A review of a community program aimed at preventing early childhood caries among Jerusalem infants--a brief communication

Early childhood caries (ECC) has not been adequately investigated in Israel. A previous Jerusalem study has demonstrated a potential effect on toothbrushing among infants. The present study was initiated in order to examine caries prevalence and the potential effect of a community intervention program. OBJECTIVES: This study aims to review an intervention program and assess ECC distribution and associated variables. METHODS: The study sample included 1,500 infants in matched "intervention" and "control" Mother and Child Health centers. The 2-year program, initially including all children at the age of 6 months, focused on the free distribution of toothbrushes and toothpastes. ECC prevalence was determined in a cross-sectional study. RESULTS: At 2.5 years, 596 children were examined (40 percent compliance). About half of the parents reported that they had participated once or not at all over the 2-year period, which demonstrated low program participation. Among the examined children, ECC prevalence was 15.3 percent. No difference in caries levels was found between the program and control groups. The reported level of brushing twice daily was 13.9 percent, while 26.8 percent reported not brushing at all. Eighty-one percent reported going to bed at night with a bottle. Children who drank sugar-sweetened beverages had ECC levels significantly higher than those who drank milk or natural juice (18.8 percent versus 8.9 percent). CONCLUSIONS: The dental health and behavior and lack of intervention success emphasized the need to seek a more effective strategy. Emphasis on toothbrushing might not be the only nor optimal solution for this serious public health problem.