Effect of oral health promotion provided by public health nurses on the behaviors of mothers with infants

The Boston Public Health Commission's Healthy Baby/Healthy Child Program (HBHC) is a perinatal home-visiting program that targets women at high risk for adverse birth outcomes. The purpose of this study was to explore the feasibility of incorporating a patient-centered oral health promotion model, delivered by home-visiting nurses, into HBHC and to assess the program's impact on participant's risk factors for early childhood caries (ECC). All nurses were trained in patient-centered counseling and oral health. For participating families, nurses incorporated oral health visits into their home visiting schedule. After each visit a dental hygienist conducted a follow-up oral health assessment and administered a questionnaire. Data was obtained from 18 mother-child controls and from 37 mother-child pairs who received home-based oral health counseling provided by the HBHC nurses. Chi-square tests and t-tests were performed. The participants were Black (59.5%), Hispanic (27.0%), Medicaid-eligible (70.3%), and 21.6% did not graduate high school. The results indicated an increase in the percentage of mothers who reported wiping their child's gums or brushing their teeth (55.6% of controls; 86.5% at the first assessment; 100.0% at the third assessment; p < 0.05 for both) and in the percentage who reported that their child had a dentist (0.0% of controls; 35.1% at the third assessment; p < 0.05). These findings support the use of patient-centered counseling, provided by home visiting nurses, as an effective approach to prevent ECC among those most at risk and least likely to receive dental care. More research should be conducted in this promising area.