, Blinkhorn A, Moir R, Brown N, Blinkhorn F. An assessment of dental caries among young aboriginal children in New South Wales, Australia: a cross-sectional study. BMC Public Health. 2015;15(1):1314.CrossRef
9.
go back to reference Filstrup SL, Briskie D, Da Fonseca M, Lawrence L, Wandera A, Inglehart M. Early childhood caries and quality of life: child and parent perspectives. Pediatr Dent. 2003;25(5):431–40.PubMed Filstrup SL, Briskie D, Da Fonseca M, Lawrence L, Wandera A, Inglehart M. Early childhood caries and quality of life: child and parent perspectives. Pediatr Dent. 2003;25(5):431–40.PubMed
10.
go back to reference Krisdapong S, Somkotra T, Kueakulpipat W. Disparities in early childhood caries and its impact on oral health-related quality of life of preschool children. Asia Pac J Public Health. 2014;26(3):285–94.CrossRef Krisdapong S, Somkotra T, Kueakulpipat W. Disparities in early childhood caries and its impact on oral health-related quality of life of preschool children. Asia Pac J Public Health. 2014;26(3):285–94.CrossRef
11.
go back to reference Gazal G, Mackie I. Distress related to dental extraction for children under general anaesthesia and their parents. Eur J Paediatr Dent. 2007;8(1):7–12.PubMed Gazal G, Mackie I. Distress related to dental extraction for children under general anaesthesia and their parents. Eur J Paediatr Dent. 2007;8(1):7–12.PubMed
12.
go back to reference Schroth RJ, Quinonez C, Shwart L, Wagar B. Treating early childhood caries under general anesthesia: a national review of Canadian data. J Can Dent Assoc. 2016;82(g20):1–8. Schroth RJ, Quinonez C, Shwart L, Wagar B. Treating early childhood caries under general anesthesia: a national review of Canadian data. J Can Dent Assoc. 2016;82(g20):1–8.
13.
go back to reference Fejerskov O. Changing paradigms in concepts on dental caries: consequences for oral health care. Caries Res. 2004;38(3):182–91.CrossRef Fejerskov O. Changing paradigms in concepts on dental caries: consequences for oral health care. Caries Res. 2004;38(3):182–91.CrossRef
14.
go back to reference Davies GM, Worthington HV, Ellwood RP, Bentley EM, Blinkhorn AS, Taylor GO, et al. A randomised controlled trial of the effectiveness of providing free fluoride toothpaste from the age of 12 months on reducing caries in 5-6 year old children. Community Dent Health. 2002;19(3):131–6.PubMed Davies GM, Worthington HV, Ellwood RP, Bentley EM, Blinkhorn AS, Taylor GO, et al. A randomised controlled trial of the effectiveness of providing free fluoride toothpaste from the age of 12 months on reducing caries in 5-6 year old children. Community Dent Health. 2002;19(3):131–6.PubMed
15.
go back to reference Wennhall I, Matsson L, Schröder U, Twetman S. Outcome of an oral health outreach programme for preschool children in a low socioeconomic multicultural area. Int J Pediatr Dent. 2008;18(2):84–90.CrossRef Wennhall I, Matsson L, Schröder U, Twetman S. Outcome of an oral health outreach programme for preschool children in a low socioeconomic multicultural area. Int J Pediatr Dent. 2008;18(2):84–90.CrossRef
16.
go back to reference Levin KA, Jones CM, Wight C, Valentine C, Topping GVA, Naysmith R. Fluoride rinsing and dental health inequalities in 11-year-old children: an evaluation of a supervised school-based fluoride rinsing programme in Edinburgh. Community Dent Oral Epidemiol. 2009;37(1):19–26.CrossRef Levin KA, Jones CM, Wight C, Valentine C, Topping GVA, Naysmith R. Fluoride rinsing and dental health inequalities in 11-year-old children: an evaluation of a supervised school-based fluoride rinsing programme in Edinburgh. Community Dent Oral Epidemiol. 2009;37(1):19–26.CrossRef
17.
go back to reference Levesque J-F, Harris MF, Russell G. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health. 2013;12(1):18.CrossRef Levesque J-F, Harris MF, Russell G. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health. 2013;12(1):18.CrossRef
18.
go back to reference Plutzer K, Keirse M. Influence of an intervention to prevent early childhood caries initiated before birth on children’s use of dental services up to 7 years of age. Open Dent J. 2014;8:104–8.CrossRef Plutzer K, Keirse M. Influence of an intervention to prevent early childhood caries initiated before birth on children’s use of dental services up to 7 years of age. Open Dent J. 2014;8:104–8.CrossRef
19.
go back to reference Johnson M, George A, Dahlen H, Ajwani S, Bhole S, Blinkhorn A. The midwifery initiated oral health dental service protocol: an intervention to improve oral health outcomes for pregnant women. BMC Oral Health. 2015;15(2):1–9. Johnson M, George A, Dahlen H, Ajwani S, Bhole S, Blinkhorn A. The midwifery initiated oral health dental service protocol: an intervention to improve oral health outcomes for pregnant women. BMC Oral Health. 2015;15(2):1–9.
20.
go back to reference Anil S, Anand PS. Early childhood caries: prevalence, risk factors, and prevention. Front Pediatr. 2017;5(157):1–7. Anil S, Anand PS. Early childhood caries: prevalence, risk factors, and prevention. Front Pediatr. 2017;5(157):1–7.
21.
go back to reference Leong PM, Gussy MG, Barrow SY, de Silva-Sanigorski A, Waters E. A systematic review of risk factors during first year of life for early childhood caries. Int J Pediatr Dent. 2013;23(4):235–50.CrossRef Leong PM, Gussy MG, Barrow SY, de Silva-Sanigorski A, Waters E. A systematic review of risk factors during first year of life for early childhood caries. Int J Pediatr Dent. 2013;23(4):235–50.CrossRef
22.
go back to reference Weintraub J, Prakash P, Shain S, Laccabue M, Gansky S. Mothers’ caries increases odds of children’s caries. J Dent Res. 2010;89(9):954–8.CrossRef Weintraub J, Prakash P, Shain S, Laccabue M, Gansky S. Mothers’ caries increases odds of children’s caries. J Dent Res. 2010;89(9):954–8.CrossRef
23.
go back to reference Albino J, Tiwari T. Preventing childhood caries: a review of recent behavioral research. J Dent Res. 2016;95(1):35–42.CrossRef Albino J, Tiwari T. Preventing childhood caries: a review of recent behavioral research. J Dent Res. 2016;95(1):35–42.CrossRef
24.
go back to reference Council on Clinical Affairs. Guideline on perinatal oral health care. Am Acad Pediatr Dent. 2011;36(6):14–15. Council on Clinical Affairs. Guideline on perinatal oral health care. Am Acad Pediatr Dent. 2011;36(6):14–15.
25.
go back to reference Marrs J-A, Trumbley S, Malik G. Early childhood caries: determining the risk factors and assessing the prevention strategies for nursing intervention. Pediatr Nurs. 2011;37(1):9–15.PubMed Marrs J-A, Trumbley S, Malik G. Early childhood caries: determining the risk factors and assessing the prevention strategies for nursing intervention. Pediatr Nurs. 2011;37(1):9–15.PubMed
26.
go back to reference El Fadl RA, Blair M, Hassounah S. Integrating maternal and children's oral health promotion into nursing and midwifery practice-a systematic review. PLoS One. 2016;11(11):1–15. El Fadl RA, Blair M, Hassounah S. Integrating maternal and children's oral health promotion into nursing and midwifery practice-a systematic review. PLoS One. 2016;11(11):1–15.
27.
go back to reference Chaffee BW, Feldens CA, Vítolo MR. Cluster-randomized trial of infant nutrition training for caries prevention. J Dent Res. 2013;92(7_suppl):S29–36.CrossRef Chaffee BW, Feldens CA, Vítolo MR. Cluster-randomized trial of infant nutrition training for caries prevention. J Dent Res. 2013;92(7_suppl):S29–36.CrossRef
28.
go back to reference Mohebbi SZ, Virtanen JI, Vahid-Golpayegani M, Vehkalahti MM, Mohebbi SZ, Virtanen JI, et al. A cluster randomised trial of effectiveness of educational intervention in primary health care on early childhood caries. Caries Res. 2009;43(2):110–8.CrossRef Mohebbi SZ, Virtanen JI, Vahid-Golpayegani M, Vehkalahti MM, Mohebbi SZ, Virtanen JI, et al. A cluster randomised trial of effectiveness of educational intervention in primary health care on early childhood caries. Caries Res. 2009;43(2):110–8.CrossRef
29.
go back to reference Larsen CD, Larsen MD, Ambrose T, Degano R, Gallo L, Cardo VA Jr. Efficacy of a prenatal oral health program follow-up with mothers and their children. N Y State Dent J. 2016;82(3):15–20.PubMed Larsen CD, Larsen MD, Ambrose T, Degano R, Gallo L, Cardo VA Jr. Efficacy of a prenatal oral health program follow-up with mothers and their children. N Y State Dent J. 2016;82(3):15–20.PubMed
30.
go back to reference Riggs E, Slack-Smith L, Yelland J, Chadwick B, Robertson L, Kilpatrick N. Interventions with pregnant women and new mothers for preventing caries in children. Cochrane Database Syst Rev. 2016;4:1–10. Riggs E, Slack-Smith L, Yelland J, Chadwick B, Robertson L, Kilpatrick N. Interventions with pregnant women and new mothers for preventing caries in children. Cochrane Database Syst Rev. 2016;4:1–10.
31.
go back to reference Harrison RL, Wong T. An oral health promotion program for an urban minority population of preschool children. Community Dent Oral Epidemiol. 2003;31(5):392–9.CrossRef Harrison RL, Wong T. An oral health promotion program for an urban minority population of preschool children. Community Dent Oral Epidemiol. 2003;31(5):392–9.CrossRef
32.
go back to reference Fisher-Owens SA, Gansky SA, Platt LJ, Weintraub JA, Soobader M-J, Bramlett MD, et al. Influences on children's oral health: a conceptual model. Pediatrics. 2007;120(3):e510–e20.CrossRef Fisher-Owens SA, Gansky SA, Platt LJ, Weintraub JA, Soobader M-J, Bramlett MD, et al. Influences on children's oral health: a conceptual model. Pediatrics. 2007;120(3):e510–e20.CrossRef
34.
go back to reference Feldens CA, Vitolo MR, Drachler ML. A randomized trial of the effectiveness of home visits in preventing early childhood caries. Community Dent Oral Epidemiol. 2007;35(3):215–23.CrossRef Feldens CA, Vitolo MR, Drachler ML. A randomized trial of the effectiveness of home visits in preventing early childhood caries. Community Dent Oral Epidemiol. 2007;35(3):215–23.CrossRef
35.
go back to reference Hallas D, Fernandez JB, Lim LJ, Catapano P, Dickson SK, Blouin KR, et al. OHEP: an oral health education program for mothers of newborns. J Pediatr Health Care. 2015;29(2):181–90.CrossRef Hallas D, Fernandez JB, Lim LJ, Catapano P, Dickson SK, Blouin KR, et al. OHEP: an oral health education program for mothers of newborns. J Pediatr Health Care. 2015;29(2):181–90.CrossRef
36.
go back to reference Weinstein P, Harrison R, Benton T. Motivating parents to prevent caries in their young children: one-year findings. J Am Dent Assoc. 2004;135(6):731–8.CrossRef Weinstein P, Harrison R, Benton T. Motivating parents to prevent caries in their young children: one-year findings. J Am Dent Assoc. 2004;135(6):731–8.CrossRef
37.
go back to reference Yuan S, Kerr G, Salmon K, Speedy P, Freeman R. Evaluating a community-based dental registration program for preschool children living in areas of high social deprivation. Eur Arch Paediatr Dent. 2007;8(1):55–61.CrossRef Yuan S, Kerr G, Salmon K, Speedy P, Freeman R. Evaluating a community-based dental registration program for preschool children living in areas of high social deprivation. Eur Arch Paediatr Dent. 2007;8(1):55–61.CrossRef
38.
go back to reference Milgrom P, Sutherland M, Shirtcliff RM, Ludwig S, Smolen D. Children’s tooth decay in a public health program to encourage low-income pregnant women to utilize dental care. BMC Public Health. 2010;10(76):1–5. Milgrom P, Sutherland M, Shirtcliff RM, Ludwig S, Smolen D. Children’s tooth decay in a public health program to encourage low-income pregnant women to utilize dental care. BMC Public Health. 2010;10(76):1–5.
39.
go back to reference Weinstein P, Harrison R, Benton T. Motivating mothers to prevent caries: confirming the beneficial effect of counseling. J Am Dent Assoc. 2006;137(6):789–93.CrossRef Weinstein P, Harrison R, Benton T. Motivating mothers to prevent caries: confirming the beneficial effect of counseling. J Am Dent Assoc. 2006;137(6):789–93.CrossRef
40.
go back to reference George A, Duff M, Ajwani S, Johnson M, Dahlen H, Blinkhorn A, et al. Development of an online education program for midwives in Australia to improve perinatal oral health. J Perinat Educ. 2012;21(2):112–22.CrossRef George A, Duff M, Ajwani S, Johnson M, Dahlen H, Blinkhorn A, et al. Development of an online education program for midwives in Australia to improve perinatal oral health. J Perinat Educ. 2012;21(2):112–22.CrossRef
41.
go back to reference Skeie MS, Skaret E, Espelid I, Misvær N. Do public health nurses in Norway promote information on oral health? BMC Oral Health. 2011;11(23):1–9. Skeie MS, Skaret E, Espelid I, Misvær N. Do public health nurses in Norway promote information on oral health? BMC Oral Health. 2011;11(23):1–9.
42.
go back to reference Heilbrunn-Lang AY, de Silva AM, Lang G, George A, Ridge A, Johnson M, et al. Midwives’ perspectives of their ability to promote the oral health of pregnant women in Victoria, Australia. BMC Pregnancy Childbirth. 2015;15(110):1–11. Heilbrunn-Lang AY, de Silva AM, Lang G, George A, Ridge A, Johnson M, et al. Midwives’ perspectives of their ability to promote the oral health of pregnant women in Victoria, Australia. BMC Pregnancy Childbirth. 2015;15(110):1–11.
43.
go back to reference Rabiei S, Mohebbi SZ, Yazdani R, Virtanen JI. Primary care nurses’ awareness of and willingness to perform children’s oral health care. BMC Oral Health. 2014;14(1):26.CrossRef Rabiei S, Mohebbi SZ, Yazdani R, Virtanen JI. Primary care nurses’ awareness of and willingness to perform children’s oral health care. BMC Oral Health. 2014;14(1):26.CrossRef
44.
go back to reference George A, Lang G, Johnson M, Ridge A, de Silva AM, Ajwani S, et al. The evaluation of an oral health education program for midwives in Australia. Women Birth. 2016;29(3):208–13.CrossRef George A, Lang G, Johnson M, Ridge A, de Silva AM, Ajwani S, et al. The evaluation of an oral health education program for midwives in Australia. Women Birth. 2016;29(3):208–13.CrossRef
45.
go back to reference George A, Duff M, Ajwani S, Johnson M, Dahlen H, Blinkhorn A, et al. The development of an education program for midwives in Australia to improve perinatal oral health. J Perinat Educ. 2012;21(2):112–22.CrossRef George A, Duff M, Ajwani S, Johnson M, Dahlen H, Blinkhorn A, et al. The development of an education program for midwives in Australia to improve perinatal oral health. J Perinat Educ. 2012;21(2):112–22.CrossRef
46.
go back to reference George A, Duff M, Johnson M, Dahlen H, Blinkhorn A, Ellis S, et al. Piloting of an oral health education programme and knowledge test for midwives. Contemp Nurse. 2014;46(2):180–6.CrossRef George A, Duff M, Johnson M, Dahlen H, Blinkhorn A, Ellis S, et al. Piloting of an oral health education programme and knowledge test for midwives. Contemp Nurse. 2014;46(2):180–6.CrossRef
47.
go back to reference Blinkhorn F, Brown N, Freeman R, Humphris G, Martin A, Blinkhorn A. A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries. BMC Public Health. 2012;12(1):681.CrossRef Blinkhorn F, Brown N, Freeman R, Humphris G, Martin A, Blinkhorn A. A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries. BMC Public Health. 2012;12(1):681.CrossRef
48.
go back to reference George A, Dahlen HG, Blinkhorn A, Ajwani S, Bhole S, Ellis S, et al. Evaluation of a midwifery initiated oral health-dental service program to improve oral health and birth outcomes for pregnant women: a multi-Centre randomised controlled trial. Int J Nurs Stud. 2018;82:49–57.CrossRef George A, Dahlen HG, Blinkhorn A, Ajwani S, Bhole S, Ellis S, et al. Evaluation of a midwifery initiated oral health-dental service program to improve oral health and birth outcomes for pregnant women: a multi-Centre randomised controlled trial. Int J Nurs Stud. 2018;82:49–57.CrossRef
Metadata
Title
Effectiveness of preventive dental programs offered to mothers by non-dental professionals to control early childhood dental caries: a review
Authors
Ajesh George
Mariana S. Sousa
Ariana C. Kong
Anthony Blinkhorn
Tiffany Patterson Norrie
Jann Foster
Hannah G. Dahlen
Shilpi Ajwani
Maree Johnson
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Caries
Published in
BMC Oral Health / Issue 1/2019
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-019-0862-x

Other articles of this Issue 1/2019

BMC Oral Health 1/2019 Go to the issue