Suraj Abdulkarim, Stephen John, Tomon Garba, Hunpiya Basason, Paul Balogun, Joseph Kuye
Perceptions of TB-HIV comorbidity among the Nomads in Adamawa State, Nigeria
BMC public health
dental caries common chronic disease childhood associated adverse health economic consequences infants families socioeconomically disadvantaged children higher risk early childhood caries ecc review updates one published 2019 assess effects interventions undertaken pregnant women new mothers primary caregivers infants first year life preventing ecc birth six years searched cochrane oral healths trials register cochrane pregnancy childbirths trials register central medline ovid embase ovid cinahl ebsco us national institutes health ongoing trials register clinicaltrialsgov international clinical trials registry platform appswhointtrialsearch latest searches run 3 january 2023 randomised controlled trials rcts comparing interventions pregnant women new mothers primary caregivers infants first year life standard care placebo another intervention reporting primary outcome caries presence primary teeth dmfs decayed missing filled primary surfaces index dmft decayed missing filled teeth index children six years age intervention types include clinical oral health promotioneducation hygiene education breastfeeding dietary advice policy service two review authors independently assessed study eligibility extracted data assessed risk bias assessed certainty evidence grade included 23 rcts 5 clusterrandomised involving 25953 caregivers mainly mothers children fifteen trials assessed oral health educationpromotion interventions standard care six trials assessed clinical intervention mother dentition placebo different type clinical intervention two trials assessed oral healtheducation promotion plus clinical intervention mothers dentition standard care five trials maximum 1326 children 130 mothers contributed data comparison enamelonly caries included diagnosis caries studies many trials risk bias unclear due lack methodological details reported thirteen trials participants socioeconomically disadvantaged trial indicated receiving funding likely influenced results oral health educationpromotion interventions child diet feeding practice advice versus standard care observed probable 15 per cent reduced risk caries presence primary teeth intervention rr 085 95 ci 075 097 3 trials 782 participants moderatecertainty evidence may slightly lower mean dmfs md 029 95 ci 058 0 2 trials 757 participants lowcertainty evidence however evidence uncertain regarding difference groups mean dmft md 090 95 ci 185 005 1 trial 340 participants lowcertainty evidence breastfeeding promotion support versus standard care observed little difference groups risk caries presence primary teeth rr 096 95 ci 089 103 2 trials 1148 participants lowcertainty evidence mean dmft md 012 95 ci 059 036 2 trials 652 participants lowcertainty evidence dmfs reported child diet advice compared standard care uncertain effect risk caries presence primary teeth rr 108 95 ci 034 337 1 trial 148 participants lowcertainty evidence dmfs dmft reported oral hygiene child diet feeding practice advice versus standard care evidence uncertain effect risk caries presence primary teeth rr 073 95 ci 050 107 5 trials 1326 participants lowcertainty evidence maybe little difference mean dmfs md 087 95 ci 218 043 2 trials 657 participants lowcertainty evidence mean dmft md 030 95 ci 096 036 1 trial 187 participants lowcertainty evidence highdose versus lowdose vitamin supplementation pregnancy uncertain effect risk caries presence primary teeth rr 099 95 ci 070 141 1 trial 496 participants lowcertainty evidence dmfs dmft reported clinical interventions mother dentition chlorhexidine chx commonly prescribed antiseptic agent iodinenaf application prophylaxis versus placebo uncertain regarding difference risk caries presence primary teeth antimicrobial placebo treatment mother dentition rr 097 95 ci 080 119 3 trials 479 participants lowcertainty evidence trial reported dmfs dmft xylitol compared chx antimicrobial treatment uncertain effect caries presence primary teeth rr 062 95 ci 027 139 1 trial 96 participants lowcertainty evidence observed may lower mean dmft xylitol md 239 95 ci 410 068 1 trial 113 participants lowcertainty evidence trial reported dmfs oral health educationpromotion plus clinical interventions mother dentition diet feeding practice advice infants young children plus basic dental care mothers compared standard care uncertain effect risk caries presence primary teeth rr 044 95 ci 005 395 2 trials 324 participants lowcertainty evidence mean dmft 1 study estimable trial reported dmfs trials evaluated policy health service interventions moderatecertainty evidence providing advice diet feeding pregnant women mothers caregivers children age one year probably leads slightly reduced risk early childhood caries ecc remaining evidence low verylow certainty insufficient determining intervention types features may effective preventing ecc settings large highquality rcts oral health educationpromotion clinical policy service access interventions warranted determine effects relative effects different interventions inform practice identified 13 ongoing studies future studies consider effects modified intervention features participant characteristics including socioeconomic status