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Prevention of Early Childhood Caries (ECC) Review of literature published 1998–2007

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Summary

Aim: This was to examine the literature published during the last decade and review the effectiveness of methods used for the prevention of early childhood caries (ECC). Study design: A critical review of papers. Methods: A br search of the PubMed database was conducted from 1998 through September 2007, using “early childhood caries”, “baby bottle tooth decay”, “nursing caries”, “infant caries”, “caries prevention” and “oral health education” as index terms. Relevant papers published in English between 1998 and 2007 were identified after a review of their abstracts. Papers were selected if they reported a prospective controlled design with preventive or non-invasive intervention directed to children under the age of 3 years. A defined end-point measure of cavitated or non-cavitated clinical caries, expressed as incidence or prevalence, was required. The targeted publications were critically assessed by the author concerning design, methodology and performance. Results: The initial search revealed 66 papers of which 22 met the inclusion criteria. The results reinforced the role of fluoride toothpaste as the most cost-effective homecare measure and semi-annual fluoride varnish applications as the best professional method for infants at risk. The evidence concerning the preventive effect of antibacterial agents, primary-primary prevention and dental health education were inconclusive but the included studies supported the importance of early start, outreach activities and motivational interviewing as key factors to overcome cultural and socioeconomic barriers. Conclusions: Although there is a body of evidence for the use of fluoride in preventing ECC, further high-quality studies are needed to further establish the best way to maintain oral health in infants.

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References

  • Aaltonen AS, Suhonen JT, Tenovuo J, Inkila-Saari I. Efficacy of a slow-release device containing fluoride, xylitol and sorbitol in preventing infant caries. Acta Odontol Scand 2000;58:285–92.

    Article  PubMed  Google Scholar 

  • Agency for Health Care Policy and Research. Woolf SH, editor. Manual for conducting systematic reviews. Rockville (MD): AHCPR; 1992

  • Alsada LH, Sigal MJ, Limeback H, Fiege J, Kulkarni GV. Development and testing of an audio-visual aid for improving infant oral health through primary caregiver education. J Can Dent Assoc 2005;71:241–45.

    PubMed  Google Scholar 

  • American Dental Association Council on Scientific Affairs: Professionally applied topical fluoride. Evidence-based clinical recommendations. J Amer Dent Assoc 2006;13:1151–59.

    Google Scholar 

  • Amin MS, Harrison RL, Benton TS, Roberts M, Weinstein P. Effect of povi-done-iodine on Streptococcus mutans in children with extensive dental caries. Pediatr Dent 2004;26:5–10.

    PubMed  Google Scholar 

  • Ammari JB, Baqain ZH, Ashley PF. Effects of programs for prevention of early childhood caries. A systematic review. Med Princ Pract 2007;16:437–442.

    Article  PubMed  Google Scholar 

  • Brambilla E, Felloni A, Gagliani M, et al. Caries prevention during pregnancy: results of a 30-month study. J Am Dent Assoc 1998;129:871–77.

    PubMed  Google Scholar 

  • Chadwick BL, Treasure ET, Playle RA. A randomised controlled trial to determine the effectiveness of glass ionomer sealants in pre-school children. Caries Res 2005;39:34–40.

    Article  PubMed  Google Scholar 

  • Davies GM, Worthington HV, Ellwood RP, et al. A ramdomized controlled trial of the effectiveness of providing free fluoride toothpaste from the age of 12 months on reducing caries in 5–6 year old children. Community Dent Health 2002;19:131–136.

    PubMed  Google Scholar 

  • Davies GM, Duxbury JT, Boothman NJ, Blinkhorn AS. A staged intervention dental health programme to reduce early childhood caries. Community Dent Health 2005;22:118–122.

    PubMed  Google Scholar 

  • Davies GM, Duxbury JT, Boothman NJ, Davies RM. Challenges associated with the evaluation of a dental health promotion program in a deprived area. Community Dent Health 2007;24:117–21.

    PubMed  Google Scholar 

  • Egger M, Juni P, Bartlett C, Holenstein F, Sterne J. How important are comprehensive literature searches and the assessment of trial quality in systematic reviews? Empirical study. Health Technol Assess 2003;7:1–76.

    PubMed  Google Scholar 

  • Ercan E, Dulgergil CT, Yildirim I, Dalli M. Prevention of maternal bacterial transmission on children’s dental-caries-development: 4-year results of a pilot study in a rural-child population. Arch Oral Biol 2007;52:748–752.

    Article  PubMed  Google Scholar 

  • Feldens CA, Vitolo MR, Drachler ML. A randomised trial of the effectiveness of home visits in preventing early childhood caries. Community Dent Oral Epidemiol 2007;35:215–223.

    Article  PubMed  Google Scholar 

  • Gomez SS, Weber AA. Effectiveness of a caries preventive program in pregnant women and new mothers on their offspring. Int J Peadiatr Dent 2001;11:117–122.

    Article  Google Scholar 

  • Gomez SS, Weber AA, Emilson CG. A prospective study of a caries prevention program in pregnant women and their children five and six years of age. J Dent Child 2001;68:191–195.

    Google Scholar 

  • Günay H, Dmoch-Bockhorn K, Günay Y, Geurtsen W. Effect on caries experience of a long-term preventive program for mothers and children starting during pregnancy. Clin Oral Investig 1998;2:137–142.

    Article  PubMed  Google Scholar 

  • Gussy MG, Waters EG, Walsh O, Kilpatrick NM. Early childhood caries: Current evidence for aetiology and prevention. J Paediatr Child Health 2006;42:37–43.

    Article  PubMed  Google Scholar 

  • Ismail AI. Prevention of early childhood caries. Community Dent Oral Epidemiol 1998;26:Supplement 1:49–61.

    Google Scholar 

  • Isokangas P, Söderling E, Pienihäkkinen, Alanen P. Occurrence of dental decay in children after maternal consumption of xylitol chewing gum. A follow-up from 0 to 5 years of age. J Dent Res 2000;79:1885–1889.

    Article  PubMed  Google Scholar 

  • Kowash MB, Pinfield A, Smith J, Curzon MEJ. Effectiveness on oral health of a long-term health education programme for mothers with young children. Br Dent J 2000;188:201–205.

    PubMed  Google Scholar 

  • Kowash MB, Toumba KJ, Curzon MEJ. Cost-effectiveness of a long-term dental health education program for the prevention of early childhood caries. Eur Arch Paediatr Dent 2006;7:130–135.

    Article  PubMed  Google Scholar 

  • Lin YT, Tsai CL. Comparative anti-caries effects of tablet and liquid fluorides in cleft children. J Clin Dent 2000;11:104–106.

    PubMed  Google Scholar 

  • Livny A, Sgan-Cohen HD. A review of a community program aimed at preventing early childhood caries among Jerusalem infants—a brief communication. J Public Health Dent 2007;67:78–82.

    Article  PubMed  Google Scholar 

  • Lopez L, Berkowitz R, Zlotnik H, Moss M, Weinstein P. Topical antimicrobial therapy in the prevention of dental caries. Pediatr Dent 1999;21:9–11.

    PubMed  Google Scholar 

  • Lopez L, Berkowitz R, Spiekerman C, Weinstein P. Topical antimicrobial therapy in the prevention of early childhood caries: a follow-up report. Pediatr Dent 2002;24:204–206.

    PubMed  Google Scholar 

  • Marinho VC, Higgins JP, Sheiham A, Logan S. Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2003;(1):CD002278.

  • Martignon S, González MC, Santamaria RM, et al. Oral-health workshop targeted at 0–5-yr. old deprived children’s parents and caregivers: effect on knowledge and practices. J Clin Pediatr Dent 2006;31:104–108.

    PubMed  Google Scholar 

  • Näse L, Hatakka K, Savilahti E, et al. Effect of long-term consumption of a probiotic bacterium, Lactobacillus rhamnosus GG, in milk on dental caries and caries risk in children. Caries Res 2001;35:412–420.

    Article  PubMed  Google Scholar 

  • Petersson LG, Twetman S, Dahlgren H, et al. Professional fluoride varnish treatment for caries control: a systematic review of clinical trials. Acta Odontol Scand 2004;62:170–176.

    Article  PubMed  Google Scholar 

  • Peretz B, Gluck G. Early childhood caries (ECC): a preventive-conservative treatment mode during a 12-month period. J Clin Pediatr Dent 2006;30:191–194.

    PubMed  Google Scholar 

  • Plozitza B, Kneist S, Berger J, Hetzer G. Efficacy of chlorhexidine varnish applications in the prevention of early childhood caries. Eur J Paediatr Dent 2005;6:149–154.

    Google Scholar 

  • Quinonez RB, Stearns SC, Talekar BS, Rozier RG, Downs SM. Simulating cost-effectiveness of fluoride varnish during well-child visits for Medicaid-enrolled children. Arch Pediatr Adolesc Med 2006;160:164–170.

    Article  PubMed  Google Scholar 

  • Rong WS, Bian JY, Wang WJ, Wang WD. Effectiveness of an oral health education and caries prevention program in kindergartens in China. Community Dent Oral Epidemiol 2003;31:412–416.

    Article  PubMed  Google Scholar 

  • Schwartz E, Lo EC, Wong MC. Prevention of early childhood caries — results of a fluoride toothpaste demonstration trial in Chinese preschool children after three years. J Public Health Dent 1998;58:12–18.

    Article  Google Scholar 

  • Sgan-Cohen HD, Mansbach IK, Haver D, Gofin R. Community-oriented oral health promotion for infants in Jerusalem: evaluation of a program trial. J Public Health Dent 2001;61:107–113.

    Article  PubMed  Google Scholar 

  • Tavener JA, Davies GM, Davies RM, Ellwood R. The prevalence and severity of fluorosis in children who received toothpaste containing either 440 or 1,450 ppm F from the age of 12 moths in deprived and less deprived communities. Caries Res 2006;40-66-72.

  • Thorild I, Lindau B, Twetman S. Caries in 4-year-old children after maternal chewing of gums containing combinations of xylitol, sorbitol, chlorhexidine and fluoride. Eur Arch Paediatr Dent 2006;7:241–245.

    Article  PubMed  Google Scholar 

  • Türksel Dülgergil C, Satici O, Yildirim I, Yavuz I. Prevention of caries in children by preventive and operative dental care for mothers in rural Anatolia, Turkey. Acta Odontol Scand 2004;62:251–257.

    Article  PubMed  Google Scholar 

  • Twetman S. Antimicrobials in future caries control? A review with specific reference to chlorhexidine treatment. Caries Res 2004;38:223–229.

    Article  PubMed  Google Scholar 

  • Twetman S, Axelsson S, Dahlgren H, et al. Caries-preventive effect of fluoride toothpaste: a systematic review. Acta Odontol Scand 2003;61:347–355.

    Article  PubMed  Google Scholar 

  • Weinstein P, Harrison R, Benton T. Motivating parents to prevent caries in their young children. One-year findings. J Am Dent Assoc 2004;135:731–738.

    PubMed  Google Scholar 

  • Weinstein P, Harrison R, Benton T. Motivating mothers to prevent caries: confirming the beneficial effect of counselling. J Am Dent Assoc 2006;137:789–793.

    PubMed  Google Scholar 

  • Weintraub JA, Ramos-Gomez F, Jue B, et al. Fluoride varnish efficiency in preventing early childhood caries. J Dent Res 2006;85:172–176.

    Article  PubMed  Google Scholar 

  • Wennhall I, Mårtensson EM, Sjunnesson I, et al. The preventive effect of an oral health program for preschool children in a low socio-economic, multicultural area in Sweden: results after one year. Acta Odontol Scand 2005;63:163–167.

    Article  PubMed  Google Scholar 

  • Vachirarojpisan T, Shinada K, Kawaguchi Y. The process and outcome of a programme for preventing early childhood caries in Thailand. Community Dent Health 2005;22:253–259.

    PubMed  Google Scholar 

  • You BJ, Jian WW, Sheng RW, et al. Caries prevention in Chinese children with sodium fluoride dentifrice delivered through a kindergarten-based oral health program in China. J Clin Dent 2002;13:179–184.

    PubMed  Google Scholar 

  • Zanata RL, Navarro MF, Pereira JC, et al. Effect of caries preventive measures directed to expectant mothers on caries experience in their children. Braz Dent J 2003;14:75–81.

    Article  PubMed  Google Scholar 

  • Zhan L, Featherstone JD, Gansky SA, et al. Antibacterial treatment needed for severe early childhood caries. J Public Health Dent 2006;66:173–179.

    Article  Google Scholar 

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Twetman, S. Prevention of Early Childhood Caries (ECC) Review of literature published 1998–2007. Eur Arch Paediatr Dent 9, 12–18 (2008). https://doi.org/10.1007/BF03321590

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