Mother and youth access (MAYA) maternal chlorhexidine, counselling and paediatric fluoride varnish randomized clinical trial to prevent early childhood caries

Int J Paediatr Dent. 2012 May;22(3):169-79. doi: 10.1111/j.1365-263X.2011.01188.x. Epub 2011 Oct 17.

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.

Aim: Comparison of the efficacy of two prevention interventions in reducing early childhood caries (ECC).

Design: 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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Anti-Infective Agents, Local / therapeutic use*
  • Bacterial Load / drug effects
  • California
  • Cariostatic Agents / therapeutic use*
  • Child, Preschool
  • Chlorhexidine / therapeutic use*
  • Counseling*
  • DMF Index
  • Dental Caries / prevention & control*
  • Female
  • Fluorides, Topical / therapeutic use*
  • Follow-Up Studies
  • Humans
  • Infant
  • Lactobacillus / drug effects
  • Lactobacillus / isolation & purification
  • Mexican Americans
  • Mouthwashes / therapeutic use*
  • Saliva / microbiology
  • Streptococcus mutans / drug effects
  • Streptococcus mutans / isolation & purification
  • Streptococcus sobrinus / drug effects
  • Streptococcus sobrinus / isolation & purification
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Infective Agents, Local
  • Cariostatic Agents
  • Fluorides, Topical
  • Mouthwashes
  • Chlorhexidine