A nutritional program involving home visits may reduce the incidence of early childhood caries

Subjects: The study was conducted in a low socioeconomic community in Sao Leopoldo as part of a Brazilian government program to promote healthy feeding in children. The subjects were 200 mother-child pairs in the intervention group who were participating in the nutritional program, and 300 mother-child pairs who served as nonintervention controls. Of these children, 141 (70%) who were in the intervention group and 199 (66%) who were in the control group completed the follow-up visit. The children were apparently healthy, of single births, and of normal birth weight and gestation. Key Exposure/Study Factor: The primary study factor was nutritional advice given through home visits on a monthly basis up to 6 months, and at 8, 10, and 12 months. The dietary advice aimed at exclusive breastfeeding up to 6 months, and included advice not to use the bottle or breastfeeding as pacifiers, and advice against the addition of sugars in fruits, porridge, juices, and milk, as well as giving soft drinks and snacks. The dietary information was given by university nutrition students. Main Outcome Measure: The primary outcome measure was the occurrence of early childhood caries at 4 years of age. A secondary outcome was the occurrence of severe early childhood caries and the number of decayed, (d) (white spots and cavities), missing (m), and filled (f) teeth. Main Results: The main result was that 76 (53.9%) intervention children compared with 138 (69.3%) controls had early childhood caries. The incidence of caries was reported to be reduced by 22% (relative risk [RR] 0.78; 95% confidence interval [CI] 0.65-0.93), severe early childhood caries (dmft index of 5 or greater) incidence was reduced by 32% (RR 0.68; 95% CI 050-0.92), and the mean number of affected teeth was lower for the intervention group (3.25) compared with the control group (4.15) (Mann Whitney U test; P = .023). Conclusions: General nutritional advice delivered at home, approximately 9 times during a childs first year of life, is associated with reduced incidence and severity of early childhood caries at 4 years of age in a low socioeconomic community in Brazil