scholarly journals Randomized Trial of Motivational Interviewing to Prevent Early Childhood Caries in American Indian Children

2018 ◽  
Vol 3 (4) ◽  
pp. 366-375 ◽  
Author(s):  
T.S. Batliner ◽  
T. Tiwari ◽  
W.G. Henderson ◽  
A.R. Wilson ◽  
S.E. Gregorich ◽  
...  
Keyword(s):  
Early Childhood ◽  
Oral Health ◽  
High Risk ◽  
Motivational Interviewing ◽  
American Indian ◽  
Early Childhood Caries ◽  
Caries Experience ◽  
Indian Children ◽  
Percentage Points ◽  
Childhood Caries

Introduction: In a randomized controlled trial, the effectiveness of motivational interviewing (MI) combined with enhanced community services (MI + ECS) was compared with ECS alone for reducing dental caries in American Indian children on the Pine Ridge Reservation. The intervention was developed and delivered with extensive tribal collaboration. Methods: A total 579 mother-newborn dyads were enrolled and randomized to the MI + ECS and ECS groups. They were followed for 36 mo. Four MI sessions were provided, the first shortly after childbirth and then 6, 12, and 18 mo later. Both groups were exposed to ECS, which included public service announcements through billboards and tribal radio, as well as broad distribution of brochures on behavioral risk factors for early childhood caries (ECC), toothbrushes, and toothpaste. MI impact was measured as decayed, missing, and filled tooth surfaces (dmfs). Secondary outcomes included decayed surfaces, caries prevalence, and maternal oral health knowledge and behaviors. Modified intention-to-treat analyses were conducted. Eighty-eight percent of mothers completed at least 3 of 4 MI sessions offered. Results: After 3 y, dmfs was not significantly different for the 2 groups (MI + ECS = 10, ECS = 10.38, P = 0.68). In both groups, prevalence of caries experience was 7% to 9% after 1 y, 35% to 36% at 2 y, and 55% to 56% at 3 y. Mean knowledge scores increased by 5.0, 5.3, and 5.9 percentage points at years 1, 2, and 3 in the MI + ECS group and by 1.9, 3.3, and 5.0 percentage points in the ECS group (P = 0.03), respectively. Mean maternal oral health behavior scores were not statistically significantly different between the treatment arms. Conclusion: In summary, the MI intervention appeared to improve maternal knowledge but had no effect on oral health behaviors or on the progression of ECC (ClinicalTrials.gov NCT01116726). Knowledge Transfer Statement: The findings of this study suggest that motivational interviewing focusing on parental behaviors may not be as effective as previously hoped for slowing the development of childhood caries in some high-risk groups. Furthermore, social factors may be even more salient determinants of oral health than what we previously supposed, perhaps interfering with the capacity to benefit from behavioral strategies that have been useful elsewhere. The improvement of children’s oral health in high-risk populations characterized by poverty and multiple related life stresses may require more holistic approaches that address these formidable barriers.

scholarly journals A Formative Assessment of Social Determinants of Health Related to Early Childhood Caries in Two American Indian Communities

2021 ◽  
Vol 18 (18) ◽  
pp. 9838
Author(s):  
Kristan Elwell ◽  
Carolyn Camplain ◽  
Christine Kirby ◽  
Katharine Sanderson ◽  
Gloria Grover ◽  
...  
Keyword(s):  
Early Childhood ◽  
Oral Health ◽  
Dental Caries ◽  
Formative Assessment ◽  
American Indian ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Early Childhood Caries ◽  
The Social ◽  
Childhood Caries

In the United States, children from diverse ethnic groups and those with low socioeconomic status are at a significantly increased risk for early childhood caries. Despite the efforts focused on decreasing early childhood caries in American Indian (AI) populations, these children have the highest incidence of dental caries of any ethnic group, with four times the cases of untreated dental caries compared to white children. This qualitative formative assessment was conducted in two AI communities. Semi-structured interviews (n = 57) were conducted with caregivers and providers to understand the social and community contexts in which oral health behaviors and practices occur from the perspective of the caregivers, oral health care providers, and social service providers in the communities. The analysis was informed by the social determinants of health framework. The key social determinants of pediatric oral health relevant to our study communities included limited access to: oral health promoting nutritious foods, transportation for oral health appointments, and pediatric specialty care. This formative assessment provided locally and contextually relevant information to shape the development of an oral health clinical trial intervention to address early childhood caries in these two communities.

Factors Influencing Early Childhood Caries of Cleft Lip and/or Palate Children Aged 18 to 36 Months in Southern Thailand

2008 ◽  
Vol 45 (5) ◽  
pp. 468-472 ◽  
Author(s):  
Teerapong Mutarai ◽  
Wipapun Ritthagol ◽  
Jaranya Hunsrisakhun
Keyword(s):  
Early Childhood ◽  
Oral Health ◽  
Early Childhood Caries ◽  
Cleft Lip ◽  
Feeding Habit ◽  
Caries Experience ◽  
Night Time ◽  
Oral Clefts ◽  
Southern Thailand ◽  
Childhood Caries

Objective: To clarify whether oral health care behavior or oral cleft status influences early childhood caries in southern Thailand cleft children. Design: A comparative cross-sectional study. Patients, Participants: A total of 138 southern Thai children aged 18 to 36 months comprised two groups of 69 participants, one with cleft lip and/or palate and controls with no cleft. Methods: All children were examined for early childhood caries by using the severity (DMFT/tooth) index. A structured interview was conducted among caregivers, and then multiple regression analysis was applied. Results: Children with oral clefts had a larger number of early childhood caries (ECC) and poorer feeding habits than those without. From a structured questionnaire, the caregivers of children with clefts exercised poorer oral health behavior than those of the controls, but the cleft status was not an important factor for caries prevalence when oral health behaviors were controlled. Multivariate analysis showed that sweetened bottled milk consumption, night-time feeding habit, and frequent sugary food consumption were the variables significantly associated with dental caries. Conclusions: Children with oral clefts in southern Thailand had greater caries experience when compared with noncleft subjects. However, cleft status was not significant for ECC, and night-time feeding habit was the most important factor for higher ECC in children with clefts.

scholarly journals Using chlorhexidine varnish to prevent early childhood caries in American Indian children

2012 ◽  
Vol 73 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Lawrence D. Robertson ◽  
Kathy R. Phipps ◽  
Junhie Oh ◽  
Walter J. Loesche ◽  
Niko Kaciroti ◽  
...  
Keyword(s):  
Early Childhood ◽  
American Indian ◽  
Early Childhood Caries ◽  
Indian Children ◽  
Childhood Caries

scholarly journals Timing of sugar introduction in diet and early childhood caries: a population-based study in preschoolers

2021 ◽  
Vol 50 ◽  
Author(s):  
Guilherme Nilson ALVES DOS SANTOS ◽  
Cacilda Castelo Branco LIMA ◽  
Ananda Souza PEREIRA ◽  
Marina de Deus Moura LIMA ◽  
Lúcia de Fátima Almeida de Deus MOURA ◽  
...  
Keyword(s):  
Early Childhood ◽  
Oral Health ◽  
Dental Caries ◽  
Low Income ◽  
Early Childhood Caries ◽  
Maternal Education ◽  
Population Based ◽  
Caries Experience ◽  
Population Based Study ◽  
Childhood Caries

Abstract Introduction Sugar ingestion is the most important isolated factor related to dental caries. Contact with sugary foods at an early age may represent a risk to the oral health of preschool children. Objective To evaluate the timing of the introduction of sugar in the diet of preschoolers and its association with early childhood caries. Material and method Cross-sectional population-based study with 888 five-year-old preschoolers from public and private schools. Parents answered a questionnaire on sociodemographic data, eating habits and oral health. The variables timing of sugar introduction (>1 year and ≤1 year) and dental caries experience were dichotomized and data were analyzed using descriptive statistics and Poisson regression (p<0.05). Result The introduction of sugar in the diet occurred during the first twelve months of life for 73.8% of preschoolers. There was no association between the timing of sugar introduction and early childhood caries (p>0.05). The interruption of exclusive breastfeeding and low family income increased the prevalence of preschoolers having early contact with sugar by 32% and 23%, respectively (p<0.05). The prevalence of early childhood caries was 42.3% and was associated with a lower level of maternal education, low income, increased frequency of ingestion of candy and the use of nonfluoridated toothpaste (p<0.05). Conclusion The introduction of sugar in the diet occurred during the first year of life in most preschoolers and there was no association with early childhood caries.

scholarly journals Oral Health Status of 3- to 5 -Year-old Children Attending Early Childhood Care and Development Centers in Bhutan: A Pilot Study

2020 ◽  
Vol 6 (2) ◽  
pp. 19-26
Author(s):  
Dorji Phurpa ◽  
Sonam Ngedup ◽  
Deki Pem ◽  
Mary Alice Lee
Keyword(s):  
Early Childhood ◽  
Oral Health ◽  
Dental Care ◽  
Early Childhood Caries ◽  
Oral Health Status ◽  
Caries Experience ◽  
Modifiable Risk Factors ◽  
Early Childhood Care ◽  
Childhood Care ◽  
Childhood Caries

Introduction: Early Childhood Caries (ECC) is a common childhood dental disease worldwide. To date, dental disease prevalence in children in Bhutan is unknown. Objectives: This study was conducted to estimate the prevalence of early childhood caries and its modifiable risk factors. Methods: We conducted a cross-sectional survey in 3-5-years old children attending Early Childhood Care and Development Centers in Bhutan. Mouth examination recorded teeth with decay (d), missing due to decay (m) and filled (f), to calculate caries experience (mean dmft and standard deviation=SD). Parents and caregivers were interviewed about their children’s oral health status, oral hygiene practices and diets among others. The prevalence of modifiable risk factors for disease was described based on parental responses. The association between decay and selected sociodemographic characteristics and oral health variables were investigated with bivariate analyses (X2). Results: Overall, 80.5% children had caries experience with mean dmft + or - SD (4.9 + 4.2). In fact, 79.9% had untreated decay. Only few had fillings as an evidence for availing dental care with mean filled 0.2 (SD=0.7). The percentage of decay increased significantly as maternal education increased and with low socioeconomic status (p=0.02). Conclusions: Early Childhood Caries are highly prevalent in Bhutan. Very few young children sought dental care. We recommend engaging relevant stakeholders in efforts to promote dental care and educate parents to use fluoridated toothpastes.

Promotion of Oral Health Care in Infants - A Preventive Strategy to Reduce the Burden of Early Childhood Caries

2020 ◽  
Vol 4 (5) ◽  
pp. 18-22
Author(s):  
Subhathira Rajasekaran ◽  
Sham S Bhat ◽  
Vidya Bhat ◽  
Sundeep Hegde K ◽  
Neha Thilak ◽  
...  
Keyword(s):  
Health Care ◽  
Early Childhood ◽  
Oral Health ◽  
Early Childhood Caries ◽  
Oral Health Care ◽  
Preventive Strategy ◽  
Childhood Caries

scholarly journals Protocol for a family-centered behavioral intervention to reduce early childhood caries: the MySmileBuddy program efficacy trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christie L. Lumsden ◽  
Burton L. Edelstein ◽  
Charles E. Basch ◽  
Randi L. Wolf ◽  
Pamela A. Koch ◽  
...  
Keyword(s):  
Early Childhood ◽  
High Risk ◽  
Behavioral Intervention ◽  
Early Childhood Caries ◽  
Text Messages ◽  
Trial Registration ◽  
Control Group ◽  
Causal Pathways ◽  
Family Centered ◽  
Childhood Caries

Abstract Background Although largely preventable through diet management and topical fluoride use, early childhood caries (ECC) often progresses to severity that necessitates surgical repair. Yet repair often fails to mitigate caries progression. Needed is an effective behavioral intervention to address underlying behavioral causes. Methods This randomized controlled trial will evaluate the efficacy of a behaviorally focused, family-centered intervention, the MySmileBuddy Program (MSB Program), to reduce ECC progression in high-risk preschoolers in New York City. Recruitment will target 858 children ages 24–71 months with ECC and their parents from primary care medical and dental clinics. The study aims to assess the MSB Program’s efficacy to: (1) decrease ECC progression measured 12-months post-randomization; and (2) enhance adoption of a low cariogenic diet and twice-daily fluoridated toothpaste use compared to control group. Potential causal pathways (mediators and moderators) will be explored. The MSB Program equips community health workers (CHWs) with an app that facilitates multilevel risk assessment and provides motivational interviewing-based counseling to inform parents about the caries process, develop personalized goals, and create family-level action plans to achieve targeted behaviors. Social support from CHWs (4 interactions during the 6-month intervention, supplemented by up to 4 in-person/remote contacts throughout the 12-month study period, based on need) is bolstered by automated text messages. Participants will be randomized to a Control Group (paper-based educational handout plus toothbrushes and fluoridated toothpaste for the child) or Intervention Group (MSB Program, two tooth-brushing observations with feedback and instruction, and toothbrushes and toothpaste for the entire family). All children will receive visual ICDAS dental examinations and parents will complete study measures at baseline and 12-months. An incentive up to $150 plus round-trip transit cards ($5.50 value) will be provided. Discussion This study hypothesizes that the MSB Program can reduce ECC progression in a high-risk population. Sufficient incentives and a focus on establishing rapport between participants and CHWs are anticipated to mitigate recruitment and retention challenges. If successful, this study will advance the long-term goal of reducing pediatric oral health disparities by demonstrating the efficacy of an acceptable and feasible intervention that shifts attention from dental repair to behavioral risk mitigation. Trial registration: Trial registration was completed on 4/13/2021 through the U.S. National Library of Medicine ClinicalTrials.gov website (Identifier: NCT04845594).

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