Oral health promotion and prevention of Early Childhood Caries
Article Sidebar
Published:
Jun 30, 2017
Keywords:
Early childhood caries tooth decay in young children dental caries in young children prevention of Early Childhood Caries Oral health promotion of early childhood caries
Main Article Content
Abstract
Dental caries is a common childhood chronic disease which affects not only oral health of children but also their quality of life and their families. This paper reviewed the effectiveness of various preventive measures, categorized as primary, secondary and tertiary prevention. Primary prevention includes oral health education, tooth-brushing with fluoridated toothpaste, water fluoridation, fluoridated milk, and dietary control. Systematic reviews showed that effectiveness of simple health education for the prevention of ECC is limited. However, health education in conjunction with motivational intervention, active hands-on training, regular home visit, or with professional preventive programmes showed some promise results. Educational programmes that integrated with other health issues were also found more effective than simple oral health education alone. For fluoride strategies, water fluoridation is accepted as a high cost-effectiveness measure and most equitable method in dental health across social classes. Fluoridated milk, when provide before the age of 4 years, showed caries preventive effect on primary teeth. There is also evidence from systematic reviews and meta-analysis that tooth brushing with fluoridated toothpaste at least 1,000 ppm fluoride concentration, as home care intervention or school programs, is a cost effective way in reducing dental caries for young children. Sugar is a common risk to a number of other non-communicable diseases. The ‘common risk approach’, by multidisciplinary collaboration, as well as food policy development to reduce sugar consumption, is necessary. Fluoride varnish, as secondary prevention, can decrease caries incidence in early childhood. 10% providone iodine has been shown to provide some benefit to control of microbial colonization after treatment for severe ECC but for a limited period of time. Filling decayed teeth can be considered as tertiary prevention. The benefits of restoration not only help delay the new colonization of microorganism, but also enhance the healthy ecology of mouth and good nutrition of children.
Downloads
Download data is not yet available.
Article Details
How to Cite
1.
Ungchusak C. Oral health promotion and prevention of Early Childhood Caries. Th Dent PH J [Internet]. 2017 Jun. 30 [cited 2024 Dec. 23];22(พิเศษ):44-61. Available from: https://he02.tci-thaijo.org/index.php/ThDPHJo/article/view/149597
Section
Original Article
References
1. Pine CM, McGoldrick PM, Burnside G, Curnow MM, Chesters RK, Nicholson J, Huntington E. An intervention programme to establish regular toothbrushing: understanding parents' beliefs and motivating children. Int Dent J. 2000;Suppl Creating A Successful:312-23.
2. Castilho AR, Mialhe FL, Barbosa Tde S, Puppin-Rontani RM. Influence of family environment on children's oral health: a systematic review. J Pediatr (Rio J). 2013 Mar-Apr;89(2):116-23. (abstract)
3. Ammari JB, Baqain ZH, Ashley PF. Effects of programs for prevention of early childhood caries. A systematic review. Med Princ Pract. 2007;16(6):437-42.
4. Ismail AI. Prevention of early childhood caries. Community Dent Oral Epidemiol. 1998;26(1 Suppl):49-61
5. Harrison R, Benton T et al. Effect of motivational interviewing on rates of early childhood caries: a randomized trial. Pediatr Dent 2007; 29: 16-2
6. Cascaes AM, Bielemann RM, Clark VL, Barros AJ. Effectiveness of motivational interviewing at improving oral health: a systematic review. Rev Saude Publica. 2014 Feb;48(1):142-53.
7. Weber-Gasparoni K, Reeve J et al. An effective psychoeducational intervention for early childhood caries prevention: part 1. Ped Dent 2013; 35: 241-246.
8. Weber-Gasparoni K, Warren JJ, Reeve J, Drake DR, Kramer KW, Marshall TA, Dawson DV. An effective psychoeducational intervention for early childhood caries prevention: part II. Pediatr Dent. 2013 May-Jun;35(3):247-51
9. Ismail AI, Ondersma S et al. Evaluation of a brief tailored motivational intervention to prevent early childhood caries. Community Dent Oral Epidemiol. 2011 Oct;39(5):433 – 438
10. Vachirarojpisan T, Shinada K, Kawaguchi Y. The process and outcome of a programme for preventing early childhood caries in Thailand. Community Dent Health. 2005; 22(4): 253 – 259.
11. Sgan-Cohen HD, Mansbach IK, Haver D, Gofin R. Community-oriented oral health promotion for infants in Jerusalem: evaluation of a program trial. J Public Health Dent. 2001 Spring;61(2):107-13.
12. Kowash MB, Pinfield A, Smith J, Curzon ME.Effectiveness on oral health of a long-term health education programme for mothers with young children. Br Dent J. 2000 Feb 26;188(4):201-5.
13. Feldens CA, Vítolo MR, Drachler ML. A randomized trial of the effectiveness of home visits in preventing early childhood caries. Community Dent Oral Epidemiol 2007; 35: 215-223.
14. Thanakanjanaphakdee W and Trairatvorakul C. Effectiveness of Parental Toothbrushing Instruction toward The 1-Year Incremental DMF Rate of 9-18 Month Old Children. J Dent Assoc Thai 2010; 60(2):82-91
15. Plonka KA, Pukallus ML et al. A controlled, longitudinal study of home visits compared to telephone contacts to prevent early childhood caries. Int J Paediatr Dent. 2013 Jan;23(1):23-31.
16. Petti S, Cairella G. Rampant Early Childhood Dental Decay: an Example from Italy. Journal of Public Health Dentistry 2000;60:3,159-166.
17. Levy S.M., Warren J.J., Broffitt B., Hillis S.L., Kanellis M.J. Fluoride, Beverages and Dental Caries in the Primary Dentition. Caries Res 2003;37:157–165
18. Clark MB, Slayton RL. Fluoride Use in Caries Prevention in the Primary Care Setting. www.pediatrics.org/cgi/doi/10.1542/peds.2014-1699 doi:10.1542/peds.2014-1699 Accepted for publication Jun 9, 2014
19. Wright JT, Hanson N, Ristic H, Whall CW, Estrich CG, Zentz RR, Fluoride toothpaste efficacy and safety in children younger than 6 years. A systematic review. JADA 145(2) https://jada.ada.org February 2014
20. Slot DE, Wiggelinkhuizen L, Rosema NAM,Van der Weijden GA. The efficacy of manual toothbrushes following a brushing exercise: a systematic review. Int J Dent Hygiene 10, 2012; 187–197
21. Schwarz E, Lo ECM, Wong MCM. Prevention of Early Childhood Caries- Results of Fluoride Toothpaste Demonstration Trial on Chinese Preschool Children after Three years. Int J Paed Dent 1998; 58(1): 12-18
22. Curnow M.M.T., Pine C.M., Burnside G. A Randomised Controlled Trial of the Efficacy of Supervised Toothbrushing in High-Caries-Risk Children. Caries Res 2002;36:294-300
23. Twetman S, Axelsson S, Dahlgren H, Holm A-K, Kallestal C, Lagerlof F, Lingstrom P, Mejare I, Nordenram G, Norlund A, Petersson LG, Soder B. Caries-preventive effect of fluoride toothpaste: a systemic review. Acta Odontol Scand 2003;61:347-355.
24. Wong M.C.M, Clarkson J, Glenny AM, Lo E.C.M, Marinho V.C.C, Tsang B.W.K, Walsh T, and Worthington H.V. Cochrane Reviews on the benefits/ risks of fluoride toothpastes.J Dent Res 90(5)2011; 573-579
25. AAPD 2014, Classifications, Consequences, and Preventive Strategies. AMERICAN ACADEMY OF PEDIATRIC DENTISTRY. REFERENCE MANUAL V 37 / NO 615 / 16. Available from: https://www.aapd.org/media/policies_guidelines/p_eccclassifications.pdf
26. AAPD 2014, Guideline on Infant Oral Health Care REFERENCE MANUAL V 37 / NO 6 15 / 16. https://www.aapd.org/media/policies_guidelines/g_infantoralhealthcare.pdf
27. Gillcrist J.A., Brumley D.E. Blackford J.U. Community fluoridation status and caries experience in children. J Public Health Dent 2001;61(3):168-71
28. Iheozor-Ejiofor Z, Worthington HV, Walsh T, O'Malley L, Clarkson JE, Macey R, Alam R, Tugwell P, Welch V, Glenny A. Water fluoridation for the prevention of dental caries (Review) A reprint of Cochrane review, prepared and maintained by The Cochrane Collabolation and published in The Cochrane Library 2015, Issue 6. https://www.thecochranelibrary.com
29. Petersen P.E., Baez R.J., and Lennon M.A. Community-oriented administration of fluoride for the prevention of dental caries: A summary of the current situation in Asia. Adv Dent Res 24(1):5-10, 2012.
30. Bánóczy J, Petersen JE, Rugg-Gunn AJ. Milk fluoridation for the prevention of dental caries. [Last accessed on 2015 November 10]. Available from: https://www.who.int/oral_health/publications/milk_fluoridation_2009_en.pdf
31. Mariño, R., Villa, A. and Guerrero, S. A community trial of fluoridated powdered milk in Chile. Community Dentistry and Oral Epidemiology, 2001, 29: 435–442.
32. Bian, J. Y., Wang, W. H., Wang, W. J., Rong, W. S. and Lo, E. C. M. (2003), Effect of fluoridated milk on caries in primary teeth: 21-month results. Community Dentistry Oral Epidemiology, 31: 241–245.
33. Yeung CA,Chong LY and Glenny AM. Fluoridated milk for preventing dental caries. . Fluoridated milk for preventing dental caries (Review) A reprint of Cochrane review, prepared and maintained by The Cochrane Collabolation and published in The Cochrane Library 2015, Issue 5. https://www.thecochranelibrary.com
34. Petersen P.E., Kwan S. and Ogawa H. Long term evaluation of the clinical effectiveness of community milk fluoridation in Bulgaria Community Dental Health (2015) 32, 199–203
35. Rugg-Gunn A, and Woodward M. Milk and oral health. [Last accessed on 2015 November 10]. Available from: https://www.borrowfoundation.org/assets/uploads/milk-and-oral-health.pdf.
36. Birungi N, Fadnes LT, Okullo I, Kasangaki A, Nankabirwa V, Ndeezi G, Tumwine JK, Tylleskär T, Lie SA, Aström AN. Effect of breastfeeding promotion on early childhood caries and breastfeeding duration among 5 year old children in Eastern Uganda: a cluster randomized trial. PLoS ONE 2015; 10: e125352.
37. Avila WM, Pordeus IA, Paiva SM, Martins CC. Breast and bottle feeding as risk factors for dental caries: a systematic review and meta-analysis. PLoS ONE 2015; 10: e142922.
38. Sheiham A and Watt RG. The common risk factor approach: a rational basis for promoting oral health.Community Dent Oral Epidemiol. 2000 Dec;28(6):399-406.
39. WHO-FAO, 2003. Diet, nutrition and the prevention of chronic diseases. https://apps.who.int/iris/bitstream/10665/42665/1/WHO_TRS_916.pdf
40. World Health Organization. Guideline: Sugars intake for adults and children. Geneva: World Health Organization; 2015. [Last accessed on 2015 November 10]. Available from: https://www.who.int/nutrition/publications/guidelines/sugars_intake/en/
41. Zimmer S Zimmer, M Bizhang, R Seemann, S Witzke… The effect of a preventive program, including the application of low-concentration fluoride varnish, on caries control in high-risk children. Clin Oral Invest (2001) 5:40-44
42. Skold UM, Petersson LG, Lith A, Birkhead D. 2005. Effect of School-Based Fluoride Varnish Programmes on Approximal Caries in Adolescents from Different Caries Risk Areas. Caries Research 39, pp. 273-279.
43. Marinho VCC, Higgins JPT, Logan S, Sheiham A. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews 2002, Issue 1.
44. Weintraub J.A., Ramos-Gomez F, Jue B, Shain S, Hoover C.I0, Featherstone J.D.B., and Gansky S.A. Fluoride Varnish Efficacy in Preventing Early Childhood Caries. J Dent Res. 2006 Feb; 85(2): 172–176
45. Lawrence HP, Binguis D et al. A 2-year community-randomized controlled trial of fluoride varnish to prevent early childhood caries in Aboriginal children. Community Dent Oral Epidemiol 2008; 36: 503-516.
46. Adams SH, Hyde S, Gansky SA. Caregiver acceptability and references for early childhood caries preventive treatments for Hispanic children. J Publ Health Dent 2009; 69: 217-224.
47. Milgrom P, Tut OK. Evaluation of Pacific Islands early childhood caries prevention project: Republic of the Marshall Islands. J Publ Health Dent 2009; 69: 201- 203.
48. Leelasithorn S, Ungchusak C, Promma S,Bunmee S. Effect of Fluoride Varnish on Caries Prevention in 0-3 Year-old Children. THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH 2009;32(2):62-71
49. Pitchika V, Kokel C, Andreeva J, Crispin A, Hickel R, Kűhnisch J, Heinrich-Weltzien R. Effectiveness of a new fluoride varnish for caries prevention in pre-school children. J Clin Pediatr Dent 2013; 38: 7-12.
50. Mohammadi TM, Hajizamani A, Hajizamani HR, Abolghasemi B. Fluoride varnish effect on preventing dental caries in a sample of 3-6 years old children. J Int Oral Health 2015; 7: 30-35.
51. Oliveira BH, Salazar M, Carvalho DM, Falcão A, Campos K, Nadanovsky P. Biannual fluoride varnish applications and caries incidence in preschoolers: a 24-month follow-up randomized placebo-controlled clinical trial. Caries Res. 2014;48(3):228-36. Epub 2014 Jan 29.
52. Agouropoulos A, Twetman S, Pandis N, Kavvadia K, Papagiannoulis L. Caries-preventive effectiveness of fluoride varnish as adjunct to oral health promotion and supervised tooth brushing in preschool children: a double-blind randomized controlled trial. J Dent. 2014 Oct;42(10):1277-83.
53. Jiang EM, Lo ECM, Chu CH, Wong MCM. Prevention of early childhood caries (ECC) through parental toothbrushing training and fluoride varnish application: a 24-month randomized controlled trial. J Dent 2014; 42: 1543-1550.
54. Simratvir M, Singh N et al. Efficacy of 10% Povidone Iodine in Children Affected with Early Childhood Caries: An In vivo Study. J Clin Paediatr Dent 2010; 34(3): 233 – 238.
55. Berkowitz RJ, Koo H et al. Adjunctive chemotherapeutic suppression of mutans Streptococci in the setting of severe early childhood caries: an exploratory study. J Publ Health Dent 2009; 69: 163-167.
56. Berkowitz R.J., Amante A, Dorota T. Kopycka-Kedzierawski, Billings R.J., Feng C, Dental caries recurrence following clinical treatment for severe early childhood caries. Pediatr Dent. 2011 Nov-Dec;33(7):510-4
57. Amin MS, Harrison RL, Benton TS, Roberts M, Weinstein P.Effect of Povidone-iodine on Streptococcus Mutans in Children With Extensive Dental Caries. Pediatr Dent. 2004;26:5-10
58. Lopez L, Berkowitz R, Zlotnik H, Moss M, Weinstein P. Topical antimicrobial therapy in the prevention of early childhood caries. Pediatr Dent. 1999 Jan-Feb;21(1):9-11
59. Lopez L, Berkowitz R , Spiekerman C, Weinstein P. Topical antimicrobial therapy in the prevention of early childhood caries: a follow-up report. Pediatr Dent 24:204-206, 2002.
60. Zhang L, Featherstone JDB et al. Antibacterial treatment needed for severe early childhood caries. J Publ Health Dent 2006; 66: 174-179.
61. Peretz B, Sarit F et al. Mutans Streptococcus counts following treatment for early childhood caries. J Dent Child 2003; 70: 111-114.
62. Palmer EA, Nielsen T et al. Children with severe early childhood caries: pilot study examining mutans streptococci genotypic strains after full-mouth caries restorative therapy. Pediatr Dent. 2012 Mar-Apr;34(2):e1 – 10.
63. Klinke T, Urban M et al. Changes in Candida spp., Mutans Streptococci and Lactobacilli following treatment of early childhood caries: A 1-Year follow-up. Caries Res 2014: 48: 24 – 31.
64. Acs G, Shulman R et al. The effect of dental rehabilitation on the body weight of children with early childhood caries. Pediatr Dent 1999; 21: 109-113.
65. de Amorim RG1, Leal SC, Frencken JE. Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis.Clin Oral Investig. 2012 Apr;16(2):429-41. doi: 10.1007/s00784-011-0513-3. Epub 2011 Jan 28.
66. Arrow P, Klobas E. Minimum intervention dentistry approach to managing early childhood caries: a randomized control trial. Community Dent Oral Epidemiol 2015; 43: 511-520.
67. Borrelli, Belinda1; Tooley, Erin M.2; Scott-Sheldon, Lori A.J.Motivational Interviewing for Parent-child Health Interventions: A Systematic Review and Meta-Analysis Pediatric Dentistry, Volume 37, Number 3, May/June 2015, pp.254-265(12)
68. Naidu R, Nunn J, Irwin JD. The effect of motivational interviewing on oral healthcare knowledge, attitudes and behaviour of parents and caregivers of preschool children: an exploratory cluster randomised controlled study. BMC Oral Health 2015; 15: 101.
69. Plutzer K, Spencer AJ. Efficacy of an oral health promotion intervention in the prevention of early childhood caries. Community Dent Oral Epidemiol 2008; 36: 335-346.
70. Plutzer K, Spencer AJ, Keirse MJNC. Reassessment at 6 – 7 years of age years of randomized controlled trial initiated before birth to prevent early childhood caries. Community Dent Oral Epidemiol. 2012; 40(2):116 – 124.
71. Azevedo MS, Romano AR, Correa MB, dos Santos IS, Cenci MS. Evaluation of a feasible educational intervention in preventing early childhood caries. Braz Oral Res 2015; 29: 1-8.
2. Castilho AR, Mialhe FL, Barbosa Tde S, Puppin-Rontani RM. Influence of family environment on children's oral health: a systematic review. J Pediatr (Rio J). 2013 Mar-Apr;89(2):116-23. (abstract)
3. Ammari JB, Baqain ZH, Ashley PF. Effects of programs for prevention of early childhood caries. A systematic review. Med Princ Pract. 2007;16(6):437-42.
4. Ismail AI. Prevention of early childhood caries. Community Dent Oral Epidemiol. 1998;26(1 Suppl):49-61
5. Harrison R, Benton T et al. Effect of motivational interviewing on rates of early childhood caries: a randomized trial. Pediatr Dent 2007; 29: 16-2
6. Cascaes AM, Bielemann RM, Clark VL, Barros AJ. Effectiveness of motivational interviewing at improving oral health: a systematic review. Rev Saude Publica. 2014 Feb;48(1):142-53.
7. Weber-Gasparoni K, Reeve J et al. An effective psychoeducational intervention for early childhood caries prevention: part 1. Ped Dent 2013; 35: 241-246.
8. Weber-Gasparoni K, Warren JJ, Reeve J, Drake DR, Kramer KW, Marshall TA, Dawson DV. An effective psychoeducational intervention for early childhood caries prevention: part II. Pediatr Dent. 2013 May-Jun;35(3):247-51
9. Ismail AI, Ondersma S et al. Evaluation of a brief tailored motivational intervention to prevent early childhood caries. Community Dent Oral Epidemiol. 2011 Oct;39(5):433 – 438
10. Vachirarojpisan T, Shinada K, Kawaguchi Y. The process and outcome of a programme for preventing early childhood caries in Thailand. Community Dent Health. 2005; 22(4): 253 – 259.
11. Sgan-Cohen HD, Mansbach IK, Haver D, Gofin R. Community-oriented oral health promotion for infants in Jerusalem: evaluation of a program trial. J Public Health Dent. 2001 Spring;61(2):107-13.
12. Kowash MB, Pinfield A, Smith J, Curzon ME.Effectiveness on oral health of a long-term health education programme for mothers with young children. Br Dent J. 2000 Feb 26;188(4):201-5.
13. Feldens CA, Vítolo MR, Drachler ML. A randomized trial of the effectiveness of home visits in preventing early childhood caries. Community Dent Oral Epidemiol 2007; 35: 215-223.
14. Thanakanjanaphakdee W and Trairatvorakul C. Effectiveness of Parental Toothbrushing Instruction toward The 1-Year Incremental DMF Rate of 9-18 Month Old Children. J Dent Assoc Thai 2010; 60(2):82-91
15. Plonka KA, Pukallus ML et al. A controlled, longitudinal study of home visits compared to telephone contacts to prevent early childhood caries. Int J Paediatr Dent. 2013 Jan;23(1):23-31.
16. Petti S, Cairella G. Rampant Early Childhood Dental Decay: an Example from Italy. Journal of Public Health Dentistry 2000;60:3,159-166.
17. Levy S.M., Warren J.J., Broffitt B., Hillis S.L., Kanellis M.J. Fluoride, Beverages and Dental Caries in the Primary Dentition. Caries Res 2003;37:157–165
18. Clark MB, Slayton RL. Fluoride Use in Caries Prevention in the Primary Care Setting. www.pediatrics.org/cgi/doi/10.1542/peds.2014-1699 doi:10.1542/peds.2014-1699 Accepted for publication Jun 9, 2014
19. Wright JT, Hanson N, Ristic H, Whall CW, Estrich CG, Zentz RR, Fluoride toothpaste efficacy and safety in children younger than 6 years. A systematic review. JADA 145(2) https://jada.ada.org February 2014
20. Slot DE, Wiggelinkhuizen L, Rosema NAM,Van der Weijden GA. The efficacy of manual toothbrushes following a brushing exercise: a systematic review. Int J Dent Hygiene 10, 2012; 187–197
21. Schwarz E, Lo ECM, Wong MCM. Prevention of Early Childhood Caries- Results of Fluoride Toothpaste Demonstration Trial on Chinese Preschool Children after Three years. Int J Paed Dent 1998; 58(1): 12-18
22. Curnow M.M.T., Pine C.M., Burnside G. A Randomised Controlled Trial of the Efficacy of Supervised Toothbrushing in High-Caries-Risk Children. Caries Res 2002;36:294-300
23. Twetman S, Axelsson S, Dahlgren H, Holm A-K, Kallestal C, Lagerlof F, Lingstrom P, Mejare I, Nordenram G, Norlund A, Petersson LG, Soder B. Caries-preventive effect of fluoride toothpaste: a systemic review. Acta Odontol Scand 2003;61:347-355.
24. Wong M.C.M, Clarkson J, Glenny AM, Lo E.C.M, Marinho V.C.C, Tsang B.W.K, Walsh T, and Worthington H.V. Cochrane Reviews on the benefits/ risks of fluoride toothpastes.J Dent Res 90(5)2011; 573-579
25. AAPD 2014, Classifications, Consequences, and Preventive Strategies. AMERICAN ACADEMY OF PEDIATRIC DENTISTRY. REFERENCE MANUAL V 37 / NO 615 / 16. Available from: https://www.aapd.org/media/policies_guidelines/p_eccclassifications.pdf
26. AAPD 2014, Guideline on Infant Oral Health Care REFERENCE MANUAL V 37 / NO 6 15 / 16. https://www.aapd.org/media/policies_guidelines/g_infantoralhealthcare.pdf
27. Gillcrist J.A., Brumley D.E. Blackford J.U. Community fluoridation status and caries experience in children. J Public Health Dent 2001;61(3):168-71
28. Iheozor-Ejiofor Z, Worthington HV, Walsh T, O'Malley L, Clarkson JE, Macey R, Alam R, Tugwell P, Welch V, Glenny A. Water fluoridation for the prevention of dental caries (Review) A reprint of Cochrane review, prepared and maintained by The Cochrane Collabolation and published in The Cochrane Library 2015, Issue 6. https://www.thecochranelibrary.com
29. Petersen P.E., Baez R.J., and Lennon M.A. Community-oriented administration of fluoride for the prevention of dental caries: A summary of the current situation in Asia. Adv Dent Res 24(1):5-10, 2012.
30. Bánóczy J, Petersen JE, Rugg-Gunn AJ. Milk fluoridation for the prevention of dental caries. [Last accessed on 2015 November 10]. Available from: https://www.who.int/oral_health/publications/milk_fluoridation_2009_en.pdf
31. Mariño, R., Villa, A. and Guerrero, S. A community trial of fluoridated powdered milk in Chile. Community Dentistry and Oral Epidemiology, 2001, 29: 435–442.
32. Bian, J. Y., Wang, W. H., Wang, W. J., Rong, W. S. and Lo, E. C. M. (2003), Effect of fluoridated milk on caries in primary teeth: 21-month results. Community Dentistry Oral Epidemiology, 31: 241–245.
33. Yeung CA,Chong LY and Glenny AM. Fluoridated milk for preventing dental caries. . Fluoridated milk for preventing dental caries (Review) A reprint of Cochrane review, prepared and maintained by The Cochrane Collabolation and published in The Cochrane Library 2015, Issue 5. https://www.thecochranelibrary.com
34. Petersen P.E., Kwan S. and Ogawa H. Long term evaluation of the clinical effectiveness of community milk fluoridation in Bulgaria Community Dental Health (2015) 32, 199–203
35. Rugg-Gunn A, and Woodward M. Milk and oral health. [Last accessed on 2015 November 10]. Available from: https://www.borrowfoundation.org/assets/uploads/milk-and-oral-health.pdf.
36. Birungi N, Fadnes LT, Okullo I, Kasangaki A, Nankabirwa V, Ndeezi G, Tumwine JK, Tylleskär T, Lie SA, Aström AN. Effect of breastfeeding promotion on early childhood caries and breastfeeding duration among 5 year old children in Eastern Uganda: a cluster randomized trial. PLoS ONE 2015; 10: e125352.
37. Avila WM, Pordeus IA, Paiva SM, Martins CC. Breast and bottle feeding as risk factors for dental caries: a systematic review and meta-analysis. PLoS ONE 2015; 10: e142922.
38. Sheiham A and Watt RG. The common risk factor approach: a rational basis for promoting oral health.Community Dent Oral Epidemiol. 2000 Dec;28(6):399-406.
39. WHO-FAO, 2003. Diet, nutrition and the prevention of chronic diseases. https://apps.who.int/iris/bitstream/10665/42665/1/WHO_TRS_916.pdf
40. World Health Organization. Guideline: Sugars intake for adults and children. Geneva: World Health Organization; 2015. [Last accessed on 2015 November 10]. Available from: https://www.who.int/nutrition/publications/guidelines/sugars_intake/en/
41. Zimmer S Zimmer, M Bizhang, R Seemann, S Witzke… The effect of a preventive program, including the application of low-concentration fluoride varnish, on caries control in high-risk children. Clin Oral Invest (2001) 5:40-44
42. Skold UM, Petersson LG, Lith A, Birkhead D. 2005. Effect of School-Based Fluoride Varnish Programmes on Approximal Caries in Adolescents from Different Caries Risk Areas. Caries Research 39, pp. 273-279.
43. Marinho VCC, Higgins JPT, Logan S, Sheiham A. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews 2002, Issue 1.
44. Weintraub J.A., Ramos-Gomez F, Jue B, Shain S, Hoover C.I0, Featherstone J.D.B., and Gansky S.A. Fluoride Varnish Efficacy in Preventing Early Childhood Caries. J Dent Res. 2006 Feb; 85(2): 172–176
45. Lawrence HP, Binguis D et al. A 2-year community-randomized controlled trial of fluoride varnish to prevent early childhood caries in Aboriginal children. Community Dent Oral Epidemiol 2008; 36: 503-516.
46. Adams SH, Hyde S, Gansky SA. Caregiver acceptability and references for early childhood caries preventive treatments for Hispanic children. J Publ Health Dent 2009; 69: 217-224.
47. Milgrom P, Tut OK. Evaluation of Pacific Islands early childhood caries prevention project: Republic of the Marshall Islands. J Publ Health Dent 2009; 69: 201- 203.
48. Leelasithorn S, Ungchusak C, Promma S,Bunmee S. Effect of Fluoride Varnish on Caries Prevention in 0-3 Year-old Children. THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH 2009;32(2):62-71
49. Pitchika V, Kokel C, Andreeva J, Crispin A, Hickel R, Kűhnisch J, Heinrich-Weltzien R. Effectiveness of a new fluoride varnish for caries prevention in pre-school children. J Clin Pediatr Dent 2013; 38: 7-12.
50. Mohammadi TM, Hajizamani A, Hajizamani HR, Abolghasemi B. Fluoride varnish effect on preventing dental caries in a sample of 3-6 years old children. J Int Oral Health 2015; 7: 30-35.
51. Oliveira BH, Salazar M, Carvalho DM, Falcão A, Campos K, Nadanovsky P. Biannual fluoride varnish applications and caries incidence in preschoolers: a 24-month follow-up randomized placebo-controlled clinical trial. Caries Res. 2014;48(3):228-36. Epub 2014 Jan 29.
52. Agouropoulos A, Twetman S, Pandis N, Kavvadia K, Papagiannoulis L. Caries-preventive effectiveness of fluoride varnish as adjunct to oral health promotion and supervised tooth brushing in preschool children: a double-blind randomized controlled trial. J Dent. 2014 Oct;42(10):1277-83.
53. Jiang EM, Lo ECM, Chu CH, Wong MCM. Prevention of early childhood caries (ECC) through parental toothbrushing training and fluoride varnish application: a 24-month randomized controlled trial. J Dent 2014; 42: 1543-1550.
54. Simratvir M, Singh N et al. Efficacy of 10% Povidone Iodine in Children Affected with Early Childhood Caries: An In vivo Study. J Clin Paediatr Dent 2010; 34(3): 233 – 238.
55. Berkowitz RJ, Koo H et al. Adjunctive chemotherapeutic suppression of mutans Streptococci in the setting of severe early childhood caries: an exploratory study. J Publ Health Dent 2009; 69: 163-167.
56. Berkowitz R.J., Amante A, Dorota T. Kopycka-Kedzierawski, Billings R.J., Feng C, Dental caries recurrence following clinical treatment for severe early childhood caries. Pediatr Dent. 2011 Nov-Dec;33(7):510-4
57. Amin MS, Harrison RL, Benton TS, Roberts M, Weinstein P.Effect of Povidone-iodine on Streptococcus Mutans in Children With Extensive Dental Caries. Pediatr Dent. 2004;26:5-10
58. Lopez L, Berkowitz R, Zlotnik H, Moss M, Weinstein P. Topical antimicrobial therapy in the prevention of early childhood caries. Pediatr Dent. 1999 Jan-Feb;21(1):9-11
59. Lopez L, Berkowitz R , Spiekerman C, Weinstein P. Topical antimicrobial therapy in the prevention of early childhood caries: a follow-up report. Pediatr Dent 24:204-206, 2002.
60. Zhang L, Featherstone JDB et al. Antibacterial treatment needed for severe early childhood caries. J Publ Health Dent 2006; 66: 174-179.
61. Peretz B, Sarit F et al. Mutans Streptococcus counts following treatment for early childhood caries. J Dent Child 2003; 70: 111-114.
62. Palmer EA, Nielsen T et al. Children with severe early childhood caries: pilot study examining mutans streptococci genotypic strains after full-mouth caries restorative therapy. Pediatr Dent. 2012 Mar-Apr;34(2):e1 – 10.
63. Klinke T, Urban M et al. Changes in Candida spp., Mutans Streptococci and Lactobacilli following treatment of early childhood caries: A 1-Year follow-up. Caries Res 2014: 48: 24 – 31.
64. Acs G, Shulman R et al. The effect of dental rehabilitation on the body weight of children with early childhood caries. Pediatr Dent 1999; 21: 109-113.
65. de Amorim RG1, Leal SC, Frencken JE. Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis.Clin Oral Investig. 2012 Apr;16(2):429-41. doi: 10.1007/s00784-011-0513-3. Epub 2011 Jan 28.
66. Arrow P, Klobas E. Minimum intervention dentistry approach to managing early childhood caries: a randomized control trial. Community Dent Oral Epidemiol 2015; 43: 511-520.
67. Borrelli, Belinda1; Tooley, Erin M.2; Scott-Sheldon, Lori A.J.Motivational Interviewing for Parent-child Health Interventions: A Systematic Review and Meta-Analysis Pediatric Dentistry, Volume 37, Number 3, May/June 2015, pp.254-265(12)
68. Naidu R, Nunn J, Irwin JD. The effect of motivational interviewing on oral healthcare knowledge, attitudes and behaviour of parents and caregivers of preschool children: an exploratory cluster randomised controlled study. BMC Oral Health 2015; 15: 101.
69. Plutzer K, Spencer AJ. Efficacy of an oral health promotion intervention in the prevention of early childhood caries. Community Dent Oral Epidemiol 2008; 36: 335-346.
70. Plutzer K, Spencer AJ, Keirse MJNC. Reassessment at 6 – 7 years of age years of randomized controlled trial initiated before birth to prevent early childhood caries. Community Dent Oral Epidemiol. 2012; 40(2):116 – 124.
71. Azevedo MS, Romano AR, Correa MB, dos Santos IS, Cenci MS. Evaluation of a feasible educational intervention in preventing early childhood caries. Braz Oral Res 2015; 29: 1-8.