Evaluation of an interdisciplinary preventive programme for early childhood caries: findings of a regional German birth cohort study.

Abstract

The aim of this prospective birth cohort study was to evaluate the effect of the interdisciplinary preventive programme (PP) for early childhood caries in 3-year-old children in Germany. From July 2009 to October 2010, all parents of newborns (n=1162) were visited after birth by the communal newborn visiting service of Jena, Thuringia, and advised on general and dental health. In the first year of life, children were invited to a dental examination in Jena University Hospital. Participating children were included in a risk-related recall system with continuous oral care over 3years. Caries-risk assessment tool of the AAPD was used for risk categorizing. High-risk children received fluoride varnish biannual. In 2013, the total birth cohort (participants and non-participants) was invited to evaluate the PP. Dental caries was scored using WHO diagnostic criteria expanded to d1-level without radiography. Data were analysed statistically (multivariate logistic regression). Seven hundred fifty-five children (mean age 3.26±0.51years) were examined. Children in the PP (n=377) showed significantly lower caries prevalence and experience than non-participants (15.6 vs. 37.8%, 0.9±3.3 d1-4mfs vs. 2.6±5.2 d1-4mfs). Lack of vitamin D supplements (OR=1.9, CI 0.99-3.51), familial caries experience (OR=2.2, CI 1.27-3.73) and visible plaque on teeth (OR=6.5, CI 4.41-9.43) were significant risk factors for caries development, whereas regular dental care (OR=0.5, CI 0.38-0.79) had a protective effect. The PP was an effective interdisciplinary approach for preventing early childhood caries in small children. Early dental visits with caries-risk-related preventive dental care are necessary to prevent early childhood caries (ECC). German Clinical Trials Register DRKS00003438, https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00003438.