Community-based Interventions to Prevent Dental Caries among Kindergarten Children in Vietnam: A 12-month Study of Field Trial
Tai T Tran, Tuyen D Hoang, Minh V Hoang, Nhu TQ Tran, Ngan GK Nguyen, Phuong M Hoang, Thang V Vo
Comprehensive intervention, Early dental caries, Kindergarteners
Citation Information :
Tran TT, Hoang TD, Hoang MV, Tran NT, Nguyen NG, Hoang PM, Vo TV. Community-based Interventions to Prevent Dental Caries among Kindergarten Children in Vietnam: A 12-month Study of Field Trial. J Contemp Dent Pract 2022; 23 (2):135-142.
Aim: To investigate the status of dental caries and assess the effectiveness of dental caries prevention interventions in children from 3 to 5-year-old in Hue City, Vietnam.
Materials and methods: The subjects were 464 children and their direct caregivers at some kindergartens in Hue City from June 2020 to October 2021. The study included two consecutive phases: the first one was a cross-sectional study to identify the rate of dental caries and related factors in the studied kindergartens, and phase 2 was a controlled comparative interventional study for a period of 12 months.
Results: The mean of decayed, missing, filled, and DMFT index was 8.25, 0.09, 0.48, and 8.82, respectively, with no statistically significant difference in these figures between the living areas. The multivariable logistic regression model revealed some factors related to dental caries, including age, frequency of toothbrushing per day, parent-assisted toothbrushing, and eating and drinking sweets. Results showed the effectiveness of a community-based intervention for preventing dental caries, gingivitis, and plaque in the intervention group, compared to the control group.
Conclusion: The rate of dental caries among Vietnamese children was remarkably high. A comprehensive intervention to prevent early childhood dental caries was effective and might be considered a necessary program in healthcare prophylaxis.
Clinical significance: This intervention was consistent with the guidelines of WHO and based on evidences of related factors of dental caries identified in a previous cross-sectional study.
Bernabe E, Marcenes W, Hernandez CR, et al. Global, regional, and national levels and trends in burden of oral conditions from 1990 to 2017: a systematic analysis for the global burden of disease 2017 study. J Dent Res 2020;99:362–373. DOI: 10.1177/0022034520908533.
World Health Organization. Pulse survey on continuity of essential health services during the COVID-19 pandemic: interim report, 27 August 2020, Geneva, 2020.
World Health Organization. Oral health: achieving better oral health as part of the universal health coverage and noncommunicable disease agendas towards 2030, Geneva, 2020.
Douglass JM, Douglass AB, Silk HJ. A practical guide to infant oral health. Am Fam Physician 2004;70:2113–2120. PMID: 15606059.
André Kramer AC, Skeie MS, Skaare AB, et al. Caries increment in primary teeth from 3 to 6 years of age: a longitudinal study in Swedish children. Eur Arch Paediatr Dent 2014;15:167–173. DOI: 10.1007/s40368-013-0079-7.
Ghazal T, Levy SM, Childers NK, et al. Prevalence and incidence of early childhood caries among African-American children in Alabama. J Public Health Dent 2015;75(1):42–48. DOI: 10.1111/jphd.12069.
Filstrup SL, Briskie D, da Fonseca M, et al. Early childhood caries and quality of life: child and parent perspectives. Pediatr Dent 2003;25:431–440. PMID: 14649606.
Singh N, Dubey N, Rathore M, et al. Impact of early childhood caries on quality of life: child and parent perspectives. J Oral Biol Craniofac Res 2020;10:83–86. DOI: 10.1016/j.jobcr.2020.02.006.
Van Tam V, Huu Nhan N, Quy Tinh H. Dental caries situation of preschool children aged from 3 to 6 in Van Xuan commune, Vinh Tuong district, Vinh Phuc province, Vietnam. VNU J Sci Nat Sci Technol 2017;33. DOI: 10.25073/2588-1140/vnunst.4538.
Nhung NT, Kien NT, Đinh TK. The early childhood caries in preschool children with age 24–71 months in urban Can Tho, Viet Nam. Can Tho J Med Pharm 2019;19:1–7.
Lee Y. Diagnosis and prevention strategies for dental caries. J Lifestyle Med 2013;3(2):107–109. PMID: 26064846.
Jagan P, Fareed N, Battur H, et al. Effectiveness of sodium fluoride mouthrinses on the prevention of dental caries: a systematic review. J Indian Assoc Public Health Dent 2015;13:110–115. DOI: 10.4103/2319-5932.159042.
Tuong LV. Dental caries status and evaluation of the effectiveness of the treatment of early childhood caries in 3-year-old children with fluoride varnish in Hanoi city, Vietnam [MD thesis]. Hanoi Medical University; 2020.
Marinho VC, Worthington HV, Walsh T, et al. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2013;(7):CD002279. DOI: 10.1002/14651858.CD002279.pub2.
Horst JA, Tanzer JM, Milgrom PM. Fluorides and other preventive strategies for tooth decay. Dent Clin N Am 2018;62:207–234. DOI: 10.1016/j.cden.2017.11.003.
de Silva AM, Hegde S, Akudo Nwagbara B, et al. Community-based population-level interventions for promoting child oral health. Cochrane Database Syst Rev 2016;9:Cd009837. DOI: 10.1002/14651858.CD009837.pub2.
Nguyen YHT, Ueno M, Zaitsu T, et al. Early childhood caries and risk factors in Vietnam. J Clin Pediatr Dent 2018;42. DOI: 173-181.10.17796/1053-4628-42.3.2.
Minh NTH, Hai TD. Primitive caries in Vietnamese children in 2019. Vietnam J Prevent Med 2020;30:123–129. https://doi.org/10.51403/0868-2836/2020/306.
Hoat LN, Thang VV. Research methods for community health. Hue University Publishing House; 2011.
World Health Organization. Oral health surveys: basic methods. 5th ed. Geneva: World Health Organization; 2013.
World Health Organization. Oral health surveys: basic methods. Geneva: World Health Organization; 1997.
Huong DM, Hang LTT. Early dental caries among 19.5 kindergarten children in Thai Nguyen city, Vietnam according to ICDAS II, Mountainous Med Pharm Bull 2016;2:61–68.
Ghandahari-Motlagh M, Zeraati H. Dental health status in 3-5 year old kindergarten children in Tehran-Iran in 2003. J Dent Tehran Univ Med Sci 2005;2(1):18.
Vejdani J, Janeshin A, Heidarzadeh A, et al. The association between body mass index and gross dental caries in a population of 3- to 5-year-old children attending kindergartens in Rasht, Iran. Caspian J Dent Res 2022;11:15–20. DOI: 10.22088/cjdr.11.1.15.
Zhang K, Li J, Lu Z. The prevalence of dental caries in primary dentition in 3- to 5-year-old preschool children in northern China. BioMed Res Int 2020;2020:5315236. DOI: 10.1155/2020/5315236.
Zhou N, Zhu H, Chen Y, et al. Dental caries and associated factors in 3 to 5-year-old children in Zhejiang Province, China: an epidemiological survey. BMC Oral Health 2019;19:9–9. DOI: 10.1186/s12903-018-0698-9.
Senesombath S, Nakornchai S, Banditsing P, et al. Early childhood caries and related factors in Vientiane, Lao PDR. Southeast Asian J Trop Med Public Health 2010;41(3):717–725. PMID: 20578562.
Slabsinskiene E, Milciuviene S, Narbutaite J, et al. Severe early childhood caries and behavioral risk factors among 3-year-old children in Lithuania. Medicina (Kaunas, Lithuania) 2010;46(2): 135–141. PMID: 20440088.
Tenelanda-López D, Valdivia-Moral P, Castro-Sánchez M. Eating habits and their relationship to oral health. Nutrients 2020;12:2619. DOI: 10.3390/nu12092619.
Moynihan P, Tanner LM, Holmes RD, et al. Systematic review of evidence pertaining to factors that modify risk of early childhood caries. JDR Clin Transl Res 2019;4:202–216. DOI: 10.1177/2380084418824262.
Vietnam Ministry of Health Decision on approving the project on capacity building for odonto-stomatology and prevention of community oral diseases in the 2021-2030. No. 5628/QD-BYT December 9,2021. Hanoi, 2021.
Vittoba Setty J, Srinivasan I. Knowledge and awareness of primary teeth and their importance among parents in Bengaluru City, India. Int J Clin Pediatr Dent 2016;9:56–61. DOI: 10.5005/jp-journals-10005-1334.
Ramakrishnan M, Banu S, Ningthoujam S, et al. Evaluation of knowledge and attitude of parents about the importance of maintaining primary dentition–a cross-sectional study. J Fam Med Prim Care 2019;8(2):414–418. DOI: 10.4103/jfmpc.jfmpc_371_18.
Khodadadi E, Niknahad A, Sistani MM, et al. Parents’ oral health literacy and its impact on their children's dental health status. Electron Phys 2016;8:3421–3425. DOI: 10.19082/3421.
Thwin K, Zaitsu T, Ueno M, et al. Early childhood caries and related risk factors among Myanmar preschool children. Int J Clin Prevent Dent 2016;12:229–236. DOI: 10.15236/ijcpd.2016.12.4.229.
Jain M, Namdev R, Bodh M, et al. Social and behavioral determinants for early childhood caries among preschool children in India. J Dent Res Dent Clin Dent Prospects 2015;9:115–120. DOI: 10.15171/joddd.2014.023.
Olczak-Kowalczyk D, Gozdowski D, Turska-Szybka A. Protective factors for early childhood caries in 3-year-old children in Poland. Front Pediatr 2021;9:583660. DOI: 10.3389/fped.2021.583660.
World Health Organization. Ending childhood dental caries: WHO implementation manual. Geneva: World Health Organization; 2019.
Finlayson TL, Cabudol M, Liu JX, et al. A qualitative study of the multi-level influences on oral hygiene practices for young children in an Early Head Start program. BMC Oral Health 2019;19:166. DOI: 10.1186/s12903-019-0857-7.
Rai NK, Tiwari T. Parental factors influencing the development of early childhood caries in developing nations: a systematic review. Front Public Health 2018;6:64. DOI: 10.3389/fpubh.2018.00064.
Hochstetter AS, Lombardo MJ, D'Eramo L, et al. Effectiveness of a preventive educational programme on the oral health of preschool children. Promot Educ 2007;14(3):155–158. PMID: 18154225.
Ramseier CA, Leiggener I, Lang NP, et al. Short-term effects of hygiene education for preschool (kindergarten) children: a clinical study. Oral Health Prev Dent 2007;5:19–24. PMID: 17366757.
Marinho VC, Higgins JP, Sheiham A, et al. One topical fluoride (toothpastes, or mouthrinses, or gels, or varnishes) versus another for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2004;2004:Cd002780. DOI: 10.1002/14651858.CD002780.pub2.
Weintraub JA, Ramos-Gomez F, Jue B, et al. Fluoride varnish efficacy in preventing early childhood caries. J Dent Res 2006;85:172–176. DOI: 10.1177/154405910608500211.
Bonetti D, Clarkson JE. Fluoride varnish for caries prevention: efficacy and implementation. Caries Res 2016;50 Suppl 1:45–49. DOI: 10.1159/000444268.
Oliveira BH, Salazar M, Carvalho DM, et al. Biannual fluoride varnish applications and caries incidence in preschoolers: a 24-month follow-up randomized placebo-controlled clinical trial. Caries Res 2014;48:228–236. DOI: 10.1159/000356863.
de Sousa FSO, Dos Santos APP, Nadanovsky P, et al. Fluoride varnish and dental caries in preschoolers: a systematic review and meta-analysis. Caries Res 2019;53:502–513. DOI: 10.1159/000499639.
Rong WS, Bian JY, Wang WJ, et al. Effectiveness of an oral health education and caries prevention program in kindergartens in China, Commun Dent Oral Epidemiol 2003;31:412–416. DOI: 10.1046/j.1600-0528.2003.00040.x.
Deghatipour M, Ghorbani Z, Mokhlesi AH, et al. Community-based interventions to reduce dental caries among 24-month old children: a pilot study of a field trial. BMC Oral Health 2021;21:637. DOI: 10.1186/s12903-021-01999-x.
Branger B, Camelot F, Droz D, et al. Breastfeeding and early childhood caries. Review of the literature, recommendations, and prevention. Arch Pediatr 2019;26(8):497–503. DOI: 10.1016/j.arcped.2019.10.004.
Shirzad M, Taghdisi MH, Dehdari T, et al. Oral health education program among pre-school children: an application of health-promoting schools approach. Health Promot Perspect 2016;6: 164–170. DOI: 10.15171/hpp.2016.26.