Data sources Database searches included Pubmed, Embase, Scopus, Web of Science, LILACS, Cochrane Library and ClinicalTrials.gov.
Study selection This review included studies that assessed the impact of pre-natal oral health care on early childhood caries experience and/or oral carriage of S. mutans. The review included case control studies, retrospective or prospective cohort studies, randomised or non-randomised controlled trials. In vitro studies, animal studies, literature reviews, cross sectional studies and literature reviews were excluded.
Data extraction and synthesis Two calibrated and independent reviewers screened the literature using a data extraction form based on defined inclusion and exclusion criteria. A PRISMA flow diagram is presented showing the process of reviewing the literature. The Cochrane Risk of Bias Tool for Randomised Trials and an adapted version of the Downs and Black score were used to assess the quality of the included studies. A qualitative synthesis of five included studies is presented. A Forest Plot then presents quantitative data from four of the studies. A meta analysis did not take place. A generalised linear mixed effects model was applied to results from four of the studies.
Results Five studies were included in the qualitative syntheses, three of the studies were randomised controlled trials, one was a prospective cohort study and one was a nested case-control in a cohort study. Two of the studies were assessed as high quality with three assessed as moderate quality. Odds ratios of children experiencing early childhood caries are reported for four studies demonstrating a reduced risk of early childhood caries in intervention groups compared to controls. A generalised linear mixed effects model using combined results from the four studies shows a reduced risk of developing early childhood caries in children up to the age of three years old whose mothers receive pre natal oral care. Above age three years the results of the modelling become non-significant.
Based on the results of two studies the authors report a reduction in levels of S. mutans in the oral cavity of children whose mother had prenatal oral care.
Conclusions The authors conclude that prenatal oral healthcare has a positive effect on incidence of early childhood caries and S. mutans carriage in children.
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