Effective Prevention of Early Childhood Caries in Well-Baby Clinics: Results of a Pragmatic Randomised Trial.

IF 2.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Caries Research Pub Date : 2025-03-18 DOI:10.1159/000545116

Peggy C J M van Spreuwel, Geert J M G van der Heijden, Naichuan Su, Cor van Loveren, Katarina Jerković-Ćosić

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引用次数: 0

Abstract

Introduction: This study evaluated the Toddler Oral Health Intervention (TOHI) for preventing early childhood caries (ECC) by 48 months. TOHI, an add-on to standard care in well-baby clinics (WBCs), aims to reduce ECC incidence and severity.

Methods: Dyads were randomised into TOHI (added to care as usual) or care as usual (CAU). The primary outcome was ECC (incidence and severity); secondary outcomes included plaque and pufa scores, and oral health behaviour changes. TOHI combined Non-Operative Caries Treatment and Prevention, Motivational Interviewing, and the Health Action Process Approach. Oral health coaches applied TOHI from enrolment (age 6-12 months) to 48 months. Data were collected at baseline, 24, and 48 months through questionnaires and clinical assessments. Blinding was maintained for clinical assessment and analysis. Intention-to-treat analysis used a Negative Binomial Hurdle Model with one-sided statistical testing.

Results: Of the 402 enrolled dyads, 353 (88%) completed the study (TOHI: 176/205, 86%; CAU: 177/197, 90%). At 48 months, 61% of TOHI toddlers and 54% of CAU toddlers remained free of any caries lesions (ICDAS ≥1). Among toddlers with caries, TOHI reduced dmfs scores by 40% (RR: 0.60; UL95% CI: 0.98, p = 0.04). For cavitated lesions (ICDAS ≥3), TOHI reduced dmfs scores by 53% (RR: 0.47; UL95% CI: 1.04, p = 0.06), and 84% of TOHI toddlers remained free of cavitated lesions versus 78% in CAU.

Conclusion: TOHI, added to usual care at WBCs, modestly reduced ECC incidence and severity at 48 months. Further research is needed to assess long-term impacts and cost-effectiveness.

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在健康婴儿诊所有效预防幼儿龋齿：一项实用随机试验的结果。

前言：本研究评估幼儿口腔健康干预（TOHI）预防48个月早期儿童龋齿（ECC）的效果。TOHI是健康婴儿诊所（wbc）标准护理的补充，旨在减少ECC的发生率和严重程度。方法：将两组患者随机分为照常护理组（TOHI）和照常护理组（CAU）。主要结局为ECC（发生率和严重程度）；次要结局包括牙菌斑和pufa评分，以及口腔健康行为的改变。TOHI结合了非手术治疗和预防龋齿，动机访谈和健康行动过程方法。口腔健康教练从入组（6-12个月）至48个月应用TOHI。通过问卷调查和临床评估，在基线、24和48个月收集数据。保持盲法进行临床评估和分析。意向治疗分析采用负二项障碍模型和单侧统计检验。结果：402对入组患者中，353对（88%）完成了研究(TOHI: 176/205, 86%；Cau: 177/ 197,90%)。在48个月时，61%的TOHI幼儿和54%的CAU幼儿没有任何龋齿病变（ICDAS≥1）。在患有龋齿的幼儿中，TOHI使dmfs得分降低40% (RR: 0.60；95% CI: 0.98, p = 0.04)。对于空化病变（ICDAS≥3），TOHI使dmfs评分降低53% (RR: 0.47；95% CI: 1.04, p = 0.06)， 84%的TOHI幼儿没有空化病变，而CAU为78%。结论：在常规护理中加入TOHI，可在48个月时适度降低ECC的发生率和严重程度。需要进一步研究以评估长期影响和成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Caries Research 医学-牙科与口腔外科

CiteScore

6.30

自引率

7.10%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Caries Research'' publishes epidemiological, clinical and laboratory studies in dental caries, erosion and related dental diseases. Some studies build on the considerable advances already made in caries prevention, e.g. through fluoride application. Some aim to improve understanding of the increasingly important problem of dental erosion and the associated tooth wear process. Others monitor the changing pattern of caries in different populations, explore improved methods of diagnosis or evaluate methods of prevention or treatment. The broad coverage of current research has given the journal an international reputation as an indispensable source for both basic scientists and clinicians engaged in understanding, investigating and preventing dental disease.