Home Visits Help Stop Toddler Tooth Decay
January 16, 2013

By Nancy Volkers
InteliHealth News Service

INTELIHEALTH - Home visits to new mothers can reduce the risk of tooth decay in their babies, says an Australian study.

The study enrolled 315 new mothers. All of them were recruited at public health clinics in a low-income area of Queensland, Australia. They were divided into two groups:

• Home visit group - 236 women
• Telephone group - 89 women

Each woman was assigned to a group, but before the study started, she could switch to the other group if she wished. Researchers made sure the two groups were similar in ways that might affect study results. These included the parents' education levels, family income, immigrant status and levels of decay-causing bacteria in the mothers' mouths.

Women in the home visit group were visited when their babies were 6 months, 12 months and 18 months old. Each visit lasted 30 minutes. Two oral health therapists asked the mothers questions about oral care. They examined each child's mouth and talked with the mothers about how to prevent tooth decay. They also took mouth swabs from each child. Women were given toothbrushes and toothpaste to use.

Women in the telephone group received a phone call when their babies were 6 months, 12 months and 18 months old. Oral health therapists asked the same questions and offered the same information as the home visit group received. Toothbrushes and toothpaste were mailed to the families.

At 24 months, all mothers and children visited a community dental clinic for exams. Of the women enrolled in the study, 188 in the home-visit group and 58 in the telephone group completed the study.

The researchers also enrolled a reference group of women. These women had babies who were about the same age as the ones in the study. Their children were examined at 24 months of age.

The researchers found:

• In the home visit group, 1.5% of the children had tooth decay by 24 months of age. This compared with 6.8% of children in the telephone group and 22.5% of children in the reference group.
• Children in the home-visit group had lower levels of Streptococcus mutans bacteria in their mouths. These bacteria are necessary for tooth decay to form.
• At 6 months, there were no differences among groups in bottle-feeding versus breastfeeding. The groups also were similar in whether and how often the children's teeth were brushed. By 24 months, women in the home-visit and telephone groups were:
  • Less likely to put their infants to bed with a bottle (for naps or at bedtime)
  • More likely to brush their child's teeth
  • More likely to brush their child's teeth at least twice a day
  • More likely to finish brushing even when the child did not cooperate

The children in the home-visit group were less likely to have tooth decay, even though mothers' behavior in the home-visit group was similar to that of mothers in the telephone group. The researchers say this is probably because the oral health therapists could instruct mothers in person about how to brush their children's teeth. In the telephone group, oral health therapists were not able to show brushing techniques in person.

The study appears in the January issue of the International Journal of Paediatric Dentistry.