Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Paper Caries Res 2009;43:110–118 DOI: 10.1159/000209343 A Cluster Randomised Trial of Effectiveness of Educational Intervention in Primary Health Care on Early Childhood Caries S.Z. Mohebbi a, b J.I. Virtanen a M. Vahid-Golpayegani b M.M. Vehkalahti a a Institute of Dentistry, University of Helsinki, Helsinki, Finland; b Shaheed Beheshti Medical University, Tehran, Iran respectively. In conclusion, oral health education given to mothers by general health staff is a valuable tool to prevent caries in infants and toddlers. Copyright © 2009 S. Karger AG, Basel Early childhood caries (ECC) remains a serious prob- lem in many developing countries as well as among mi- norities in several developed countries [Milnes, 1996; Ev- ans and Kleinman, 2000; Sheiham and Watt, 2000], and may lead to an increased threat to general health and well-being [Petersen and Kwan, 2004]. The treatment of ECC is costly, and severe cases may require treatment un- der general anaesthesia in hospital settings [Almeida et al., 2000]. Studies reveal serious problems in the dental state of young children in Iran: half of the 3-year-olds in the whole country [Samadzadeh et al., 1999] and one third in Tehran suffer from ECC [Mohebbi et al., 2006], indicating a lack of proper oral health prevention and care for children in this age group. Because the majority of young children in several countries receive no dental examination before the age of 3 [Samadzadeh et al., 1999; Wendt et al., 2001; Douglass et al., 2004], professional dental services are considered irrelevant to the public health approach for the preven- tion of ECC [Davies, 1998; Jones et al., 2005]. A more ef- ficient way to reach the target group would be to integrate oral disease prevention into broader health promotion Key Words Early childhood caries  Oral health education  Prevention of caries Abstract Early childhood caries (ECC) remains a serious problem in several developing and developed countries. This cluster randomised trial evaluated the impact of a 6-month educa- tional intervention on ECC. The trial targeted 12- to 15- month-old children (n = 242) and their mothers in Tehran, Iran, visiting 18 public health centres, randomly selected and assigned to two intervention groups and one control group. At baseline, each mother was interviewed and each child un- derwent a dental examination of all teeth for the number of decayed teeth (dt) and of upper central incisors for the num- ber of teeth with enamel caries (de). All mothers in the two intervention groups (A and B) received oral health instruc- tions from the vaccination staff. In addition, group A received extra reminders. The outcome was defined as increments in the number of teeth with dt or de, as percentages of children developing new dt or de, and as the number needed to treat (NNT). No new de appeared in group A, the mean de incre- ment in group B was 0.2 (SD = 0.6), and in the controls, it was 0.4 (SD = 0.7) (p ! 0.05). The percentages of children devel- oping new de were 0, 14, and 26%, respectively. No differ- ences in dt increments were found. Regarding de, NNT for group A was 4 and for B 9; the figures for dt were 13 and 17, Received: December 6, 2007 Accepted after revision: January 27, 2009 Published online: March 24, 2009 Simin Z. Mohebbi Department of Oral Public Health, Institute of Dentistry University of Helsinki, PO Box 41 FI–00014 Helsinki (Finland) Tel. +358 9 1912 7301, Fax +358 9 1912 7346, E-Mail simin.mohebbi@helsinki.fi © 2009 S. Karger AG, Basel 0008–6568/09/0432–0110$26.00/0 Accessible online at: www.karger.com/cre