title: Mother and youth access (MAYA) maternal chlorhexidine, counselling and paediatric fluoride varnish randomized clinical trial to prevent early childhood caries.
abstract: BACKGROUND
  Mexican-American children have a higher caries prevalence than the U.S. average. The Mothers and Youth Access (MAYA) study was a randomized clinical trial initiated to address this problem.
  
  
  OBJECTIVE
  Comparison of the efficacy of two prevention interventions in reducing early childhood caries (ECC).
  
  
  METHODS
  All 361 randomized mother-child dyads received oral health counselling. Beginning at 4 months postpartum, intervention mothers received chlorhexidine (CHX) mouthrinse for 3 months beginning 4 months postpartum and children received fluoride varnish (FV) every 6 months from age 12-36 months. Control group children received FV if precavitated lesions developed. Salivary mutans streptococci (MS) and lactobacilli were assessed.
  
  
  RESULTS
  No significant difference in children's 36-month caries incidence between groups; 34% in each group developed caries [(d(2+) fs) > 0]. About half of control group developed precavitated lesions and received therapeutic FV. Maternal MS levels declined during CHX use, but increased when discontinued.
  
  
  CONCLUSIONS
  Maternal postpartum CHX regimen, oral health counselling and preventive child FV applications were not more efficacious than maternal counselling with child therapeutic FV for precavitated lesions for ECC prevention. FV for young children with brief maternal CHX use and oral health counselling may need to be combined with additional or longer-term therapies to significantly reduce ECC in high-risk populations.
authors: Section of Pediatrics, Los Angeles School of Dentistry, University of California, Los Angeles 90095-1668, USA. frg@dentistry.ucla.edu
authors: Francisco J
authors: FJ
authors: Ramos-Gomez
authors: Stuart A
authors: SA
authors: Gansky
authors: John D B
authors: JD
authors: Featherstone
authors: Bonnie
authors: B
authors: Jue
authors: Rocio
authors: R
authors: Gonzalez-Beristain
authors: William
authors: W
authors: Santo
authors: Ed
authors: E
authors: Martinez
authors: Jane A
authors: JA
authors: Weintraub
mesh_terms: D000293:Adolescent; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D058491:Bacterial Load / Q000187:drug effects; D002140:California; D002327:Cariostatic Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D002710:Chlorhexidine / Q000627:therapeutic use*; D003376:Counseling; D004245:DMF Index; D003731:Dental Caries / Q000517:prevention & control*; D005260:Female; D005460:Fluorides, Topical / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007778:Lactobacillus / Q000187:drug effects / Q000302:isolation & purification; D017058:Mexican Americans; D009067:Mouthwashes / Q000627:therapeutic use*; D012463:Saliva / Q000382:microbiology; D013295:Streptococcus mutans / Q000187:drug effects / Q000302:isolation & purification; D016986:Streptococcus sobrinus / Q000187:drug effects / Q000302:isolation & purification; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D002327:Cariostatic Agents; D005460:Fluorides, Topical; D009067:Mouthwashes; D002710:Chlorhexidine