Jeyanthi John

Home visits for dietary advice reduce caries

DesignThis was a randomised field trial using block randomisation.InterventionA control group received routine assistance from their paediatricians in the health service, with research assessment usually within 1 month of the childs 6- and 12-month anniversary, then dietary advice by a fieldworker after the 12-month research assessment. The intervention group received home visits to advise the mother about healthy breastfeeding and weaning within 10 days of the childs birth, then monthly up to 6 months, then at 8, 10 and 12 months. This group also received the 6-month and 12-month research assessment and routine assistance from their paediatricians.Outcome measureOutcome measures were early childhood caries (ECC), defined as one or more caries surface of a tooth, duration of breastfeeding and dietary behaviours.ResultsOf the intervention group, 10.2% (16 out of 157) babies had caries compared with 18.3% (40 out of 219) babies in the control group. The odds of dental caries was 48% lower for the intervention group than for the controls (odds ratio, 0.52; 95% confidence interval, 0.27–0.97), after adjustment for the confounding effect of number of teeth. The intervention group had a longer mean duration of exclusive breastfeeding (X2 P 0.000), later introduction of sugar (X2 P 0.005) and a lower probability of their baby ever having eaten honey (X2 P 0.003), chocolate or sweets (X2 P 0.001), soft drinks (X2 P 0.020), biscuits (X2 P 0.000) and fromage frais cheese (X2 P 0.001).ConclusionsHome visits for dietary advice appear to help reduce dental caries in infants. Greater efforts are needed to tackle cariogenic dietary behaviours, however, and further studies are required to examine any longer-term effect.

Sources of evidence: search engines

Previously in this series I have described the major biomedical databases, Medline and the Cochrane Library, and other biomedical sources. In this final article I briefly outline a few of the other available sources of information on the Internet.

Sources of Evidence — MEDLINE

MEDLINE (Medical Literature, Analysis and Retrieval System Online) is the US National Library of Medicines premier bibliographical database. It concentrates on biomedical sciences and contains over 12 million references to journal articles in life sciences. It is searchable using a number of software packages and is freely available via the PubMed (National Center for Biotechnology Information, National Library of Medicine Bethesda, MD 20894, USA).