The impact of anticipatory guidance on early childhood caries: a quasi-experimental study

Azhani Ismail, Ishak A Razak, Norintan Ab-Murat, Azhani Ismail, Ishak A Razak, Norintan Ab-Murat

Abstract

Background: This study evaluated the impact of anticipatory guidance on the caries incidence of 2-3-year-old preschool children and their 4-6-year-old siblings, as well as on their mothers' oral health literacy, as compared to the conventional Ministry of Health (MOH) programme.

Methods: This quasi-experimental study was conducted at two government dental clinics in Batu Pahat District, Malaysia. The samples comprised of 478 mother-child-sibling trios (233 families in the intervention group, and 245 families in the control group). An oral health package named the Family Dental Wellness Programme (FDWP) was designed to provide dental examinations and oral health education through anticipatory guidance technique to the intervention group at six-month intervals over 3 years. The control group received the standard MOH oral health education activities. The impact of FDWP on net caries increment, caries prevented fraction, and mother's oral health literacy was assessed after 3 years of intervention.

Results: Children and siblings in the intervention group had a significantly lower net caries increment (0.24 ± SD0.8; 0.20 ± SD0.7) compared to the control group (0.75 ± SD1.2; 0.55 ± SD0.9). The caries prevented fraction for FDWP was 68% for the younger siblings and 63.6% for the older children. The 2-3-year-old children in the intervention group had a significantly lower incidence of white spot lesions than their counterpart (12% vs 25%, p < 0.05). At three-year follow-up, there were significant increments in the oral health literacy scores of mothers in the intervention group compared to the control group.

Conclusion: The FDWP is more effective than the standard MOH programme in terms of children's and siblings' caries incidence and mother's oral health literacy.

Trial registration: ClinicalTrials.gov NCT03478748 . Registered on March 26th 2018. Retrospectively registered.

Keywords: Anticipatory guidance; Early childhood caries; Oral health education; Oral health literacy.

Conflict of interest statement

Ethics approval and consent to participate

Ethical approval was obtained from the Medical Ethics Committee, Faculty of Dentistry, University of Malaya (DFCO1505/0005P) and the Medical Research Ethics Committee, Ministry of Health (NMRR-14-1680-23,783), and the research was conducted in full accordance with the World Medical Association Declaration of Helsinki. Permission to conduct the study was obtained from the Principal Director of Oral Health Division, Malaysia. Written consent was obtained from all mothers of the young children enrolled in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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