Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District, Liverpool, NSW, 2170, Australia.
Ingham Institute for Applied Medical Research, Liverpool, NSW, 2170, Australia.
BMC Oral Health. 2019 Aug 2;19(1):172. doi: 10.1186/s12903-019-0862-x.
Early childhood caries is a common chronic childhood disease and maternal oral health is a risk factor. Improving the oral health behaviours of pregnant women/young mothers can positively influence the oral health of children and reduce their caries risk. Such preventative strategies have been undertaken by non-dental professionals producing mixed results encompassing various interventions across the perinatal period. However, no comprehensive review of these studies has been undertaken. The aim of this review was to assess the effectiveness of maternal oral health programs undertaken during the antenatal and/or postnatal period by non-dental health professionals to reduce early childhood caries.
A systematic search of five databases was undertaken using key search terms. Studies were included if they (a) involved quantitative study designs with a control; (b) were published in English; (c) reported on interventions delivered by non-dental professionals (d) delivered the intervention to expectant mothers or mothers with young infants up to 24 months; (e) measured outcomes when the child was under 5 years; (f) measured changes in oral health outcomes of children clinically and oral health behaviours of mothers or children. No restrictions were placed on the study quality and setting.
Nine studies met the inclusion criteria and involved interventions delivered by diverse non-dental professionals across the antenatal (n = 1), postnatal (n = 6) and perinatal period (n = 2). Most studies were of low methodological quality (n = 6). The interventions focussed on oral health education (n = 8), dental referrals (n = 3) and oral health assessments (n = 1). Interventions conducted in either the postnatal or antenatal periods showed meaningful improvements in children's clinical and mother's behavioural oral health outcomes. The outcomes appear to be sustained when a suite of interventions were used along with referral reminders. There were mixed results from interventions across the perinatal period.
Non-dental professionals can promote maternal oral health by providing oral health education, risk assessment and referrals. Combining these interventions could provide a sustained improvement in oral health outcomes for children although current evidence is weak. More high-quality studies are needed to confirm these findings and determine whether the antenatal and/or postnatal period is best suited to deliver these interventions.
婴幼儿龋是一种常见的慢性儿童疾病，而产妇口腔健康是一个危险因素。改善孕妇/年轻母亲的口腔健康行为可以积极影响儿童的口腔健康，降低其龋齿风险。非牙科专业人员已经采取了这种预防策略，但结果喜忧参半，涵盖了围产期的各种干预措施。然而，目前尚未对这些研究进行全面审查。本综述的目的是评估非牙科保健专业人员在产前和/或产后期间进行的孕产妇口腔健康计划对降低婴幼儿龋的有效性。
使用关键搜索词对五个数据库进行了系统搜索。如果研究符合以下标准，则将其纳入：（a）采用有对照组的定量研究设计；（b）用英文发表；（c）报告由非牙科专业人员提供的干预措施；（d）将干预措施提供给孕妇或有婴儿的母亲，直至婴儿 24 个月；（e）当孩子在 5 岁以下时测量结果；（f）测量儿童临床口腔健康结果和母亲或儿童口腔健康行为的变化。对研究质量和环境没有限制。
符合纳入标准的研究有 9 项，涉及围产期（n=1）、产后（n=6）和产前（n=2）期间由不同非牙科专业人员提供的干预措施。大多数研究的方法学质量较低（n=6）。干预措施侧重于口腔健康教育（n=8）、牙科转诊（n=3）和口腔健康评估（n=1）。在产后或产前期间进行的干预措施显示出儿童临床和母亲行为口腔健康结果的有意义改善。当使用一系列干预措施并结合转诊提醒时，结果似乎可以持续。在围产期期间进行的干预措施的结果喜忧参半。
非牙科专业人员可以通过提供口腔健康教育、风险评估和转诊来促进产妇口腔健康。将这些干预措施结合起来可以为儿童的口腔健康结果提供持续的改善，尽管目前的证据较弱。需要更多高质量的研究来证实这些发现，并确定产前和/或产后期间最适合实施这些干预措施。
