Dental Caries
Conditions
Keywords
Early childhood caries (ECC), Oral health promotion, Randomized controlled trial
Brief summary
Early childhood caries (ECC) is a global health problem that causes pain and infection to the children affected. It is a common disease among preschool children in Hong Kong. There is a great need to improve at-home ECC preventive measures through oral health promotional activities as early as possible to parents. The investigators will propose a 4-year randomized controlled trial of family-centered oral health promotion for new parents which aims to increase the proportion of parents brushing their infants' teeth at 1 year, establishing proper feeding and dietary habits, reducing the transfer of MS from the parents to their infants and then reducing the risk of ECC of the children at 3 years. The investigators also aim to improve the oral hygiene status of the new parents and prevention of oral diseases among themselves. First-time expectant mothers and their husbands will be recruited. The recruited families will be randomly allocated to the test and control groups. In the test group, personal hygiene instruction (OHI) for the expectant mothers and their husbands together with oral health education materials on infant's tooth development and eruption, establishment of proper feeding, dietary and toothbrushing habits will be given before the delivery of the new born babies. Reinforcement of OHI and demonstrations on how to clean the infant's oral cavities and perform toothbrushing will be delivered after the babies are born. Comprehensive data will be collected from the mothers, fathers and the infants in both the test and control groups at different time points through dental examination, biological testing and questionnaire survey. The CONSORT statement will be strictly followed when conducting the clinical trial, analyzing the data and reporting the results. It is anticipated that the effectiveness of oral health promotion starting at the pregnancy period and for both expecting mothers and their husbands will be greater in preventing the infants from developing ECC. Furthermore, establishing good oral health care habits will have long term benefits, helping safeguard the oral health of the children as they grow and the family as a whole. This study will also provide much needed evidence for the further development of oral health policies and oral health promotion programmes in Hong Kong; specifically how these can be integrated into family health education so as to achieve a higher effectiveness. This will contribute significantly to the improvement of oral health in the population of Hong Kong.
Interventions
Personal oral health instruction (OHI) and oral health pamphlets distribution
Oral health pamphlets distribution
Sponsors
Study design
Eligibility
Inclusion criteria
* First-time pregnancy * Of Chinese ethnicity * Ability to speak Cantonese and read traditional Chinese
Exclusion criteria
* Pregnant women with any communication difficulties noted * Informed consent not obtained
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Early Childhood Caries (ECC) | 36 months | Prevalence of early childhood caries (ECC) among study children at 36 months |
| Parental Toothbrushing on Infants | 12 months | Proportion of parents who brushed their infants' teeth regularly twice daily at 12 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Feeding Habits on Infants | 12 months | Proportion of infants falling asleep during milk-feeding |
| Ratio of Mutans Streptococci (MS) | 24 months | Proportion of MS with respect to the total bacterial count |
| Mothers' Gingival Bleeding | 12 months | Percentage of probing sites with gingival bleeding (BOP%, range 0-100%) |
Countries
China
Participant flow
Recruitment details
The pregnant women and their husbands were recruited from the Obstetrics & Gynaecology Department of three public hospitals and from two Maternal and Child Health Centers in Hong Kong. The potential participants were approached during their prenatal visits with minimal disturbance to the routine care at the recruitment sites. Written informed consent was obtained from both the pregnant woman and the husband. The recruitment period was from June 2014 to June 2016.
Participants by arm
| Arm | Count |
|---|---|
| Personal Oral Health Instruction + Pamphlets Distribution Personal oral health instruction (OHI) for the expectant mothers and their husbands together with oral health education materials on infant's tooth development and eruption, establishment of proper feeding, dietary and toothbrushing habits will be given before baby delivery. Reinforcement of OHI and demonstrations on how to clean the infant's oral cavities and perform toothbrushing will be delivered after the babies are born.
Personal oral health instruction + pamphlets distribution: Personal oral health instruction (OHI) and oral health pamphlets distribution | 294 |
| Pamphlets Distribution Pamphlets for adults' and pregnant women's oral health care will be distributed when recruited and information on the babies' oral health care will be distributed before baby delivery.
Pamphlets distribution: Oral health pamphlets distribution | 286 |
| Total | 580 |
Baseline characteristics
| Characteristic | Personal Oral Health Instruction + Pamphlets Distribution | Pamphlets Distribution | Total |
|---|---|---|---|
| Age, Continuous | 33.9 years STANDARD_DEVIATION 5.1 | 33.4 years STANDARD_DEVIATION 5.2 | 33.6 years STANDARD_DEVIATION 5.1 |
| Race/Ethnicity, Customized Chinese | 294 Families | 286 Families | 580 Families |
| Sex/Gender, Customized Father | 294 Families | 286 Families | 580 Families |
| Sex/Gender, Customized Mother | 294 Families | 286 Families | 580 Families |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 294 | 0 / 286 |
| other Total, other adverse events | 0 / 294 | 0 / 286 |
| serious Total, serious adverse events | 0 / 294 | 0 / 286 |
Outcome results
Early Childhood Caries (ECC)
Prevalence of early childhood caries (ECC) among study children at 36 months
Time frame: 36 months
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Personal Oral Health Instruction + Pamphlets Distribution | Early Childhood Caries (ECC) | 8 Participants |
| Pamphlets Distribution | Early Childhood Caries (ECC) | 41 Participants |
Parental Toothbrushing on Infants
Proportion of parents who brushed their infants' teeth regularly twice daily at 12 months
Time frame: 12 months
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Personal Oral Health Instruction + Pamphlets Distribution | Parental Toothbrushing on Infants | 74 Participants |
| Pamphlets Distribution | Parental Toothbrushing on Infants | 76 Participants |
Feeding Habits on Infants
Proportion of infants falling asleep during milk-feeding
Time frame: 12 months
Population: The numbers of participants analyzed here are those who finished basiline and one-year follow-up examination.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Personal Oral Health Instruction + Pamphlets Distribution | Feeding Habits on Infants | 57 Participants |
| Pamphlets Distribution | Feeding Habits on Infants | 63 Participants |
Mothers' Gingival Bleeding
Percentage of probing sites with gingival bleeding (BOP%, range 0-100%)
Time frame: 12 months
Population: The numbers of participants analyzed here are those who finished basiline and one-year follow-up gingival bleeding examination.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Personal Oral Health Instruction + Pamphlets Distribution | Mothers' Gingival Bleeding | 35 Percentage of sites with bleeding | Standard Deviation 29 |
| Pamphlets Distribution | Mothers' Gingival Bleeding | 46 Percentage of sites with bleeding | Standard Deviation 26 |
Ratio of Mutans Streptococci (MS)
Proportion of MS with respect to the total bacterial count
Time frame: 24 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Personal Oral Health Instruction + Pamphlets Distribution | Ratio of Mutans Streptococci (MS) | 6.1 Ratio of MS in the total bacterial count | Standard Deviation 15.7 |
| Pamphlets Distribution | Ratio of Mutans Streptococci (MS) | 11.6 Ratio of MS in the total bacterial count | Standard Deviation 17.8 |