Incidence and prevention of early childhood caries in one- and two-parent families.
BACKGROUND
Since the mid-1990s, there has been an increase in early childhood caries (ECC) in Australia and an increase in children living in one-parent families.


OBJECTIVE
To examine whether single parenthood (mother only) affects the effectiveness of an oral health promotion programme to prevent ECC in their child.


METHODS
First-time mothers were enrolled in a randomized controlled trial of anticipatory guidance to prevent ECC. The intervention was applied during pregnancy and when the child was 6 and 12 months old. Mothers in the control group received no intervention. The presence of ECC was assessed at 20 months of age and compared between children from one- and two-parent families.


RESULTS
Of 649 women enrolled, 441 brought their child for dental assessment. Eighty-seven (19.7%) had a one-parent family. Children from one-parent families had a 2.3 times higher incidence of ECC than children from two-parent families. The intervention reduced the frequency of ECC from 8.1% to 1.1% in two-parent families (relative risk: 0.14) and from 16.3% to 4.5% (relative risk: 0.28) in one-parent families. One case of ECC was prevented for every nine single mothers receiving anticipatory guidance compared with one case per 15 partnered mothers. Despite a greater reduction in the absolute risk of ECC in children from one-parent families, the intervention reduced their ECC experience only 3.5-fold compared with sevenfold in children from two-parent families.


CONCLUSIONS
The intervention produced a greater reduction in the frequency of ECC in children from one-parent families than in those from two-parent families. This did not reduce their disadvantage, though, as they still had a four times higher risk than children from two-parent families. Mothers and children in one-parent families need substantially more attention and support than those in two-parent families to eliminate their disadvantage in suffering ECC.
Plutzer
K
K
Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA 5000, Australia. kamila.plutzer@adelaide.edu.au
Keirse
M J N C
MJ
D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D001315:Australia / Q000453:epidemiology; D003731:Dental Caries / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009679:Nuclear Family / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods*; D011247:Pregnancy; D020954:Single-Parent Family / Q000523:psychology; D012959:Socioeconomic Factors; D055815:Young Adult