Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia.
Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia.
Community Dent Oral Epidemiol. 2021 Jun;49(3):275-283. doi: 10.1111/cdoe.12599. Epub 2020 Nov 16.
To critically evaluate an early childhood caries (ECC) intervention performed by non-dental primary healthcare providers.
This mixed-methods investigation includes data from three sources: (a) a pilot non-randomized controlled trial to examine clinical outcomes at four health centres; (b) stakeholder focus group interviews; and (c) a survey of parents whose children were exposed to the intervention. The pilot study involved four Community Health Centres in rural Cambodia whereby mother-child (6-24 months of age)dyads received oral health education (OHE), toothbrushes, fluoride toothpaste and fluoride varnish on up to six occasions as part of the routine vaccination schedule. Outcomes were as follows: presence of ECC; impacts on oral health-related quality of life (OHRQoL); stakeholder perceptions of intervention delivery; and parental perceptions of fluoride varnish.
Participants in the intervention group had six times lower odds of developing ECC than those in the comparison group after controlling for socio-economic status (OR 0.13). Those in the intervention group also had a large reduction OHRQoL scale scores. Key knowledge and practice gaps were identified among stakeholders. Surveyed parents had favourable views of the fluoride varnish placement by medical professionals, and four out of five stated that they would recommend fluoride varnish for other children. Primary healthcare providers, commune council representatives and community health promoters supported oral health interventions being provided in CHCs.
OHE and fluoride varnish interventions provided by non-dental primary health workers were feasible and acceptable for stakeholders in a Cambodian setting. The intervention group had lower ECC experience and better OHRQoL at 2 years of age.
批判性评估非牙科初级保健提供者进行的幼儿龋病（ECC）干预措施。
本混合方法研究包括三个来源的数据：（a）一项在四个保健中心进行的初步非随机对照试验，以检查临床结果；（b）利益相关者焦点小组访谈；（c）对接触过干预措施的儿童的父母进行的调查。该试点研究涉及柬埔寨农村的四个社区卫生中心，6-24 个月大的母婴（儿童）接受口腔健康教育（OHE）、牙刷、含氟牙膏和氟化物涂料，最多可达六次，作为常规疫苗接种计划的一部分。结果如下：ECC 的存在；对口腔健康相关生活质量（OHRQoL）的影响；利益相关者对干预措施的看法；以及父母对氟化物涂料的看法。
在控制社会经济地位后，干预组发生 ECC 的可能性是对照组的六分之一（OR 0.13）。干预组的 OHRQoL 量表评分也大幅降低。利益相关者发现了关键的知识和实践差距。接受调查的父母对医疗专业人员放置氟化物涂料持赞成态度，五分之四的人表示他们会向其他孩子推荐氟化物涂料。初级保健提供者、公社理事会代表和社区卫生促进者支持在 CHC 提供口腔保健干预措施。
在柬埔寨环境中，非牙科初级卫生工作者提供的口腔健康教育和氟化物涂料干预措施是可行和可接受的。干预组在 2 岁时 ECC 发生率较低，OHRQoL 较好。
