Impact of providing free preventive dental products without health workers' counselling on infants' tooth-brushing and bottle-feeding termination practices: a randomised controlled trial

Abstract

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 practices.

Research design: a randomised 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 questionnaire 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 practices 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 practices. These findings should be supported by long-term follow up studies.

Keywords: Syria; dental caries; health behaviour; health care costs; health promotion; infant; national health programs; prevention.