Preventive Strategies for Early Childhood Caries (ECC) from Antenatal to age 24 months

This project aims to determine the best preventive methods for ECC by assessing variations of strategies. The strategies that will be used are • Education classes to antenatal and new parent groups • Preventive agents – participants will be randomly assigned to the following groups: toothbrushing with low-dose fluoride toothpaste, toothbrushing with 0.2 percent chlorhexidine gel, and toothbrushing with casein-phosphoprotein gel (CPP-ACP, Tooth Mousse) • Support through home visits and phone calls The effectiveness of these strategies will be assessed through • Pre and post questionnaires including dental knowledge, feeding practices and oral hygiene practices • Microbial analysis for the presence of decay-causing bacteria (blinded) • Dental screen analysis of participants having home visits (calibrated operators, not blinded) • Dental screen analysis at the 2 year recall (blinded) • Statistical analysis of data for case and control groups Participants will be recruited either from antenatal classes, pre-registration for maternity ward or new parent classes. All participants will be recalled when their child is approximately 6-9 months, 9-12 months and 15-18 months either through the home visit or by telephone. All will be asked to attend an appointment at the 24-26 month recall with their child. Swab samples of the teeth and gums will be taken and tested for the presence of decay-causing bacteria (mutans streptococci) and general oral bacteria in which participants will be informed of the results. The Mother’s teeth will be wiped with sterile cotton-tipped swabs at the initial contact, when the child is born and at the final recall. Those who wish to participate in home visits will also have their teeth swabbed at the 6-9 month period and their child’s teeth will be swabbed when their child is 6-9 months, 9-12 months and 15-18 months. Resources such as toothbrushes and preventive products will be supplied free of charge for the duration of participation or until the child is 24-26 months.