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A RANDOMISED CONTROLLED TRIAL TO TEST A PREVENTIVE DENTAL HEALTH PROGRAMME FOR MOTHERS OF INFANTS WITH CLEFT LIP AND/OR PALATE
[Thesis]. Manchester, UK: The University of Manchester; 2011.
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Abstract
Aim: To improve the dental behaviour and knowledge of mothers of infants with cleft lip and/or palate (CLP).Design: A randomised controlled, single blind, prospective clinical trial of one year duration, measuring the effectiveness of a preventive dental health programme.All mothers and their infants attending the regional cleft unit following primary surgery were invited to participate. All data collection took place within the same cleft unit.Primary objectives examined dental attendance, use of a fluoride toothpaste and introduction of a feeder cup.Mothers completed dental behaviour and dental health knowledge questionnaires followed by stratified random allocation concealed from the researcher, to test or control groups. Preventive dental advice was given according to group allocation. Data were collected at baseline, after 12 months and aged three years at a multidisciplinary clinic review. An independent researcher collected the 12 months data and a specialist in paediatric dentistry the data at aged three years, both were blinded to group allocation.Results: 88 infants were recruited with 87 available at 12 months and 82 at three years, median age at baseline 10.5 months.More infants in the test group had been examined by their dentist, 12 months (p = 0.063), 3 years (p = 0.054). More infants in the test group were using a high fluoride toothpaste at 12 months (p = 0.001), no difference was found at three years (p = 0.105). Fewer infants in the test group were consuming drinks considered detrimental between meals at 12 months (p = 0.022), no difference was detected at three years (p = 1.000).A comparison of dental health knowledge over time revealed some differences.The dental health status reported 60 (73%) children were caries free and 17 (21%) with dentinal caries requiring attention. Four children were in need of dental extractions under general anaesthesia. This study was not powered to detect important differences between groups. The mean caries experience, decayed, missing and filled teeth (dmft) for 82 children examined at three years was 0.51(SD 1.45) and for those 17 (21%) with caries into dentine, 2.47 (SD 2.35). Conclusion: A dental health programme initially changes behaviour, however over time this is not maintained. Due to moderate caries levels the regional cleft Unit should ensure that all children with CLP receive preventive dental advice and dental care from either a hospital or community based specialist in paediatric dentistry. Further research is needed to improve the future care of this important group.