ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Preventive Dental Programs Initiated During Pregnancy are Effective in Reducing the Incidence of Severe Early Childhood Caries in Children
Clinical Question In females, does the adherence to a caries preventive program initiated during pregnancy lower the incidence of severe early childhood caries in their children?
Clinical Bottom Line Preventive dental programs initiated during pregnancy are effective in reducing the incidence of severe early childhood caries in children. This is supported by a long-term prospective study and two randomized controlled trials that administered a preventive dental program to expecting mothers and then followed up with their children for 3-14 years after birth. All of these showed a significant reduction in caries at all stages in the child’s early life, with great benefits extending even into their teenage years.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 19543927Meyer/201086 pregnant women (mean age 28.5) in the prevention group.Prospective Cohort Study
Key resultsThis was phase IV of a long-term clinical study that examined the 29 adolescents (ages 13-14) that were the offspring of the original 86 pregnant mothers that began the study. The preventive dental program utilized consisted of an examination, oral health education, and preventive treatment such as fluoride rinses, In the first 3 years of this study none of the children in the prevention group had caries, whereas only 81.5% of children in the control group were caries free at this point. At the age of 13-14, 89.7% of the children in the prevention group remained caries free while only 56.7% of the children in the control group showed no caries, which was a significant difference between the intervention and control (p< 0.05).
#2) 19145720Plutzer/2008649 pregnant womenRandomized Controlled Trial
Key resultsThis study utilized anticipatory guidance in the form of printed information on oral health promotion. This emphasized the importance of oral health and nutrition during pregnancy and the early years of the child. Of the 441 women who had their child examined at the follow-up, the incidence of severe early childhood caries in the test group was 1.7% and in the control group 9.6% (P < 0.001).
#3) 11310134Gomez/2001241 pregnant womenRandomized Controlled Trial
Key resultsThis study used a three-part program consisting of an oral examination, oral health education, and treatment such as a dental prophylaxis and fluoride rinses. Of the mothers that participated in the Preventive Dental Program, 97% of their children were caries free when examined between the ages of 1-3.5. In the control group, only 77% of children in the same age range were found to be caries free (p < 0.05). When looking at only children in the 3-3.5 age range, 94% of the intervention group remained caries free versus only 58% in the control group (p < 0.05).
Evidence Search (("Dental Caries/prevention and control"[Mesh] AND "Pregnancy"[Mesh]) AND "Child"[Mesh]) AND "Preventive Dentistry"[Mesh]
Comments on
The Evidence
Validity: The studies used for this clinical question all did a good job of patient compliance, randomization, and long-term follow up. The above were all long-term and examined how their chosen Preventive Dental Program utilized affected the children as they aged, all the way up to early teenage years in one study. And in each of these age ranges, the PDP was shown to significantly lower the incidence of caries in the children, meaning that a PDP undergone during pregnancy has long-lasting benefits throughout the child’s early years.
Applicability The subjects used in the above studies are representative of the patients one would commonly see in the dental setting, as general dentists and pedodontists alike will be treating expecting mothers. The treatments suggested by the studies are extremely feasible in private practice, as they entail little more than providing the mothers with anticipatory guidance about their oral health and the future oral health of their children, as well as treating any existing carious lesions or periodontal diseases.
Specialty/Discipline (Public Health) (General Dentistry) (Pediatric Dentistry)
Keywords Preventive Dental Program, Anticipatory Guidance, Preventive Dentistry, Pregnancy, Severe Early Childhood Caries
ID# 2680
Date of submission: 03/28/2014spacer
E-mail faltys@livemail.uthscsa.edu
Author David Q. Faltys
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Maria Cervantes Mendez, DDS & John Roberts, DDS
Faculty mentor/Co-author e-mail cervantesmen@uthscsa.edu, jr2148327480@hotmail.com
Basic Science Rationale
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