***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The aim of this study was to evaluate the effect of maternal use of chewing gums containing combinations of xylitol , sorbitol , chlorhexidine , and fluoride on salivary mutans streptococci ( MS ) counts and caries prevalence in the mothers ' 3-year-old children . After screening 416 women with newborn babies , 173 mothers with high counts of salivary MS were r and omly assigned into 3 experimental chewing gum groups containing ( A ) xylitol ( n=61 ) , ( B ) chlorhexidine/xylitol/sorbitol ( n=55 ) , and ( C ) sodium fluoride/xylitol/sorbitol ( n=57 ) . Mothers with low or medium MS counts formed a reference group ( D ) without any intervention ( n=232 ) . The participants in the experimental groups were instructed to chew one piece of the gum for 5 min 3 times a day . The chewing regimen started when the child was 6 months old and was terminated 1 year later . The outcome measures were salivary MS counts and caries prevalence at the age of 3 years . Bacterial enumeration was carried out with a chair-side technique and caries ( defs ) was scored by clinical examination . Medium and high counts of salivary MS were found in 13 % , 16 % , and 22 % in groups A , B , and C , respectively . The mean defs was 0.1 in group A , 0.2 in group B , and 0.4 in group C. The differences concerning salivary MS and caries were not statistically significant . The MS counts and caries prevalence in children of mothers with low MS counts ( group D ) were similar to those found in groups A and B. In conclusion , lower but non-significant levels of salivary MS and dental decay were observed in 3-year-old children to mothers who used high-content xylitol gums compared with those who used lower amounts of xylitol . The efficiency of this type of targeted intervention in a low-caries community may be question ed Background Maaori are the Indigenous people of New Zeal and and do not enjoy the same oral health status as the non-Indigenous majority . To overcome oral health disparities , the life course approach affords a valid foundation on which to develop a process that will contribute to the protection of the oral health of young infants . The key to this process is the support that could be provided to the parents or care givers of Maaori infants during the pregnancy of the mother and the early years of the child . This study seeks to determine whether implementing a kaupapa Maaori ( Maaori philosophical viewpoint ) in an early childhood caries ( ECC ) intervention reduces dental disease burden among Maaori children . The intervention consists of four approaches to prevent early childhood caries : dental care provided during pregnancy , fluoride varnish application to the teeth of children , motivational interviewing , and anticipatory guidance . Methods / design The participants are Maaori women who are expecting a child and who reside within the Maaori tribal area of Waikato-Tainui . This r and omised-control trial will be undertaken utilising the principles of kaupapa Maaori research , which encompasses Maaori leadership , Maaori relationships , Maaori customary practice s , etiquette and protocol . Participants will be monitored through clinical and self-reported information collected throughout the ECC intervention .  Self-report information will be collected in a baseline question naire during pregnancy and when children are aged 24 and 36 months . Clinical oral health data will be collected during st and ardised examinations at ages 24 and 36 months by calibrated dental professionals . All participants receive the ECC intervention benefits , with the intervention delayed by 24 months for participants who are r and omised to the control-delayed arm . Discussion The development and evaluation of oral health interventions may produce evidence that supports the application of the principles of kaupapa Maaori research in the research processes . This study will assess an ECC intervention which could provide a meaningful approach for Maaori for the protection and maintenance of oral health for Maaori children and their family , thus reducing oral health disparities . Trial registration Australia and New Zeal and Clinical Trials Register ( ANZCTR ) : ACTRN12611000111976 Background Poor oral health , such as periodontal ( gum ) disease , has been found to be associated with an increased risk of adverse pregnancy outcomes including preterm birth , low birth weight , and neonatal and infant mortality , especially in low- and middle-income countries . However , there is little or no access to preventive dental care in most low- and middle-income countries . We propose to develop and test a “ Mouth Rinse Intervention ” among pregnant women to prevent the progression of periodontal disease during pregnancy and reduce adverse birth and neonatal outcomes in a rural county of China . Methods / Design This is a r and omized controlled clinical trial . A sample of 468 ( 234 in each arm of the study ) women in early pregnancy with periodontal disease will be recruited for the study . Periodontal disease will be diagnosed through the methods of Periodontal Screening and Recording . All women diagnosed with periodontal disease will be r and omly allocated into the intervention or control group . Women assigned in the intervention group will be provided with non-alcohol antimicrobial mouth rinse containing cetylpyridinium chloride throughout the pregnancy and oral health education . Women in the control group will receive a package of tooth brush and paste , plus oral hygiene education . Women will be followed-up to childbirth until the 42nd day postpartum . The main outcomes include mean birthweight ( gram ) and mean gestational age ( week ) . Discussion Compared with conventional mechanical ‘ scaling and root planning ’ periodontal treatment during pregnancy , our proposed mouth rinse intervention could be a simple , cost-effective , and sustainable solution to improve both mother ’s oral health and neonate outcomes . If the mouth rinse is confirmed to be effective , it would demonstrate great potential for the application in other low- or middle-income countries to prevent adverse birth outcomes such as preterm birth and low birth weight and to reduce neonatal and infant mortality . Trial registration This trial was registered with Chinese Clinical Trial Registry ( ChiCTR ) : ( # ChiCTR-TRC-13003768 ) on November 06 , 2013 A long-term prospect i ve , r and omized dietary intervention to prevent exposure of children to the known atherosclerosis risk factors ( the STRIP baby project ) was started when the age of the children was 7 months . The aim of this sub study was to analyze the oral effects of the dietary intervention in the children and their parents when the children had reached the age of 3 years . Every fifth family of the main study was invited to this sub study ( n = 179 ) . Those studied ( n = 148 ) represented well the intervention and the  control  groups and both genders in terms of intake of saturated fatty acids , the dietary polyunsaturated fatty acid to saturated fatty acid ( PUFA/SAFA ) ration and serum cholesterol and HDL cholesterol concentrations . Though no difference was found in sucrose consumption between the intervention and the control groups , the intervention children received relatively ( in E% ) more energy from carbohydrates than the control children ( p < 0.005 ) , used absolutely ( in g ) and relatively ( in E% ) less fat ( p < 0.05 ) and had a higher PUFA/SAFA ratio in their diet ( p < 0.001 ) . Of the 3-year-old children 93 % were caries free , and dental decay was a prevalent in the intervention as in the control children . Control children brushed their teeth unassisted more often than the intervention children ( p < 0.05 ) . The intervention fathers also received more energy ( in E% ) from carbohydrates ( p < 0.01 ) , the intervention mothers used less fat ( p < 0.05 ) and had a higher PUFA/SAFA ratio in the diet ( p < 0.05 ) than the control fathers and mothers , respectively . Dental and periodontal health of the intervention and control parents ( n = 250 , 84 % attending , mean + /- SD age : 34.2 + /- 54.5 years also showed no differences even though the control parents had more commonly last visited a dentist over 3 years before this examination ( p < 0.05 ) . We conclude that a 29-month period of a low-saturated-fat , low-cholesterol but high-carbohydrate diet as advocated in the STRIP baby trial does not seem to have harmful effects on the oral health of the children or their parents . Minor untoward differences had occurred in the dental health behavior of the control children and their parents OBJECTIVE To examine the effect of a nutrition and hygiene education intervention on oral health behaviour and whether early onset of caries was related to child growth in rural Ug and a. METHODS Follow-up study of a cluster-r and omised controlled trial conducted between October 2013 and January 2015 . Data were available from 399 mother/child pairs ( 203 in the intervention and 198 in the control group ) of the original trial ( 78 % ) when the children were 36 months old .  Oral health behaviour was evaluated using question naires . Photographs of the maxillary anterior teeth were examined for unmistakably carious lesions , and 115 water sample s from the study area were analysed for fluoride concentration . RESULTS The frequency of cleaning of the child 's teeth at 36 months was about twice as high in the intervention as in the control group ( 84.3 % vs. 46.6 % ; P = 0.0001 ) . Cavitated carious lesions occurred more frequently in the control than the intervention group ( 27.8 % vs. 18.2 % ; P = 0.04 ) . Extraction of ' false teeth ' ( ebiino ) , a painful and crude traditional operation , was profoundly reduced in the intervention group ( 8.9 % vs. 24.7 % ; P = 0.001 ) . There was no evidence of association between the occurrence of caries and child growth . CONCLUSIONS The education intervention improved oral hygiene practice s and reduced the development and progression of caries and extraction of ebiino .  Early childhood caries was not clearly associated with child growth OBJECTIVE To investigate the impact of an integrated oral health promotion intervention , within the Syrian national immunisation programme , which provided free preventive dental health products , without health workers ' counselling , on one-year-old infants ' tooth-brushing and bottle-feeding termination practice s. RESEARCH DESIGN a r and omised controlled parallel-group trial . SETTING A maternal and child health centre in Sweida city , Syria . PARTICIPANTS 92 mothers of one-year-old infants , attending an infant vaccination clinic , were allocated into three groups : Test , Control One and Control Two . INTERVENTIONS The Test group received an oral health promotion package including an infant oral health pamphlet , a baby toothbrush , fluoride toothpaste ( 1,000 mg/L ) and a trainer cup , without health workers ' counselling . Control One received only the pamphlet , whilst Control Two received no intervention . MAIN OUTCOME MEASURES after one month , the presence of old plaque on infants ' primary teeth was checked , to assess tooth-brushing behaviour . Also , a mothers ' self-completed question naire was administered to assess bottle-feeding use . RESULTS The response rate was 100 % and the attrition rate was zero . There were differences in tooth-brushing and bottle-feeding termination practice s between the three groups ( P⟩0.001 ) . Infants in the Test group were less likely to have old plaque and more likely to stop bottle-feeding than their counterparts in the two control groups . There were no differences in the abovementioned outcomes between the two control groups . CONCLUSIONS Providing free preventive dental health products , without health worker 's counselling , in an integrated oral health promotion intervention , was an effective measure to promote infants ' tooth-brushing and bottle-feeding termination practice s. These findings should be supported by long-term follow up studies BACKGROUND One hypothesis to explain the association between periodontal disease ( PD ) preterm/low birth weight ( PT/LBW ) is that PT/LBW may be indirectly mediated through translocation of bacteria or bacterial products in the systemic circulation . Transient bacteremias occur in subjects with marginal periodontitis or with gingivitis , and it is possible that bacteria and their products may reach the placental membranes hematogenously and provide the inflammatory effect to induce preterm labor . The effect of gingivitis as a potential risk factor for PT/LBW has still not been studied . A r and omized controlled trial was undertaken to determine the effect of routine plaque control and scaling on the pregnancy outcomes in women with gingivitis . METHODS Eight hundred seventy ( 870 ) pregnant women with gingivitis , aged 18 to 42 , were enrolled while receiving prenatal care in Santiago , Chile . Women were r and omly assigned in a two-to-one fashion to either a treatment group ( N = 580 ) , receiving periodontal treatment before 28 weeks of gestation or to a control group ( N = 290 ) , receiving periodontal treatment after delivery . Periodontal therapy consisted of plaque control , scaling , and daily rinsing with 0.12 % clorhexidine . Maintenance therapy was provided every 2 to 3 weeks until delivery , and consisted of oral hygiene instruction and supragingival plaque removal by instrumentation , as needed . The primary outcomes assessed were delivery at less than 37 weeks of gestation or an infant weighing less than 2,500 g 
    Output:
    
Moderate-certainty evidence suggests that providing advice on diet and feeding to pregnant women , mothers or other caregivers with children up to the age of one year probably leads to a slightly reduced risk of early childhood caries ( ECC ) .