Impact of a Culturally Adapted Intervention on Early Childhood Caries Among Immigrants-A Cluster-Randomised Trial

Early Childhood Caries (ECC) is reported to be more common among immigrant children than their native counterparts. There are no community-based studies that assess the effectiveness of an intervention in reducing the risk of ECC among immigrant children in Norway. This study aimed to assess the effect of a culturally adapted intervention on ECC, plaque, feeding and oral hygiene habits in immigrant children, as well as on their parents' oral health behaviours.

Seven primary health centres in Bergen, Norway, were randomly assigned to either an intervention or a control group. Immigrant parents of newborns participated in the baseline study (n = 345). Self-reported data were collected via questionnaires at baseline (infants aged 0-6 months) and at follow-up (18-24 months following baseline). The intervention group received a culturally adapted intervention, which consisted of two one-to-one motivational interviews, MI-informed counselling (MI), toothbrushing demonstrations and pamphlets in the participants' native languages at baseline and after 6 months. The control group received only the routine dental information provided at the primary health centres. Clinical oral examinations were performed to assess the presence or absence of ECC and plaque in the children at follow-up. Differences in outcomes were assessed and compared between intervention and control groups using generalised linear mixed models. Odds ratios with corresponding 95% confidence intervals were reported.

A lower prevalence of carious lesions was observed in the intervention group (7.7%) than in the control group (10.6%), while plaque accumulation was higher in the intervention group (19.2%) than in the control group (17.3%). The intervention group exhibited lower odds of night-time feeding, not brushing day and night, or not using fluoride. Conversely, the intervention group showed higher odds of sugar intake in feeding bottles. Parents in the intervention group had higher odds of irregular flossing, mouthwash use and frequent sweet intake. However, none of the findings were statistically significant, indicating no true effect of the intervention.

The present study suggests that the intervention had no impact on ECC, plaque, feeding or oral hygiene habits of the immigrant children or on the parents' dietary and oral hygiene habits. These findings underscore the necessity for community-based, comprehensive interventions with extended follow-up periods to effectively address the needs of this diverse population.

ClinicalTrials.gov Identifier: NCT05758454.