1. Introduction
Fisher-Owens, child-
DECAY, WEST, DENTAL DECAY, REGRESSION, EARLY CHILDHOOD CARIES
Background: This study tested the occurrence of early childhood caries (ECC) and changes in potential mediators of ECC after an early childhood oral health promotion intervention. Methods: Consenting parent/child dyads in Western Australia were randomised into test [motivational interviewing (MI) + anticipatory guidance (AG)] or control (lift the lip assessments by child health nurses). A questionnaire at baseline and follow-ups (at 18, 36 and 60 months) evaluated the parental factors and the children clinically examined. Data were analysed using parametric and non-parametric tests for two groups and paired comparisons. Multivariable analysis used negative binomial regression with robust standard errors for over-dispersed count data and effect estimates presented as incidence rate ratios. Results: Nine hundred and seventeen parent/child dyads were randomised (test In Western Australia (WA), and elsewhere, early childhood caries (ECC) is a significant public health concern. Among 5-year-old West Australian children seen within the WA School Dental Service (SDS), one in three has already experienced dental decay of the primary teeth, the majority of which is largely untreated [The conceptual model as outlined by Fisher-Owens, which posits the influences at the child-, family-, and community-level, points to opportunities for interventions to affect ECC [Variants of the MI counselling approach have been tested with mixed results; some studies found positive impacts on parental attitude and beliefs on ECC [Anticipatory guidance (AG) which seeks to provide practical information appropriate for the developmental stage of the child to parents in anticipation of significant milestones for the child has shown positive results in the prevention of early childhood decay in an Australian setting [Psychosocial factors including parental self-efficacy, fatalistic attitudes, and stress are potential mediators that were expected to impact ECC [The Fisher-Owens model suggests that changes in the child’s oral health by interventions targeted at the parent are likely to be mediated through changes in parent factors. The aim of this study was to further evaluate the effectiveness of the MI/AG approach in reducing the occurrence of ECC using a randomised controlled study design. The study tested whether the MI/AG approach improved parental attitudes and beliefs about ECC and reduced the occurrence of ECC compared with the standard approach being delivered in WA, whilst also testing the potential mediated effects of parental psycho-social factors on ECC.