Oral health promotion for pregnant women and mothers of infant

Project # 1: Health promotion and early childhood caries

Aims

The purpose of the study was to test the efficacy of an oral health promotion program (OHPP) for the parents of infants, starting with pregnant women, using a randomised controlled trial. The OHPP used anticipatory guidance to focus on the needs of each child during the first 18 months of life.

Method

In total, 649 nulliparous women were enrolled in the study. During the enrolment they were randomised into test and control groups, using Zelen’s design. Mothers in the test group (n = 327) received the first round of oral health promotion information at their enrolment in the study. They received the second round of information when their child was 6 months old and the third round when their child reached 12 months of age. This written oral health promoting material was mailed to their home address. After the second round of information test group mothers were randomised on the test A and test B groups. In test group A, the oral health promotion information was reinforced through a phone interview, in contrast to test group B where no reinforcement took place. There was no contact with mothers (n = 322) in the control group from the time of their enrolment. At the age of 18 months, all children were examined by a dentist. Baseline data at the enrolment to the study, refusal to participate in the study, retention of participants in the study according to the socio-economic factors, data from two questionnaires (First Maternal Oral Health Survey, second Child’s Oral Health Survey), medical history, dental examination, and responses of participants to the oral health promotion information were analysed. The differences in outcomes between the test and control groups, and the test A and test B groups were calculated.

Findings

From a total of 649 nulliparous women enrolled in the study, after exclusions and losses to the study since enrolment, 441 children were examined at the age of  20 ± 2.5 sd months. The number of examined children in the test group was 232 and 209 in the control group. There were no statistically significant differences between the test and control groups at baseline and follow-up according to socio-economic characteristics. Using a case definition of severe early childhood caries (S-ECC) as one or more maxillary anterior teeth carious, the incidence of S-ECC in the test group was 1.7% and in the control group 9.6%. The overall incidence of S-ECC was 5.4%. The difference in the caries incidence between test and control group was statistically significant at p<0.001. The phone call counselling to mothers in test group A received between six and 12 months of their child’s age did not influence the incidence of S-ECC (group A 1.6%, group B 1.8%). The first-time mothers proved to be a group receptive to health information.

Conclusion

The statistically significant difference in the incidence of S-ECC between the test and control groups indicates high efficacy of the oral health promoting intervention provided in the form of anticipatory guidance periodically mailed to the mother’s home address.

Contact person
Dr Kamila Plutzer
122 Frome Street
ARCPOH, Dental school, the University of Adelaide
SA 5005
Email: kamila.plutzer@adelaide.edu.au

Project # 2: Oral Health Promotion for Young Pregnant Women
Aims or brief descriptions

Pregnant adolescents represent a dually vulnerable group in terms of their own risk of poor oral health and that of their babies.  In addition, recent research is showing that the potential to promote oral health is resting increasingly in the early years of life.  This project was designed to provide information and education about infant and pregnancy oral care to pregnant adolescents.  The target group was addressed through the Young Mothers Clinic at the Royal Womens’ Hospital utilising an existing young womens’ health program.  Key issues for this group were a poor knowledge of and access to dental services and a need for knowledge about infant oral health.  The program was implemented through the development of a display and informal discussions with the clients of the clinic at their regular visits.

Findings
Evaluation was carried out using post intervention questionnaires, observation and feedback from the staff at the young mother’s clinic which showed that the young women were reluctant to seek information and that a team approach to supporting their health was important.
Involved organisations

Bachelor of Oral Health Science Student Research Project, The University of Melbourne

Lucyanne Garro,

Dimitrios Androutsopoulos,
Jane Irving
Leisha Senior

Contact person for further information

Dr Julie Satur
Senior Lecturer, Head Oral Health Therapy
School of Dental Science, The University of Melbourne
720 Swanston Street, Melbourne, 3000, Australia
Phone direct: 03 9341 1530
Email:  juliegs@unimelb.edu.au

Project # 3: Effectiveness of a preschool dental enrolment program in preventing childhood caries

Dental caries in preschool children is a pediatric health problem in Australia, with a greater prevalence than childhood asthma. Using a retrospective case control study design, this project aims to investigate whether preschool enrolment in the SA Dental Service pediatric dental program is associated with a lower likelihood of untreated dental decay in school children aged five years.

Publications or reports from study
Slade, G.D., A.E. Sanders et al. (2006). "Risk factors for dental caries in the five-year-old South Australian population." Aust Dent J 51(2): 130-9.

Project # 4: Strong teeth for little kids

Project to test on oral health promotion intervention using random community trial approach.
Contact person
Dr Kaye Roberts_Thomson
122 Frome Street
ARCPOH, Dental school, the University of Adelaide
SA 5005
Email: kaye.robertsthomson@adelaide.edu.au