Provider knowledge increased after session teaching pediatricians to use patient centered counseling
Providers at the intervention site used more counseling strategies, even after adjustment for sociodemographic characteristics and ECC risk factors.
Children at the intervention site had a 77% reduction in risk for developing ECC at follow up, after controlling for age and race/ethnicity, sociodemographics and ECC risk factors; p < .004. (unadjusted follow up rates of ECC: 17.7% vs. 31.7%)
Minah, et al. Early Childhood Caries Prevention at an Urban Pediatric Clinic. Pediatric Dentistry 30:211-216, 2008 . Objectives: To evaluate an early childhood caries (ECC) prevention program for infants and toddlers using microbial screening as a primary caries risk assessment (CRA) tool. Methods : Prevention group: 109 dentate children aged 6-15 mos. at the initial visit, who presented at an inner-city well-child clinic in Baltimore, MD for medical check-ups. They received F varnish at counseling at least every 6 months. Comparison group:110 children 12 months older than the prevention group (18-27 mos.) at the same clinic. After 26 mos. the prevention group was compared to the comparison group (initial visit). Results: Prevention group: MS counts 1.8x104 (±7.0 x104), dmfs 0.09(±0.07), 2/109 with clinical caries. Comparison group: MS counts 15.6x104 (±640x104), dmfs 1.13(±3.75), 19/110 with clinical caries . Caries and MS data both were significantly different p<0.02. Evaluation of MS counts to predict caries or no caries longitudinally showed 64% sensitivity and 98% specificity. Conclusions: This program design appears promising for ECC prevention of high risk inner-city populations at well-child or similar facilities
MEAN CARIOUS SURFACES 1.0 0.50 Carious dental surfaces in prevention and comparison group subjects. Comparison group at initial visit. Mean age 22.5 mos. Prevention group at last recall. Mean age 24.3 mos.
15 MEAN MS x 10 4 7.5 MS levels in prevention and comparison group subjects. Comparison group at initial visit. Mean age 22.5 mos. Prevention group at last recall. Mean age 24.3 mos.
Attending Physicians and nurses receive training in patient centered counseling to reduce risk factors for ECC, and office support system to remind them to do the training
Year 2 Study Design Baseline Year 1 24 month olds 36 month olds Caries Exam Mutans test Caries Exam Mutans test FV+PCC FV FV+PCC FV Caries Exam Mutans test Mutans test 12 month olds Caries Exam Mutans test Caries Exam Mutans test FV FV in in in in