How can we prevent tooth decay in the first year of life?

Tooth decay in young children, especially poor children, is very common. It affects billions of children worldwide. Tooth decay can have long‐lasting effects on health and it can cost a lot to treat it. Dental plaque is bacteria in the mouth, and it is well known that it causes tooth decay, along with sugar. The attitudes, beliefs, and habits of pregnant women, mothers and other people looking after children can influence the dental health of their children.

What was the research?

A systematic review to find out if promoting good oral health with pregnant women and people who look after children in the first year of their life can stop young children from getting tooth decay. We looked at whether giving information about healthy diets, the best way to feed babies and clean their teeth, and providing dental care makes a difference. We did not look at fluoride treatment in this review.

Who conducted the research?

The research was conducted by a team led by Elisha Riggs, of Murdoch Children’s Research Institute, Melbourne, Australia, on behalf of Cochrane Oral Health. Nicky Kilpatrick, Linda Slack‐Smith, Barbara Chadwick, Jane Yelland and M.S. Murthu were also on the team.

What evidence was included in the review?

We searched for evidence available up to 14 January 2019. We found 17 randomised controlled trials. The trials involved 23,732 caregivers who were mainly mothers, and their children.

Eleven trials looked at oral health education and promotion. This included giving support to women who were breastfeeding, giving advice on diet and feeding, and combining advice on diet and feeding with giving advice on how to keep children’s teeth clean.

Dental treatment aimed at reducing bacteria in the mother’s mouth was also considered. Four trials compared putting a special varnish on the teeth compared with a placebo. Two trials compared the use of xylitol chewing gum with a chlorhexidine dental gel.

None of the trials looked at programmes aimed at improving access to dental services.

What did the evidence say?

We found some evidence that children whose caregivers received advice on a healthy diet and feeding practices for infants and children were less likely to have tooth decay up to the age of six than those whose caregivers received the usual care.

The evidence about breastfeeding support, and advice on diet combined with tooth cleaning advice did not show that these interventions reduced the risk of tooth decay in young children compared with usual care. However, the findings of these studies were so uncertain that we cannot say that these interventions do not work.

We found mixed evidence about treatments to reduce bacteria in mothers’ mouths and cannot reach firm conclusions about whether or not these could potentially prevent early childhood caries.

None of the included trials indicated receiving funding that is likely to have influenced their results.

What are the implications for dentists and the general public?

Providing advice on diet and feeding to pregnant women, mothers or other caregivers with children up to the age of one year probably leads to a slightly reduced risk of tooth decay in their children during their early years.

What should researchers look at in the future?

We need more high-quality studies that have a large number of people taking part in them in order to find out if there are other interventions with caregivers that can help reduce tooth decay in young children. We also need more studies to find out which features of interventions make them effective. We are aware of 12 studies currently in progress.


Riggs  E, Kilpatrick  N, Slack‐Smith  L, Chadwick  B, Yelland  J, Muthu  MS, Gomersall  JC. Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries. Cochrane Database of Systematic Reviews 2019, Issue 11. Art. No.: CD012155. DOI: 10.1002/14651858.CD012155.pub2.

This post is an extended version of the review’s plain language summary, compiled by Anne Littlewood at the Cochrane Oral Health Editorial Base.

1 thought on “How can we prevent tooth decay in the first year of life?

  1. Pingback: Early childhood caries: Preventive interventions for pregnant and nursing mothers and other primary caregivers - National Elf Service

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