Early Childhood Caries Prevention at a Pediatric Clinic

NCT ID: NCT00497029

Last Updated: 2023-05-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

219 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-06-30

Study Completion Date

2006-08-31

Brief Summary

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This purpose of this study was to evaluate effectiveness of a risk-based dental caries prevention program conducted by dental personnel at an urban pediatric primary care clinic serving largely low-income residents of Baltimore, Maryland, and to appraise this program as a model for similar urban pediatric settings.

Detailed Description

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A demonstration caries prevention trial lasting 26 months was conducted with a total of 219 children aged 6 to 27 months of age. The "prevention" group consisting of children 6-15 months of age at their initial visit were compared at the end of the trial with a "comparison" group at their initial visit. The comparison group was 12 months older than the enrollment age of the prevention group (18-27 months) and had not received previous routine professional dental care. Interventions were dental examination and periodic recalls, caries-risk assessments, monitoring of oral mutans streptococci (MS) levels, application of 5.0% sodium fluoride varnish to teeth, dental health counseling to care-givers, referral for dental treatment if indicated and periodic recalls.

Outcome measures were: 1) number of decayed, missing, filled primary tooth surfaces, 2) number of pre-carious lesions, 3) counts of oral MS and 3) care-giver responses to a questionnaire about the child's diet and home care.

Prevention group children at the last recall experienced fewer mean carious dental surfaces (0.1 vs. 1.29, p\<0.014) and over 8-fold less MS (p\<0.013) than comparison group subjects at the initial visit. The number of precarious lesions, however, were not significantly different. In the absence of carious or precarious lesions, oral levels of MS was a reliable indicator of caries risk status, particularly for low risk subjects (sensitivity, 0.64; specificity, 0.98). Caregiver reports of dietary practices and presence or absence of visible dental plaque also served as caries-risk determinants.

Conditions

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Dental Caries

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Interventions

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fluoride varnish

Intervention Type DRUG

patient education

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* children in good health who were dentate and 6-27 months
* a signed informed consent

Exclusion Criteria

* antibiotic usage within the previous 14 days
* oral topical fluoride administration within the previous 7 days
* previous routine professional dental care
Minimum Eligible Age

6 Months

Maximum Eligible Age

27 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Maryland, Baltimore

OTHER

Sponsor Role lead

Principal Investigators

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Glenn E Minah, DDS, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Biomedical Sciences, University of Maryland Dental School

Lindsey K Grossman, MD

Role: STUDY_DIRECTOR

Department of Pediatrics, University of Maryland School of Medicine

Locations

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University of Maryland Medical Center: Pediatric Ambulatory Center

Baltimore, Maryland, United States

Site Status

Countries

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United States

References

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Newacheck PW, Hughes DC, Hung YY, Wong S, Stoddard JJ. The unmet health needs of America's children. Pediatrics. 2000 Apr;105(4 Pt 2):989-97.

Reference Type BACKGROUND
PMID: 10742361 (View on PubMed)

Gomez SS, Weber AA. Effectiveness of a caries preventive program in pregnant women and new mothers on their offspring. Int J Paediatr Dent. 2001 Mar;11(2):117-22. doi: 10.1046/j.1365-263x.2001.00255.x.

Reference Type BACKGROUND
PMID: 11310134 (View on PubMed)

Weintraub JA, Ramos-Gomez F, Jue B, Shain S, Hoover CI, Featherstone JD, Gansky SA. Fluoride varnish efficacy in preventing early childhood caries. J Dent Res. 2006 Feb;85(2):172-6. doi: 10.1177/154405910608500211.

Reference Type BACKGROUND
PMID: 16434737 (View on PubMed)

Recommendations for using fluoride to prevent and control dental caries in the United States. Centers for Disease Control and Prevention. MMWR Recomm Rep. 2001 Aug 17;50(RR-14):1-42.

Reference Type BACKGROUND
PMID: 11521913 (View on PubMed)

American Dental Association Council on Scientific Affairs. Professionally applied topical fluoride: evidence-based clinical recommendations. J Am Dent Assoc. 2006 Aug;137(8):1151-9. doi: 10.14219/jada.archive.2006.0356.

Reference Type BACKGROUND
PMID: 16873333 (View on PubMed)

Rozier RG, Sutton BK, Bawden JW, Haupt K, Slade GD, King RS. Prevention of early childhood caries in North Carolina medical practices: implications for research and practice. J Dent Educ. 2003 Aug;67(8):876-85.

Reference Type BACKGROUND
PMID: 12959161 (View on PubMed)

Bader JD, Rozier RG, Lohr KN, Frame PS. Physicians' roles in preventing dental caries in preschool children: a summary of the evidence for the U.S. Preventive Services Task Force. Am J Prev Med. 2004 May;26(4):315-25. doi: 10.1016/j.amepre.2003.12.001.

Reference Type BACKGROUND
PMID: 15110059 (View on PubMed)

Douglass JM, Douglass AB, Silk HJ. Infant oral health education for pediatric and family practice residents. Pediatr Dent. 2005 Jul-Aug;27(4):284-91.

Reference Type BACKGROUND
PMID: 16317967 (View on PubMed)

Grindefjord M, Dahllof G, Nilsson B, Modeer T. Prediction of dental caries development in 1-year-old children. Caries Res. 1995;29(5):343-8. doi: 10.1159/000262090.

Reference Type BACKGROUND
PMID: 8521434 (View on PubMed)

Barsamian-Wunsch P, Park JH, Watson MR, Tinanoff N, Minah GE. Microbiological screening for cariogenic bacteria in children 9 to 36 months of age. Pediatr Dent. 2004 May-Jun;26(3):231-9.

Reference Type BACKGROUND
PMID: 15185804 (View on PubMed)

Alaluusua S, Renkonen OV. Streptococcus mutans establishment and dental caries experience in children from 2 to 4 years old. Scand J Dent Res. 1983 Dec;91(6):453-7. doi: 10.1111/j.1600-0722.1983.tb00845.x.

Reference Type BACKGROUND
PMID: 6581521 (View on PubMed)

Kohler B, Andreen I, Jonsson B. The earlier the colonization by mutans streptococci, the higher the caries prevalence at 4 years of age. Oral Microbiol Immunol. 1988 Mar;3(1):14-7. doi: 10.1111/j.1399-302x.1988.tb00598.x. No abstract available.

Reference Type BACKGROUND
PMID: 3268743 (View on PubMed)

Other Identifiers

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Minah-1

Identifier Type: -

Identifier Source: org_study_id

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