Clinical Oral Investigations

, Volume 14, Issue 3, pp 257–264 | Cite as

An early oral health care program starting during pregnancy

Results of a prospective clinical long-term study
Original Article

Abstract

This study covers phase IV of a prospective clinical long-term study. Objective of this clinical investigation was to analyze the effects of a long-term prevention program on dental and oral health of teenagers at the age of 13 to 14 years. The entire study was subdivided into four phases. Phase I comprised an individual preventive care during pregnancy (“primary-primary prevention”); phase II assessed mothers and their young children until the age of 3 years (“primary prevention”); and in phase III, mothers and children at the age of 6 years were investigated. In phase IV of the study, the oral health of 13- to 14-year-old teenagers was examined (13.4 ± 0.5 years; n = 29). All phases consisted of an examination, education about oral health care, and treatment based on the concept of an early oral health care promotion. The control group consisted of randomly selected adolescents at the same age (n = 30). The following clinical parameters were assessed: decayed/missing/filled teeth (DMF-T)/decayed, missing, and filled surface teeth index, hygiene index, papilla bleeding index, Periodontal Screening Index, and Streptococcus mutans/Lactobacillus concentration in saliva. The teenagers of the “prevention” group of phase IV of our prospective study revealed a share of 89.7% caries-free dentitions (65.5% sound; 24.2% caries-free with fillings). Mean DMF-T was 0.55 ± 1.0. The control group showed a significantly higher mean DMF-T of 1.5 ± 1.5 (p < 0.05) and revealed 56.7% of caries-free dentitions (30% sound, 26.7% caries-free with restorations). Our data clearly document that an early oral health care promotion starting during pregnancy may cause a sustained and long-term improvement of the oral health of children.

Keywords

Early oral health care Clinical long-term study Primary-primary-prevention Pregnancy Caries prevalence Adolescents 

Notes

Acknowledgements

The authors wish to thank Vivadent, Ellwangen, Germany for providing CRT®bacteria. Our thanks are due to Dr. L. Hoy at the Institute of Biometry, Hannover Medical School for her assistance and advice in the statistical evaluation.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Adair PM, Pine CM, Burnside G et al (2004) Familial and cultural perceptions and beliefs of oral hygiene and dietary practices among ethnically and socio-economically diverse groups. Com Dent Health 21:102–111Google Scholar
  2. 2.
    Alaluusua S, Renkonen OV (1983) Streptococcus mutans establishment and dental caries experience in children 2–4 years old. Scand J Dent Res 91:453–457PubMedGoogle Scholar
  3. 3.
    Asikainen S, Chen C (2000) (1999) Oral ecology and person-to-person transmission of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Periodontol 20:65–81CrossRefGoogle Scholar
  4. 4.
    Axelsson P, Bockelbrink W (1984) Präventive Zahnmedizin in Schweden. Phillip-J 1:9–14Google Scholar
  5. 5.
    Axelsson P (1989) Präventivzahnmedizinische Programme. Schweiz Monatsschr Zahnmed 99:1045–1048PubMedGoogle Scholar
  6. 6.
    Axelsson P (1990) Prophylaxe: Erfolge in Schweden. Phillip-J 7:146–154PubMedGoogle Scholar
  7. 7.
    Axelsson P, Paulander J, Svärdström G, Tollskog G, Nordenstern S (1994) Umfassende Kariespräventionsergebnisse nach 12 Jahren. Phillip-J 11:533–542Google Scholar
  8. 8.
    Baden A, Schiffner U (2008) Milchzahnkaries bei 3- bis 6-jährigen Kindern im Landkreis Steinburg. Oralprophylaxe 30:70–74Google Scholar
  9. 9.
    Berkowitz RJ, Turner J, Green P (1980) Primary oral infection of infants with Streptococcus mutans. Arch Oral Biol 25:221–224CrossRefPubMedGoogle Scholar
  10. 10.
    Berkowitz RJ (2003) Causes, treatment and prevention of early childhood caries: a microbiologic perspective. J Can Dent Assoc 69:304–307PubMedGoogle Scholar
  11. 11.
    Berkowitz RJ (2003) Acquisition and transmission of mutans streptococci. J Calif Dent Assoc 31:135–138PubMedGoogle Scholar
  12. 12.
    Brambilla E, Felloni A, Gagliani M, Malerba A, Garcia-Godoy F, Stohmenger L (1998) Caries prevention during pregnancy: results of a 30-month study. J Am Dent Assoc 129:871–877PubMedGoogle Scholar
  13. 13.
    Caufield PW, Cutter GR, Dasanayake AP (1993) Initial acquisition of mutans streptococci by infants: evidence of a discrete window of infectivity. J Dent Res 72:33–45Google Scholar
  14. 14.
    Goepel K (1985) Zahngesundheitserziehung während der Schwangerschaft. Med Diss HannoverGoogle Scholar
  15. 15.
    Gomez SS, Weber AA (2001) Effectiveness of a caries preventive program in pregnant women and new mothers on their offspring. Int J Paediatr Dent 11:117–122CrossRefPubMedGoogle Scholar
  16. 16.
    Gomez SS, Weber AA, Emilson CG (2001) A prospective study of a caries prevention program in pregnant women and their children five and six years of age. J Dent Child 68:191–195Google Scholar
  17. 17.
    Gomez SS, Emilson CG, Weber AA, Uribe S (2007) Prolonged effect of a mother–child caries preventive program on a dental caries in the permanent 1st molars in 9 to 10-years-old children. Acta Odontol Scand 65:271–274CrossRefPubMedGoogle Scholar
  18. 18.
    Günay H, Goepel K, Stock KH, Schneller T (1991) Stand der Mundgesundheitserziehung während der Schwangerschaft. Oralprophylaxe 13:1–14Google Scholar
  19. 19.
    Günay H, Jürgens B, Geurtsen W (1996) “Primär-Primär-Prophylaxe“ und Mundgesundheit von Kleinkindern. Dtsch Zahnärztl Z 51:223–226Google Scholar
  20. 20.
    Günay H, Dmoch-Bockhorn K, Günay Y, Geurtsen W (1998) Effect on caries experience of a long-term preventive program for mothers and children starting during pregnancy. Clin Oral Investig 2:137–142CrossRefPubMedGoogle Scholar
  21. 21.
    Günay H, Meyer K, Rahman A (2007) Gesundheitsfrühförderung in der Schwangerschaft-ein Frühpräventionskonzept. Zahnärztl Mitt 97:2348–2358Google Scholar
  22. 22.
    Haker A, Günay H, Geurtsen W (1999) Langzeitprävention und Kariesprävalenz bei Mutter und Kind. Dtsch Zahnärztl Z 54:12Google Scholar
  23. 23.
    van Houte J, Yanover L, Brecher S (1981) Relationship of level of the bacterium Streptococcus mutans in saliva of children and their parents. Arch Oral Biol 26:381–386CrossRefPubMedGoogle Scholar
  24. 24.
    Kneist S, Borutta A, Merte A (2004) Zur Infektionsquelle der Karies. Quintessenz 55:237–242Google Scholar
  25. 25.
    Kneist S, Grimmer S, Harzendorf A, Udhardt a, Senf K, Borutta A (2008) Mundgesundheit von Patienten mit frühkindlicher Karies: Eine klinisch-mikrobiologische Studie. Das deutsche Zahnärzteblatt 117:74–82CrossRefGoogle Scholar
  26. 26.
    Köhler B, Bratthall D (1978) Intrafamilial levels of Streptococcus mutans and some aspects of the bacterial transmission. Scand J Dent Res 86:35–42PubMedGoogle Scholar
  27. 27.
    Köhler B, Andréen Y, Jonsson B (1984) The effect of caries preventive measures in mothers on dental caries and the oral presence of the bacteria Streptococcus mutans and lactobacilli in their children. Arch Oral Biol 29:879–883CrossRefPubMedGoogle Scholar
  28. 28.
    Lapp CA, Thomas ME, Lewis JB (1995) Modulation by progesteron of interleukin-6 production by gingival fibroblasts. J Periodontol 66:279–248PubMedGoogle Scholar
  29. 29.
    Li Y, Caufield PW (1995) The fidelity of initial acquisition of mutans streptococci by infants from their mothers. J Dent Res 74:681–685CrossRefPubMedGoogle Scholar
  30. 30.
    Li Y, Wang W (2002) Predicting caries in permanent teeth from caries in primary teeth: an eight-year cohort study. J Dent res 81:561–566CrossRefPubMedGoogle Scholar
  31. 31.
    van Loveren C (2006) Ernährung und Zahnkaries. Oralprophylaxe 28:76–81Google Scholar
  32. 32.
    Mariotti A (1999) Dental plaque-induced gingival diseases. Ann Periodontol 4:7–17CrossRefPubMedGoogle Scholar
  33. 33.
    Mathaler TM (1990) Changes in the prevalence of dental caries: how much can be attributed to changes in diet? Caries Res 24:3–15CrossRefGoogle Scholar
  34. 34.
    Mejàre I, Stenlund H, Julihn A, Larsson I, Permert 1 (2001) Influence of approximal caries in primary molars on caries rate for the mesial surface of the first permanent molar in Swedish children from 6 to 12 years of age. Caries Res 35:178–185CrossRefPubMedGoogle Scholar
  35. 35.
    Micheelis W, Schiffner U (2006) Vierte Deutsche Mundgesundheitsstudie (DMS IV). Neue Ergebnisse zu oralen Erkrankungsprävalenzen, Risikogruppen und zum zahnärztlichen Versorgungsgrad in Deutschland. Dtsch Zahnärzte Verlag, KölnGoogle Scholar
  36. 36.
    Olds D, Henderson CR, Cole R, Eckenrode J, Kitzman H, Luckey D, Pettitt L, Sidora K, Morris P, Powers J (1998) Long-term effects of nurse home visitation on children's criminal and antisocial behavior: 15-year follow-up of a randomized controlled trial. J Am Med Assoc 280:1238–1244CrossRefGoogle Scholar
  37. 37.
    Pieper K (2005) Epidemiologische Begleituntersuchungen zur Gruppenprophylaxe 2004. Deutsche Arbeitsgemeinschaft für Jugendzahnpflege e.V., BonnGoogle Scholar
  38. 38.
    Pieper K, Jablonski-Momeni A (2008) Prävalenz der Milchzahnkaries in Deutschland. Oralprophylaxe 30:6–10Google Scholar
  39. 39.
    Pistorius J, Kraft J, Willershausen B (2005) Umfrage zum Mundgesundheitsverhalten von Schwangeren Frauen unter besonderer Berücksichtigung psychosozialer Aspekte. Dtsch Zahnärztl Z 60:628–633Google Scholar
  40. 40.
    Raadal M, Espelid I (1992) Caries prevalence in primary teeth as a predictor of early fissure caries in permanent first molars. Community Dent Oral Epidemiol 20:30–34CrossRefPubMedGoogle Scholar
  41. 41.
    Rahman A, Günay H (2006) Awareness of dental and oral health during pregnancy. Ital J Oper Dent Vol 4:255Google Scholar
  42. 42.
    Ramos-Gomez FJ, Weintraub JA, Gansky SA, Hoover CI, Featherstone JD (2002) Bacterial behavioral and environmental factors associated with early childhood caries. J Clin Pediatr Dent 26:165–173PubMedGoogle Scholar
  43. 43.
    Schenk L, Knopf H (2007) Mundgesundheitsverhalten von Kindern und Jugendlichen in Deutschland – erste Ergebnisse aus dem Kinder- und Jugendgesundheitssurvey. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 5/6:653–658Google Scholar
  44. 44.
    Steegmann C, Pratsch P, Effenberger S, Schiffner U (2008) Caries in 3- to 6-year old pre-school children in Hamburg. Abstract, Caries Res 42:199Google Scholar
  45. 45.
    van Steenkiste M, Becher A, Banschbach R, Gaa S, Kreckel S, Pocanschi C (2004) Prävalenz von Karies, Fissurenversiegelung und Füllungsmaterial bei deutschen Kindern und Kindern von Migranten. Gesundheitswesen 66:754–758CrossRefPubMedGoogle Scholar
  46. 46.
    Wan AK, Seow WK, Purdie DM, Bird PS, Tudehope DI, Purdie DM (2001) Association of Streptococcus mutans infection and oral developmental nodules in pre-dentate infants. J Dent Res 80:1945–1948CrossRefPubMedGoogle Scholar
  47. 47.
    Wan AK, Seow WK, Purdie DM, Bird PS, Walsh LJ, Tudehope DI (2001) Oral colonization of Streptococcus mutans in six-month-old predentate infants. J Dent Res 80:2060–2065CrossRefPubMedGoogle Scholar
  48. 48.
    WHO Oral health survey (1997) Basic method 4th ed. GenevaGoogle Scholar
  49. 49.
    van Winkelhoff AJ, Boutaga K (2005) Transmission of periodontal bacteria and models of infection. J Clin Periodontol 6:16–27CrossRefGoogle Scholar
  50. 50.
    Woodward M, Walker ARP (1994) Sugar consumption and dental caries: evidence from 90 countries. Br Dent J 176:297–302CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Karen Meyer
    • 1
  • Werner Geurtsen
    • 1
  • Hüsamettin Günay
    • 1
  1. 1.Department of Conservative Dentistry, Periodontology and Preventive DentistryHannover Medical SchoolHannoverGermany

Personalised recommendations