John Jeyanthi
Department of Public Health, Southampton City Primary Care Trust, Oatlands House, Winchester Road, Southampton, UK.
Evid Based Dent. 2008;9(1):11. doi: 10.1038/sj.ebd.6400562.
This was a randomised field trial using block randomisation.
A control group received routine assistance from their paediatricians in the health service, with research assessment usually within 1 month of the child's 6- and 12-month anniversary, then dietary advice by a fieldworker after the 12-month research assessment. The intervention group received home visits to advise the mother about healthy breastfeeding and weaning within 10 days of the child's birth, then monthly up to 6 months, then at 8, 10 and 12 months. This group also received the 6-month and 12-month research assessment and routine assistance from their paediatricians.
Outcome measures were early childhood caries (ECC), defined as one or more caries surface of a tooth, duration of breastfeeding and dietary behaviours.
Of the intervention group, 10.2% (16 out of 157) babies had caries compared with 18.3% (40 out of 219) babies in the control group. The odds of dental caries was 48% lower for the intervention group than for the controls (odds ratio, 0.52; 95% confidence interval, 0.27-0.97), after adjustment for the confounding effect of number of teeth. The intervention group had a longer mean duration of exclusive breastfeeding (X(2) P 0.000), later introduction of sugar (X(2) P 0.005) and a lower probability of their baby ever having eaten honey (X(2) P 0.003), chocolate or sweets (X(2) P 0.001), soft drinks (X(2) P 0.020), biscuits (X(2) P 0.000) and fromage frais cheese (X(2) P 0.001).
Home visits for dietary advice appear to help reduce dental caries in infants. Greater efforts are needed to tackle cariogenic dietary behaviours, however, and further studies are required to examine any longer-term effect.
