Maternal Infant Oral Healthv2 Aug09
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Transcript of Maternal Infant Oral Healthv2 Aug09
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Maternal and Child Oral Health -
Systematic Review and Analysis
A report for the New Zealand Ministry of Health
Prepared by the Oral Health Research ro!p"M!rdoch Children#s Research $nstit!te%
September &''(
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$N)RO*+C)$ON%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% &
,ACRO+N*%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% .
EPIDEMIOLOGY.................................................................................................................................... 5
AETIOLOGY..........................................................................................................................................7
S/S)0MA)$C R01$02 O3 01$*0NC0%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%4
METHODS....................................................................................................................................... 10
Data Search................................................................................................................................. 10
Practical screen...........................................................................................................................10
Quality of methods screen...........................................................................................................11
Presentation of the findings.........................................................................................................11
Quality assurance........................................................................................................................ 11
QUESTION 1: WHAT IS THE INFLUENCE OF MATERNAL ORAL HEALTH ON GESTATIONAL AND PERI NATAL
EVENTS?........................................................................................................................................... 12
QUESTION 2: WHAT IS THE IMPACT OF MATERNAL HEALTH AND PRE AND PERI-NATAL EVENTS ON THE
DEVELOPMENT OF DEVELOPMENTAL DEFECTS OF ENAMEL?..................................................................15QUESTION : WHAT IS THE INFLUENCE OF MATERNAL GENERAL HEALTH ON THE ECC E!PERIENCE IN
THEIR OFFSPRING?............................................................................................................................ 17
QUESTION ": WHAT IS THE INFLUENCE OF MATERNAL ORAL HEALTH ON ECC E!PERIENCE IN THEIR
OFFSPRING?...................................................................................................................................... 1#
QUESTION 5. HOW EFFECTIVE ARE INTERVENTIONS INVOLVING MOTHERS IN REDUCING ECC IN THEIR
INFANTS?........................................................................................................................................... 22
CONCLUSIONS AND RECOMMENDATIONS.............................................................................................27
APP0N*$5 6 7 S0ARCH S)RA)0$0S%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%86
APP0N*$5 & 7 05P0R) R01$02 PAN09%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%8:
APP0N*$5 )HR00 7 01$*0NC0 )A,90S%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%8;
R030R0NC0S%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% .8
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Systematic Review of 0vidence%
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Methods
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?!estion 6< 2hat is the infl!ence of maternal oral health on >estational and peri natal
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http://clinicaltrials.gov/ct2/show/NCT00097656?term=mouth+and+tooth+diseases&rank=36&show_desc=Y#deschttp://clinicaltrials.gov/ct2/show/NCT00097656?term=mouth+and+tooth+diseases&rank=36&show_desc=Y#deschttp://clinicaltrials.gov/ct2/show/NCT00097656?term=mouth+and+tooth+diseases&rank=36&show_desc=Y#deschttp://clinicaltrials.gov/ct2/show/NCT00097656?term=mouth+and+tooth+diseases&rank=36&show_desc=Y#desc
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New Zealand perspective
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S!mmary ,oB 6
Highest level of available evidence: T/&$ I S/%($6('8 R$'$
Strength of evidence: M3$($
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?!estion &< 2hat is the impact of maternal health and pre and peri-natal events on the
development of developmental defects of enamel
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I* %966/ ,(39+ '( &&$% (( &3),$6% 9'*+ &$+**8/; )'( * 9'*+ ($ *$3-*(, &$'3
83*(')9($ (3 '+$ '*8'$*8$ 3 $*6$, $$8(% '* ($ &'6/ $*('('3*; ($ %&$8''8 $('3,3+'8,
8(3% $%&3*%'),$ $ *3( )$$* '$*(''$ * 6/ &3$ ''89,( (3 '%3,($ 9$ (3 ($ $>'%($*8$ 3
69,('&,$ 83*39*'*+ 8(3%. N$$($,$%% &363('3* 3 6($*, $,( 9'*+ &$+**8/ '* 3$ (3
6'*'6'%$ &33 )'( 39(836$% * $98$ &$'-*(, 63)''(/ '% ,'@$,/ (3 $**8$ '**( 3, $,(;*3( 3*,/ (39+ ($ '*,9$*8$ 3* ($ $$,3&'*+ $*('('3* )9( ,%3 )/ '*8$%'*+ 6($*, $,, )$'*+;
$98'*+ %($%% * $**8'*+ ($' )3$ &$*('*+ )','('$%.
S!mmary ,oB &
Highest level of available evidence: T/&$ IV O)%$('3*, S(9/
Strength of evidence: L3 (3 63$($
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?!estion 8< 2hat is the infl!ence of maternal >eneral health on the 0CC eBperience in
their offsprin>
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)$$* *3 (($6&( (3 $,($ $&$%%'$ %/6&(36% (3 8',$*% 8(9, 8'$% ($. T$$ '% ,%3 %36$
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SES * 8',33 *9('('3*. F9($ %(9'$% $ $&3%9$ (3 %63@$
'*8$%$% ($ '%@ 3 $$,3&'*+ %%38'($ 6$'8, 83*'('3*%; %98 % %(6 3 $%&'(3/
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S$83*,/; %63@$% 6/ 83*%96$ 63$ %9+ '* ($' 33 * ($ %6$; '+,/ 8'3+$*'8 33% ',,
)$ +'$* (3 ($' 8',$*.# A,(39+ %63@'*+ &8('8$% 6/ ,%3 )$ ,'*@$ (3 SES * 83*(3,,'*+ 3
($ 836&,$> '*,9$*8$ 3 SES 8* )$ ''89,(; (3 %(9'$% (( $ %3* &3%'('$ $,('3*%'&
)$($$* &%%'$ %63@'*+ * 8'$%. I* 3*$ %98 %(9/ &%%'$ %63@'*+ % 39* (3 )$ *
'*$&$*$*( &$'8(3 3 8'$% '* -".5 /$ 3, 8',$* ($ 83*(3,,'*+ 3 SES.#
W',%( ('% % ,+$ %(9/ '( % *3( &3%&$8('$ ($; ($ ( $$ $'$ 36 '*36('3* 83,,$8($ 3 ($ UK
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$%$8; 83*(3,,'*+ 3 83*39*'*+ '),$% %98 % SES '% ($$3$ $
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&$,$*8$ '% @*3* (3 )$ '+$ '* M3' * P8''8 &$3&,$. F9($ '( % )$$* $&3($ (( 63
$&$%%'$ ',,*$%%$% 4% $>&$'$*8$ '* NB '* ($ &%( 12 63*(% $ $
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?!estion @< 2hat is the infl!ence of maternal oral health on 0CC eBperience in their
offsprin>
E,/ 8',33 8'$% '% 69,('-8(3', '%$%$ '* '8 6($*, 88($'%('8% 9*39)($,/ &,/
%'+*''8*( 3,$. T'% 6/ )$ '$8(,/ (39+ )8($', (*%$ 3 '*'$8(,/ (39+ ($' 6',/ '$(/
&(($*% * %38', %'(9('3*. A ,+$ *96)$ 3 %(9'$% $ )$$* &9),'%$ '* ($ $*(, ,'($(9$
(( $ '*$%('+($ ($ '*,9$*8$ 3 &$*(, (('(9$% * @*3,$+$ 3 &&3&'($ (33( )9%'*+;
'$( * 9%$ 3 (33(&%($ 3* ($ $*(, $,( 3 ($' 8',$*. H3$$ $,('$,/ ,'((,$ $%$8 %
)$$* 83*98($ (3 '*$%('+($ ($ ,'*@ )$($$* &$*(, 3, $,( %((9% 48'$% * &$'33*(,
'%$%$ * ECC '* ($' 3%&'*+. T),$ " %966'%$% ($ %(9'$% (( $$ '$*(''$ (39+ 39
%$8 * '*8,9$ '* ('% $'$ (( $,($ ($ 8'$% %((9% 3 8',$* '( ($' &$*(% 3,
$,(. $89%$ 3 ,8@ 3 */ '+ %(9'$% 7; 77; 7; 7#; 0; 1 $&3($ $,('3*%'&% 9%'*+ 8,'*'8, 6$%9$%
3 $,( 39(836$% 46(DMFT; &3&3('3* 8'$% $$; &$%$*8$ 3 *($'3 8'$%; 3 *$$ 3
($(6$*( 3 )3( 63($ * 8',. T$$ %(9'$% 2; ; " 836&$ &$*( 43*$ %(9/ ,%3 %9$/$
($% %$,-$&3($ $*(, %((9% '( ($ '*'*+% 36 8,'*'8, $>6'*('3* 3 ($' 8',. A %'*+,$%(9/ 5 9%$ &$*( $&3($ $*(, %((9% 3 )3( 63($ * 8',. T$ 63'(/ 3 %(9'$% 4*7
$$ 83%% %$8('3*,; 3*$ 9%$ &3%&$8('$ 833( * 3*$ 9%$ 8%$ 83*(3, &&38. W'( 3*$
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,+$ &3%&$8('$ 833(. A% $%9,( 63%( 3 ($ %(9'$% 3*,/ $&3( 83$,('3*% )$($$* 63($
* 8', 3, $,( %((9% * $ *3( ),$ (3 $%(),'% 89%$ * $$8(.
D$%&'($ ('% '('3* '* $%'+* * 39(836$ '),$% ,, '*8,9$ %(9'$% $>8$&( 3*$ 77 39* (( ($
3, %((9% 3 &$*(% 463%(,/ 63($% % $,($ (3 (( 3 ($' 8',$*. O*$ %(9/ 39*
%'+*''8*( %%38'('3*% '( 9*''($ *,/%'% )9( *3( '( ,($ 69,(''($ ,3+'%('8 ($%(%.7
I* ,+$; &3%&$8('$ %(9/" +39& 3 1"" &$+**( F'*'% 63($% $$ 3,,3$ 9& 3$ '$ /$%.
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T$ 3*$ %(9/ (( ',$ (3 %3 */ %'+*''8*( %%38'('3* )$($$* 63($ * 8', 3, $,(
%((9% '*3,$ '**(% )3* '( 8,$( 3 ($ ,'& *3 &,($. 77 I( '% &3%%'),$ (( ('% %9)+39& 3
8',$* '% 63$ ,'@$,/ (3 $$,3& 8'$% (* * 3($'%$ $,(/ &3&9,('3* 9$ (3 )'$% (3
$6'*('3* 3 ($ '**( '% $&3($; $(',$ 8,'*'8,
$>6'*('3* 3 ($' 63($% 4&$*(% '% *3(. R($ '(($* 3 $), %$,-$&3( &$'$*8$ * 3)$8('$ 8,'*'8, 6$%9$% *3
%9&&3('*+ $'$*8$ 3 ('% % &$%$*($. I* '('3*; 6($*, %$,-$&3( 3 ($' 8',$*%
$%(3('3* * (33( $>(8('3* $*(, '%(3/ * 3 3, $,( * '$(/ )$'39% '% %9)$8( (3
$8,, * %38', $%')','(/ )'%$%. 5
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A,(39+ ('% %(9/ % %'+*''8*( ,'6'(('3*% '( 3$% &3'$ %36$ '*%'+( '*(3 &3&9,('3* '* N$
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P8''8 &3&9,('3*% 4S63*; C33@ I%,* M3' * T3*+*. T'% '+,'+(% ($ $($3+$*$39%
*(9$ 3 ($%$ &3&9,('3* +39&% * %9&&3(% 89('3* '* +$*$,''*+ ($ '*'*+% 36 %(9'$%
83*98($ '* '$$*( 839*('$% 3 83669*'('$% '('* N$ B$,*. I( ,%3 $6&%'$% ($ *$$ 3 %'+*''8*( &$,'6'*/ 83669*'(/ )%$ 83*%9,(('3* * $*++$6$*( '* 3$ (3 '$*('/ +39&-
%&$8''8 )$,'$%; *36% * &8('8$%. T'% '*36('3* '% '6&3(*( $* $$,3&'*+ 89,(9,,/
88$&(),$ '*($$*('3*% * 3 $%(),'%'*+ &&3&'($ 39(836$ 6$%9$% * $,9('3* (33,% (3
%%$%% ($ %988$%% 3 %98 '*($$*('3*%.
S!mmary ,oB @
Highest level of available evidence: T/&$ IV O)%$('3*, S(9/
Strength of Evidence: M3$($
• A,(39+ ($$ '% *3 $/ %(3*+ $'$*8$ 4'$ RCT% $+'*+ ($ $,('3*%'& )$($$* &$*(,
4$%&$8',,/ 6($*, 3, $,( * (( 3 ($' 3%&'*+; ( $'$*8$ 3$% $>'%( '% 83*%'%($*(,/
%9&&3('$.
• I*($$*('3*% '8 '6 (3 '6&3$ ($ 3, $,( 3 &$*(% $ ,'@$,/ (3 $ )$*$'8', $$8(% 3*
($ 3, $,( 3 ($' 3%&'*+.
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?!estion .% How effective are interventions involvin> mothers in red!cin> 0CC in
their infants
I6&3'*+ ($ 3, $,( %((9% 3 63($% 6/ )$*$'( ($' 8',$* '* (3 +$*$, /%. F'%(,/;
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8)3/($ '*(@$ * '6&3'*+ 3, /+'$*$ )'(% $ ,'@$,/ (3 '6&8( 3* 3 ($/ 8$ 3 ($'
'**(% 3, $,(. S$83*,/ * '6&3$6$*( '* 6($*, 3, $,( 6/ $98$ ($ *96)$ 3 S.
mutans &$%$*( '* ($' 3, 8'(/ ($$)/ $98'*+ ($ &3($*(', '%@ 3 (*%6'%%'3* 3 ($%$
8'3+$*'8 )8($' (3 ($' 8',$*. I( '% &3)),$ (( ($ 63'(/ 3 8',$* 8/,'(3, %(9'$%. M3%( 3 ($ %(9'$% %6,, *96)$% 3 %9)$8(% * ($ '*($$*('3*%
'$ '* $>($*(; ,'6'('*+ ($ )','(/ (3 ++$+($ ($ $%9,(% 3 (3 83*8,9%'3*% 3* 3 )$*$'8',
'*($$*('3*% 39, )$ 3* &3&9,('3* )%'%. D$%&'($ ($%$ 8$(% ($ 63'(/ 3 %(9'$% 45 3
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,$%'3*% (( $$ &$%$*( '* ($ 63($% 3, 8'(/ (3 $,'6'*($ 3 $98$ 6($*, S. mutans ,$$,%
9'*+ 3 '66$'($,/ ($ &$+**8/. I( '% /&3($%'$ (( ($ &&38$% 9%$ '* ($%$ %'>
%(9'$% 6/ $ $98$ 6($*, S. mutans ,$$,% * %9)%$/,'(3,
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$8($ S. mutans )9( ,%3 839, $ ,$ (3 )$'39, 8*+$% '* 63($% '( $,('3* (3 ($'
8',% '$( 3 3, /+'$*$ &8('8$%.
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63($ 3* ($ ECC '* ($' 3%&'*+. T$ '%( %(9/; 8'$ 39( )/ K3% * 83-3@$% 42000;
($%($ ($ '6&8( 3 36$ '%'(% (3 63($% ,''*+ '* '%*(+$ %9)9)% 3 L$$% '* ($ UK. 7
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%&$@'*+ 83669*'(/ '* '('% C3,96)'; C*. T$ &$*(% * 8',$* $$ *36,/ %%'+*$
'*(3 3*$ 3 (3 +39&% $'($ * MI 839*%$,'*+ 3 $,( $98('3* 483*(3, +39&; ($ %(('/'*+
($ 8',$* '*(3 (3 +$ +39&% 4 (3 12 63*(% * 3,$ (* 12 63*(%. A( 3*$ * (3 /$ ('6$
&3'*(% ($ 8',$* '* ($ MI +39& %'+*''8*(,/ ,$%% 8'$% $* 836&$ (3 8',$* '* ($
83*(3, +39&. T$ 9(3% %9++$%($ (( ($ 839*%$,'*+ '*8$%$ $*(, '%'('*+ 3 ,93'$ *'%
&&,'8('3*% '8 % &363($ (3 )3( +39&% (39+ &6&,$(.
A*3($ %(9/ 9(','%'*+ ($ 36$ '%'('*+ &&38 % *36'%$ 83*(3,,$ '$, (', '* ', )/F$,$*% * 83-3@$%.#1 M3($% 3 '**(% $8$'$ '8$ )39( $,(/ )$%( $$'*+; $*'*+
* '**( '$( 36 ($* /% 9& (3 %'> 63*(% * ($* +'* ( $'+(; ($* * ($,$ 63*(%. T$
'8$ % )%$ 3* WHO $8366$*('3*% 3 $,(/ '$( 3 ))'$% * ,(39+ '( ' 83*('*
'8$ $%'+*$ (3 $($ 8'3+$*'8 $$'*+ &8('8$% % *3( %&$8''8,,/ $,'$$ % 3, $,(
'8$. N3 '*36('3* )39( 3, /+'$*$ 3 ($ 8', % '*8,9$. M3($% '( *$)3* ))'$% 3
,3 SES ,''*+ '* * 3&('6,,/ ,93'($ $+'3* 3 ', $$ $89'($ * *36,/ %%'+*$ (3
$'($ * '*($$*('3* 3 %(* 8$ +39&. M3($% $$ %9$/$ * 8',$* $>6'*$ )/
$*(, $>6'*$% ),'*$ (3 ($ ,,38('3* &38$%%. T$ '*($$*('3* +39& %'+*''8*(,/ ,$%%
$*(, 8'$% ( ($,$ 63*(%; * % $>&3%$ (3 %9+ 83*('*'*+ '*@% * 33% %'+*''8*(,/
,($ (* ($ 83*(3, +39&. I*($$%('*+,/; ,(39+ +'* 83*%'%($*( '( ($ '*'*+% '* 3($ %(9'$%;
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($ '*($$*('3* *3 '6&8( 3* ($ 9%$ 3 *'+( ('6$ )3((,$% $%&'($ '*8,9%'3* 3 ('% '8$ '* ($
3$,, &3+6. T'% +33
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M3' 83669*'(/ * ,%3 (39+ ($' &%%'3* * 8366'(6$*( (3 3*+ *'3 63 ($ '' M3'
43, $,( 3 ,, M3'.100
T$$( " K$$&%J % R$+'3*, P9),'8 H$,( &3+6 3 36$ '%'(% (3 '%( ('6$ 63($% $%''*+ '*
,3 SES $% 3 W$,,'*+(3* 3&$('*+ 36 2000-200. H36$ '%'(% $$ 6$ )/ W$,,-C', N9%$%
* ($$ ,38, M3' H$,( P3'$% $$ 3, $,( $98('3* * &'*($ $%398$% $$
&3'$. E*3,6$*( '* %833, $*(, %$'8$% % ,%3 &363($. P38$%% $,9('3* '* ($ 36 3
63*(,/ $&3(% )/ ($ '%'('*+ $98(3% * %6,, *96)$ 3 389% +39& '%89%%'3* '( 6','$%
* &3'$% %3$ '+ 88$&(*8$ * '6&3$6$*(% '* @*3,$+$ * $&3($ &8('8$%.
C',$* $ )$'*+ (8@$ (39+ %833, $*(, %$'8$% ' 9*'6'*('3* 3 +$*$, $,( &363('3* '*'('('$% '* N$ B$,* 83*8$*'*+ 63($% *
&$%833, 8',$* +'* 39* $/ $ &3+6% (( */ 36 3 $,9('3* ',),$. I* N$
B$,* % '* 3($ &(% 3 ($ 3,; 6%% 6$' 86&'+*% $ )$$* %3* (3 '*8$%$
@*3,$+$ )9( $ ,'((,$ $$8( 3* $,( $,($ )$'39, 8*+$.101; 102 O*$ %(9/ '8 389%$
3* M3' * P8''8 8',$* ,''*+ '* ,3 SES $% * '8 '*8,9$ $,( 39(836$ 6$%9$%
% &( 3 '(% $,9('3* '% 3(/ 3 6$*('3*. I( % * $,9('3* 3 &9),'8 $*$%% 86&'+* '*
A98@,* '* 1##. I( 3%$ '* $%&3*%$ (3 6('8 '*8$%$ '* 6$*'*+38388, '%$%$ '( M3'* P8''8 '$ /$ 3,% )$'*+ ( &('89,,/ '+ '%@. T$ 86&'+* '*3,$ 33-(3-33 '%'('*+
)/ ,/ M3' * P8''8 $98(3% '* ($ 39 8'(/ %9)9)% '( ($ '+$%( ($% 3 '%$%$. T$
$98(3% $$ %$,$8($ 36 ($%$ 83669*'('$% 9%'*+ 8'($' %98 % '*+ +33 %(*'*+ '* ($
83669*'(/; ($ )%$*8$ 3 8'6'*, $83; * 8366'(6$*( (3 )$ '*3,$ 3 $'+( $$@%.
H*39(% * $98('3*, '% $$ &3'$ (3 ($ ,/ $98(3% * &('8'&*(%. A*,/%'% 3 ($
%988$%% % $($6'*$ (39+ 389% +39& '%89%%'3*% * 6$%9'*+ ($ *96)$ 3 *$
6$*'*+38388, 8%$% '('* ($ 83669*'(/ 3$ ($ 63*( &$'3($ ($ %(( 3 ($ $98('3*.
S'+*''8*(,/ +$($ $*$%% 3 ($ $,/ 8,'*'8, $(9$% 3 6$*'*+38388, '%$%$ *
&&3&'($ 8('3* (3 (@$ % 39* '* &$3&,$ '%'($ )/ ,/ $98(3% 836&$ (3 (3%$ *3( '%'($.
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F9($63$ 3 ($ '%( ('6$ '* 5 /$%; ($$ $$ *3 6$*'*+38388, $(% 63*+ ($ (+$(
&3&9,('3* 3 ($ 63*(% 36 ($ %(( 3 ($ 86&'+*.
S!mmary ,oB .
Highest level of evidence available: T/&$ II R*36'%$ 83*(3,,$ (',%
Strength of Evidence: M3$($
• P'6/-&'6/ &$$*('3* &3+6% '8 '6 (3 $98$ $*(, 8'$% '* 8',$* )/ '6&3'*+
($ 3, $,( 3 63($% $ %9&&3($ )/ ',),$ $'$*8$.
• P3+6% '8 &3'$ 3*$ 3* 3*$ $98('3* * %9&&3( (3 63($% $ ,%3 ,'@$,/ (3 $%9,( '*
%'+*''8*( )$*$'( &('89,,/ $$ ($/ '*3,$ 39($8 '*(3 6',/ 36$%.
• T$ 9%$ 3 ,/ 83669*'(/ 6$6)$% '* '*($$*('3*% '% %9&&3($ )/ ,'6'($ *96)$ 3 ,38, N$
B$,* %(9'$% '$*(''$ '* ($ +$/ ,'($(9$ )9( $6'*% (3 )$ ($%($ '* ($ $ 3 8', $*(,
$,(.
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Concl!sions
ECC &&$% (3 )$ * 3*+3'*+ * %'+*''8*( &3),$6 3 8',$* '* N$ B$,*. A',),$ ( 3*
'%$%$ $>&$'$*8$ %9++$%(% ((:
• M3' * P8''8 8',$* $ ,$%% ,'@$,/ (3 )$ 8'$% $$ ( 5 /$%
• M3' * P8''8 8',$* $>&$'$*8$ 63$ $*(, 8'$% ( 5 /$%
• W($ ,93'('3* * $ 3 $%'$*8$ $ 63$('*+ $$8(% 3* ($ $,('3*%'& )$($$*
$(*'8'(/ * 8'$% $>&$'$*8$
L'((,$ '*36('3* '% ',),$ 3* ($ '%$%$ ,$$,% 3 8',$* 9*$ ($ +$ 3 '$ * $$* ,$%%
)39( ($ '6&8( 3 $*(, '%$%$ 3* ($ 9*8('3*'*+ 3 6','$% * ($ &$'$*8$ '* ($' 8',$*. H3$$ ($
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3$$ ($ 88$&()','(/ * $$8('$*$%% 3 ('% &&38 $* 9%$ '( &3&9,('3* +39&% %98
% M3' * P8''8 6','$% *$$% (3 )$ $%(),'%$.
A,(39+ *3( %&$8''8 389% 3 ($ $'$ &$'$*8$ $*(,
8'$%. H3$$ *3('*+ '% @*3* )39( ($ *(9, '%(3/ 3 $*(, 8'$% ,$'*+ 9& (3 ('% +$ *3;
63$ %&$8''8,,/; ($ $&'$6'3,3+/ 3 ($ '%$%$ '* '%*(+$ +39&%. G'$* ($ $,, $83+*'%$
,3*+ ($6 )$*$'(% 3 $,/ '*($$*('3* '* ($ '%( '$ /$% 3 ,'$ 83%% ($ )3$%( *+$ 3 $,(
39(836$%; '( 39, )$ )$*$'8', (3 $%(),'% %36$ 39('*$ 3, $,( %9$',,*8$ 3 ('% +$ +39&
'* NB. S98 ( 39, &3'$ *3( 3*,/ )%$,'*$ ( +'*%( '8 $$8('$*$%% 3 '*($$*('3*%
839, )$ 836&$ )9( 39, ,%3 8','(($ 63*'(3'*+ 3 ($*% 83%% ($ &3&9,('3*.
• A$%%'*+ '*$($*( 3 3, $,( '%*(+$ $>&$'$*8$ )/ %&$8''8 83669*'('$% '*
NB '% '*836&,$($ ($$ '% *3 $%3* (3 )$,'$$ (( %'6', '*$'%( '* NB %
$,%$$$. A 83669*'(/ 389%%$; (+$($ '*($$*('3* 839, &3'$ * 3&&3(9*'(/ (3 '6&3$ ($
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3, $,( 39(836$% 3 ($ 63$ '%*(+$ (9% $98'*+ '*$&$8(*( 63($% %39, )$ (+$($ +$*$,,/ 3 3, $,( &363('3*; )9( '('3*, $%398$%
%39, )$ 6$ ',),$ (3 $$,3& %9&&3('$ $,( &363('*+ &3+6% 3 %38',,/ '%*(+$
36$* * (3%$ 36 '+ '%@ &3&9,('3*%.
• H$,( &363('3*.
W',%( ($ $'$*8$ %939*'*+ ($ $,('3*%'& )$($$* 6($*, 3, * +$*$, $,( * ($
3, $,( 3 ($' 3%&'*+ '% 89$*(,/ *3( %(3*+; ($$ $ 6*/ 3, * +$*$, $,( )$*$'(% (3
)$ +'*$; $%&$8',,/ )/ 36$* '* '%*(+$ 83669*'('$%; 36 )$'*+ $>&3%$ (3 3, $,(
&363('3*. T$%$ )$*$'(% $ ,'@$,/ (3 )$ 3&('6'%$ )/ 3&('*+ )3$ $($6'**(% 3 $,(
&&38 * '*($+('*+ 3, $,( '* (3 +$*$, $,( &363('3*. O&&3(9*'('$% 3 3, $,(
&363('3* %39, )$ $,'$$ '* * '*($+($ / '('* $>'%('*+ %$'8$% ,$/ 88$%%$ )/
36$* 36 '%*(+$ +39&% %98 % ($ W$,, C',T6'@' O %$'8$% 3 &'6/ $,(
%$'8$%. T$ &3($*(', )$*$'(% 3 63($% '6&3'*+ ($' 3* 3, $,( %39, )$ &363($ '*
$,('3* (3 +$*$, 8', $,( * $,,)$'*+ % $,, % ($ 3, $,( 39(836$% 3 ($ '*''9,%
($6%$,$% * ($' )3$ 83669*'('$%.
G'$* (( 36$* '* ($ (+$( +39& $ ,'@$,/ (3 $ %'+*''8*( ,$$,% 3 9*($($ $*(, '%$%$;
($ $$8('$*$%% 3 %98 %(($+'$% '* '%3,('3* 36 88$%% (3 &'6/ $*(, 8$ '% ,'@$,/ (3 )$
'6'*'%$. I* ($ N$ B$,* 83*($>( ($$3$ 88$%% (3 &'6/ $*(, 8$; &('89,,/ 3
36$* 63%( ( '%@ 3 3, '%$%$ %39, )$ 83*%'$$.
• E,9('3*.
A*/ &3&3%$ 3, $,( &363('3* &3+66$ '6$ ( '6&3'*+ '**( 3, $,( 69%( '*8,9$
836&$$*%'$ $,9('3* &,* '8 (@$% '* (3 8839*( &38$%%; '6&8(; 39(836$ * $83*36'8
%&$8(% 3 $,9('3*.
• C9,(9, 836&$($*8/
P3+66$% %39, '*83&3($ %'+*''8*( 83669*'(/ '*3,$6$*( 36 ($ &,**'*+; (39+
'6&,$6$*(('3* (3 ($ $,9('3* &%$. %$ 9&3* ($ $'$*8$; ($ '*3,$6$*( 3 83669*'(/
$98(3% (3+$($ '( 8', * $,( 8$ 3@$%; '% ,'@$,/ (3 )$ )$*$'8',. F9($63$ '
$$6$ 89,(9,,/ &&3&'($ * 88$&(),$ (3 ($ 83669*'(/ '('* ($ NB 83*($>(; 36$ '%'(%
8* )$ '('3*,,/ %9&&3('$.
A*/ &,**$ 3, $,( '*($$*('3*% 3 &3+6% %39, )$ &$8$$ )/ 8$9, * 836&$$*%'$
*$$% %%$%%6$*( 9%'*+ ($8*'
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• C3*($*(
P'6/ - &'6/ &$$*('3* &&38$% (( 389% 3* ,3 ($8*3,3+/ %(($+'$% %98 % &,
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AppendiB 6 7 Search Strate>ies
?!estion 6%
W( '% ($ '*,9$*8$ 3 6($*, 3, $,( 3* +$%(('3*, * &$'*(, $$*(%?
1 $>& &$'33*(, '%$%$% 3 $>& ,$3, )3*$ ,3%% 3 $>& 98('3* $$8(% 3 $>& +'*+','%$%$% 3 $>& +'*+', $63+$ 3 $>& +'*+', *$3&,%6% 3 $>& +'*+', 3$+3( 3 $>&+'*+', $8$%%'3* 3 $>& +'*+''('% 3 $>& +*9,36; +'*( 8$,, 3 $>& &$'833*'('% 3 $>&&$'33*(, ((86$*( ,3%% 3 $>& &$'33*(, 8/%( 3 $>& &$'33*('('% 3 $>& (33( ,3%% 3 $>&(33( 6'+('3* 3 $>& 6$%', 63$6$*( 3 ($$( 3 $>& (33( 63)','(/
2 $>& G'*+', H$63+$
1 3 2
" $>& P$+**8/
5 $>& &$+**8/ 836&,'8('3*% 3 $>& )3('3*; %&3*(*$39% 3 $>& 83$ +'96 3 $>&')$($%; +$%(('3*, 3 $>& $(, $( 3 $>& $(, '%$%$% 3 $>& /&$($*%'3*; &$+**8/-'*98$ 3 $>& 63*'*+ %'8@*$%% 3 $>& &,8$*( '%$%$% 3 $>& &$+**8/ 836&,'8('3*%;8'3%89, 3 $>& &$+**8/ 836&,'8('3*%; $6(3,3+'8 3 $>& &$+**8/ 836&,'8('3*%;'*$8('39% 3 $>& &$+**8/ 836&,'8('3*%; *$3&,%('8 3 $>& &$+**8/ '* ')$('8% 3 $>&&$+**8/; $8(3&'8 3 $>& &$*(, '*9'$% 3 $>& &9$&$, '%3$%
" 3 5
7 $>& '**( 3 $>& '**(; *$)3* 3 $>& '**(; ,3 )'( $'+( 3 $>& '**(; &$6(9$
* * 7
# *
10 ,'6'( # (3 $*+,'% ,*+9+$
11 ,'6'( 10 (3 4$'$ ('8,$% * /1##7 - 200
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?!estion &%
W( '% ($ '6&8( 3 6($*, $,( * &$'-*(, $$*(% 3* ($ $$,3&6$*( 3 $$,3&6$*(,$$8(% 3 $*6$,?
1. (33( )*36,'('$%
2. $*(, $*6$, /&3&,%'
. (33( '%83,3('3*
". $*(, $*6$,
5. 63,
. (33( 8,8''8('3*
7. 4$*6$, 2 $$8(.6&. 6&('(,$; 3'+'*, ('(,$; )%(8(; *6$ 3 %9)%(*8$ 3; %9)$8($'*+ 3X
. 4$*6$, 2 /&3.6&. 6&('(,$; 3'+'*, ('(,$; )%(8(; *6$ 3 %9)%(*8$ 3; %9)$8( $'*+3X
#. 4MIH 3 63, '*8'%3 /&36'*$,'('3* 3 63, '*8'%3 /&3-6'*$,'('3*.6&. 6&('(,$;3'+'*, ('(,$; )%(8(; *6$ 3 %9)%(*8$ 3; %9)$8( $'*+ 3X
10. ''3&('8 $*6$,.6&. 6&('(,$; 3'+'*, ('(,$; )%(8(; *6$ 3 %9)%(*8$ 3; %9)$8( $'*+3X
11. 8$$%$ 63,.6&. 6&('(,$; 3'+'*, ('(,$; )%(8(; *6$ 3 %9)%(*8$ 3; %9)$8( $'*+3X
12. $*6$, 3&8'(.6&. 6&('(,$; 3'+'*, ('(,$; )%(8(; *6$ 3 %9)%(*8$ 3; %9)$8( $'*+3X
1. 31-12
1". ,'6'( 1 (3 4$*+,'% ,*+9+$ * $('3,3+/ 43&('6'$ * ,, 8', 40 (3 1 /$%
15. (33( )*36,'('$%$(; )
1. $*(, $*6$, /&3&,%'$(; )
17. (33( '%83,3('3*$(; )
1. 63,)
1#. $*(, $*6$,)
20. (33( 8,8''8('3*)
21. (33( )*36,'('$%$(; ) 3 $*(, $*6$, /&3&,%'$(; ) 3 (33( '%83,3('3*$(; ) 363,) 3 $*(, $*6$,) 3 (33( 8,8''8('3*)
22. ,'6'( 21 (3 4$*+,'% ,*+9+$ * ,, 8', 40 (3 1 /$%
2. 1" 3 22
2". (33( )*36,'('$% 3 $*(, $*6$, /&3&,%' 3 (33( '%83,3('3* 3 $*(, $*6$, 363, 3 (33( 8,8''8('3* 3 7 3 3 # 3 10 3 11 3 12
25. ,'6'( 2" (3 4$*+,'% ,*+9+$ * $('3,3+/ 43&('6'$ * ,, 8', 40 (3 1 /$%
2. 22 3 25
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?!estion 8
W( '% ($ '*,9$*8$ 3 6($*, +$*$, $,( 3* ($ ECC $>&$'$*8$ 3 ($' 3%&'*+?
S$8 S(($+/:
1 $>& $,( 3 $>& 6',/ $,( 3 $>& 3,'%('8 $,( 3 $>& 6$*(, $,( 3 $>& 6'*3'(/
$,( 3 $>& 3889&('3*, $,( 3 $>& &/%'8, '(*$%% 3 $>& &9),'8 $,( 3 $>& 9, $,( 3
$>& %9)9)* $,( 3 $>& 9)* $,( 3 $>& 36$*Z% $,( 3 $>& &3&9,('3* 3 $>&
%38'3$83*36'8 8(3%
2 $>& 6$*(, $,( 3 $>& 6$*(, '%3$%
$>& '**( 3 $>& '**(; *$)3*
" $>& 8', 3 $>& 8',; &$%833,
5 $>& (33( '%$%$% 3 $>& $*(, $&3%'(% 3 $>& $*(, ,$@+$ 3 $>& $*(, &9,& '%$%$% 3 $>& $*('* %$*%'(''(/ 3 $>& 38, '*$8('3*; $*(, 3 $>& (33( )*36,'('$% 3 $>& (33( )%'3*
3 $>& (33( $6'*$,'('3* 3 $>& $*(, 8'$% 3 $>& (33( $3%'3* 3 $>& (33( ,3%% 3 $>&
(33(8$
$*(, $8/.6&. 3 $>& D$*(, C'$%
7 $>& M($*, E>&3%9$ 3 $>& M($*, N9('('3* P/%'3,3+/ 3 $>& M($*,-F$(, E>8*+$ 3
$>& M($*, H$,( S$'8$% 3 $>& M($*, W$,$ 3 $>& M($*, $'3 3 6($*,.6&. 3
$>& M($*,-F$(, R$,('3*% 3 $>& M($*, A+$ 3 $>& M($*, M3(,'(/ 3 $>& M($*,
D$&'('3*
6($*, $,$.6&. 3 $>& M($*, W$,$
# $>& S93+($ M3($% 3 $>& M3($% 3 63($%.6&.
10 1 3 2 42511
11 3 " 45###
12 5 3 422
1 7 3 3 # 4#525
1" 10 * 1 45#75
15 11 * 12 410117
1 1" * 15 42#
17 ,'6'( 1 (3 $*+,'% ,*+9+$
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?!estion @%
W( '% ($ '*,9$*8$ 3 6($*, 3, $,( 3* ECC $>&$'$*8$ '* ($' 3%&'*+?
S$8 S(($+/:
1 $>& O, H$,(
2 $>& &$'33*(, '%$%$% 3 $>& ,$3, )3*$ ,3%% 3 $>& 98('3* $$8(% 3 $>& +'*+','%$%$% 3 $>& +'*+', $63+$ 3 $>& +'*+', *$3&,%6% 3 $>& +'*+', 3$+3( 3 $>&+'*+', $8$%%'3* 3 $>& +'*+''('% 3 $>& +'*+', &38@$( 3 $>& +'*+''('%; *$83(''*+ 9,8$('$ 3$>& +*9,36; +'*( 8$,, 3 $>& &$'833*'('% 3 $>& &$'33*(, ((86$*( ,3%% 3 $>&&$'33*('('% 3 $>& &$'33*(, )%8$%% 3 $>& &$'33*(, &38@$( 3 $>& &$'33*('('%; 9$*',$ 3$>& (33( ,3%% 3 $>& (33( 63)','(/ 3 $>& %,'/ +,* '%$%$%
$>& (33( $6'*$,'('3* 3 $>& $*(, 8'$% 3 $>& $*(, '%%9$% 3 $>& 33( 8'$% 3
$>& (33( '%83,3('3* 3 $>& (33( $3%'3* 3 $>& (33( $9&('3*; $8(3&'8
" $>& $*(, 8'$% 3 $>& (33(8$
5 1 3 2 3 3 "
$>& $,( %((9% 3 $>& +$'('8 %%$%%6$*( 3 $>& $,( %((9% '%&'('$%
7 $>& S63@'*+ 3 $>& M'9* S63@'*+ 3 $>& S63@'*+ C$%%('3*
$>& )'( 3$ 3 $>& 6',/ $,('3*% 3 $>& 6($*, )$'3 3 $>& 6($*,-$(, $,('3*%3 $>& 6($*, $&'('3* 3 $>& &$*(-8', $,('3*% 3 $>& &$*('*+ 3 $>& &($*, )$'33 $>& &($*, $&'('3* 3 $>& %'),'*+ $,('3*%
# $>& H$,( $'3
10 $>& M($*, W$,$
11 3 7 3 3 # 3 10
12 $>& &$*(% 3 $>& ($% 3 $>& 63($% 3 $>& %'*+,$ &$*( 3 $>& %93+($ 63($%
1 F$6,$
1" 12 3 1
15 11 * 1"
1 $>& 8', 3 $>& 8',; &$%833, 3 $>& '**(
17 5 * 1
1 15 * 17
1# ,'6'( 1 (3 $*+,'% ,*+9+$
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?!estion .%
H3 $$8('$ $ '*($$*('3*% '*3,'*+ 63($% '* $98'*+ ECC '* ($' '**(%?
S$8 S(($+/:
1 $>& ($% 3 $>& 63($% 3 $>& %'*+,$-&$*( 6',/
2 6($*,.6&.
$>& %(36(3+*('8 '%$%$% 3 $>& (33( '%$%$% 3 $>& $*(, $&3%'(% 3 $>& $*(,,$@+$ 3 $>& $*(, &9,& '%$%$% 3 $>& 38, '*$8('3*; $*(, 3 $>& 639(; $$*(9,39% 3 $>&(33( )*36,'('$% 3 $>& (33( $6'*$,'('3* 3 $>& $*(, 8'$% 3 $>& $*(, '%%9$% 3 $>&33( 8'$% 3 $>& (33( '%83,3('3* 3 $>& (33( ,3%% 3 $>& (33( $%3&('3* 3 $>& (33(8$
" $>& D$*(, C'$%
5 $>& &$'33*(, '%$%$% 3 $>& ,$3, )3*$ ,3%% 3 $>& 98('3* $$8(% 3 $>& +'*+',
'%$%$% 3 $>& +'*+', $63+$ 3 $>& +'*+', *$3&,%6% 3 $>& +'*+', 3$+3( 3 $>&+'*+', $8$%%'3* 3 $>& +'*+''('% 3 $>& +'*+', &38@$( 3 $>& +'*+''('%; *$83(''*+ 9,8$('$ 3$>& &$'33*(, ((86$*( ,3%% 3 $>& &$'33*(, 8/%( 3 $>& &$'33*('('% 3 $>& (33( ,3%% 3 $>&(33( 6'+('3* 3 $>& (33( 63)','(/
1 3 2
7 3 " 3 5
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AppendiB & 7 0Bpert Review Panel
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AppendiB 8 7 0vidence )ables
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O$*)8$ $( ,.;
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C',$* 36$* T$(6$*(: 200 ($(6$*(
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M$
OH - oral health" Ob 7 Obstetric" P* - periodontal disease" P) 7 preterm% 9,2 7 low birth wei>ht" SRP 7 scalin>root planin>" OH$ 7 oral
hy>iene instr!ction" OR 7 odds ration" RC) 7 randomiDed controlled trial" CH5- chlorheBidine" SS 7 statistically si>nificant
Kilpatrick NM, Gussy MG, Mahoney E. Murdoch Children’s Research Institute %!
Septemer !""#
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E'$*8$ T),$- Q9$%('3* 2: W( '% ($ '6&8( 3 6($*, $,( * &$'*(, $$*(% 3* ($ $$,3&6$*( 3 $$,3&6$*(, $$8(% 3 $*6$,
A!thors )ype of
St!dy
Pop!lation Maternal or Child
Health)ooth defect
variables !sed
3indin>s ?!a
Rat
N'33 $( , C%$
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9'*+ &$+**8/; &3%(-*(, *9('('3*, %((9%; '*$8('3* 2-
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Kilpatrick NM, Gussy MG, Mahoney E. Murdoch Children’s Research Institute %$
Septemer !""#
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#-1 /$% 3,
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MCH 7 maternal or child health" )* 7 tooth defect" **0 7 developmental defect of enamel" SS 7 statistical si>nificant" 9,2 7 low birth
wei>ht" 19,2 7 very low birth wei>ht" P) 7 preterm" ,MC 7 bone mineral content
Kilpatrick NM, Gussy MG, Mahoney E. Murdoch Children’s Research Institute %%
Septemer !""#
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Kilpatrick NM, Gussy MG, Mahoney E. Murdoch Children’s Research Institute %&
Septemer !""#
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T9@$/ C',$* +$ 15-5
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%(9/. C',$* +$
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OH 7 oral health" SS 7 statically si>nificant" dmfs 7 decayed" missin> or filled s!rfaces Edecid!o!s teethF" *M3S - decayed" missin> or
filled s!rfaces Epermanent teethF" S0S 7 socio-economic stat!s" *) 7 decayed teeth" 0CC 7 early childhood caries
Kilpatrick NM, Gussy MG, Mahoney E. Murdoch Children’s Research Institute %(
Septemer !""#
-
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Q9$%('3* 5 H3 $$8('$ $ '*($$*('3*% '*3,'*+ 63($% '* $98'*+ ECC '* ($' '**(%
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Kilpatrick NM, Gussy MG, Mahoney E. Murdoch Children’s Research Institute %#
Septemer !""#
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References