Maternal Oral Health Education for Predicting Early Childhood Caries among Preschool Children: A Systematic Review and Meta-analysis

Abstract

Introduction: Early Childhood Caries (ECC) is a pressing public health issue in preschool-aged children. Preventive guidelines have not significantly reduced ECC incidence. Maternal education programmes have been proposed as interventions, but systematic reviews on their effectiveness are scarce. Aim: To evaluate the effectiveness of oral health education programmes for mothers in preventing ECC. Materials and Methods: Eight eligible Randomised Controlled Trials (RCTs) were identified through searches in the Cochrane Oral Health Group’s Trial Register, PubMed, and Google Scholar, as well as manual review of references from English-only studies. The interventions targeted mothers starting from 12 weeks of pregnancy onwards, with the exclusion of treatment-based methods, pharmacological interventions, and post-pregnancy programmes. The primary outcome assessed was ECC incidence, analysed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Participants exclusively received oral health educational programmes designed to prevent ECC in their children, highlighting the importance of early preventive measures during pregnancy. Results: Global studies varied in interventions and outcomes. A study from Brazil showed no reduction in ECC, while a study from Uganda reported reduced dental caries. Another study from Australia demonstrated a significant reduction in severe ECC. Risk of bias analysis revealed that five studies had a low risk of bias while one study had an unclear risk of bias. Moderate risk of bias was found in one study. Conclusion: Evidence suggests a positive impact of maternal education on ECC prevention, supporting tailored programmes for mothers with lower education. The overall recommendation strength is modest due to intervention variations and limited trials. Tailored educational programmes for mothers, especially those with lower education levels, should be integrated into maternal and child health services to effectively address social determinants of oral health.

Keywords

• child development
• dental caries
• prenatal education