Abstract
BackgroundRural, low-income pregnant women and their children are at high risk for poor oral health and have low utilization rates of dental care. The Baby Smiles study was designed to increase low-income pregnant women’s utilization of dental care, increase young children’s dental care utilization, and improve home oral health care practices.Methods/designBaby Smiles was a five-year, four-site randomized intervention trial with a 2 × 2 factorial design. Four hundred participants were randomly assigned to one of four treatment arms in which they received either brief Motivational Interviewing (MI) or health education (HE) delivered during pregnancy and after the baby was born. In the prenatal study phase, the interventions were designed to encourage dental utilization during pregnancy. After childbirth, the focus was to utilize dental care for the infant by age one. The two primary outcome measures were dental utilization during pregnancy or up to two months postpartum for the mother, and preventive dental utilization by 18 months of age for the child. Medicaid claims data will be used to assess the primary outcomes. Questionnaires were administered at enrollment and 3, 9 and 18 months postpartum (study end) to assess mediating and moderating factors.DiscussionThis trial can help define the most effective way to provide one-on-one counseling to pregnant women and new mothers regarding visits to the dentist during pregnancy and after the child is born. It supports previous work demonstrating the potential of reducing mother-to-child transmission of Streptococcus mutans and the initiation of dental caries prevention in early childhood.Trial registrationClinicalTrials.gov Identifier NCT01120041
Highlights
Rural, low-income pregnant women and their children are at high risk for poor oral health and have low utilization rates of dental care
This trial can help define the most effective way to provide one-on-one counseling to pregnant women and new mothers regarding visits to the dentist during pregnancy and after the child is born. It supports previous work demonstrating the potential of reducing mother-to-child transmission of Streptococcus mutans and the initiation of dental caries prevention in early childhood
Low-income women who report being in good dental health, and who believe in the benefit of dental care for their children, are more likely to have a usual source of dental care for themselves than are women who report both poor oral health and more negative attitudes toward pediatric dental care [1]
Summary
The prevalence of Early Childhood Caries among disadvantaged North American populations ranges from 17-61% [44,45,46,47] and is as high as 87% among preschoolers living in rural communities [48,49,50,51]. Clinicians’ attempts to educate parents about the importance of children’s oral health have had mixed success and the two studies using Motivational Interviewing [16,20,21] obtained different results The results of this trial should provide guidance for implementing brief cognitive interventions that may be more effective. We used a carefully-scripted approach to both the MI and HE interventions We did this because the interventionists had little or no previous training or experience with oral health of pregnant women or young children. PW was a co-author of the formal study protocol and contributed to the paper. CEH was a co-author of the formal study protocol and contributed to the paper. All of the authors reviewed and approved the final version of the paper
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