maternal infant oral healthv2 aug09

8/20/2019 Maternal Infant Oral Healthv2 Aug09

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Maternal and Child Oral Health -

Systematic Review and Analysis

A report for the New Zealand Ministry of Health

Prepared by the Oral Health Research ro!p"M!rdoch Children#s Research $nstit!te%

September &''(


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$N)RO*+C)$ON%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% &

,ACRO+N*%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% .

EPIDEMIOLOGY.................................................................................................................................... 5

AETIOLOGY..........................................................................................................................................7

S/S)0MA)$C R01$02 O3 01$*0NC0%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%4

METHODS....................................................................................................................................... 10

Data Search................................................................................................................................. 10

Practical screen...........................................................................................................................10

Quality of methods screen...........................................................................................................11

Presentation of the findings.........................................................................................................11

Quality assurance........................................................................................................................ 11

QUESTION 1: WHAT IS THE INFLUENCE OF MATERNAL ORAL HEALTH ON GESTATIONAL AND PERI NATAL

EVENTS?........................................................................................................................................... 12

QUESTION 2: WHAT IS THE IMPACT OF MATERNAL HEALTH AND PRE AND PERI-NATAL EVENTS ON THE

DEVELOPMENT OF DEVELOPMENTAL DEFECTS OF ENAMEL?..................................................................15QUESTION : WHAT IS THE INFLUENCE OF MATERNAL GENERAL HEALTH ON THE ECC E!PERIENCE IN

THEIR OFFSPRING?............................................................................................................................ 17

QUESTION ": WHAT IS THE INFLUENCE OF MATERNAL ORAL HEALTH ON ECC E!PERIENCE IN THEIR

OFFSPRING?...................................................................................................................................... 1#

QUESTION 5. HOW EFFECTIVE ARE INTERVENTIONS INVOLVING MOTHERS IN REDUCING ECC IN THEIR

INFANTS?........................................................................................................................................... 22

CONCLUSIONS AND RECOMMENDATIONS.............................................................................................27

APP0N*$5 6 7 S0ARCH S)RA)0$0S%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%86

APP0N*$5 & 7 05P0R) R01$02 PAN09%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%8:

APP0N*$5 )HR00 7 01$*0NC0 )A,90S%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%8;

R030R0NC0S%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% .8


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Methods

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?!estion 6< 2hat is the infl!ence of maternal oral health on >estational and peri natal

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http://clinicaltrials.gov/ct2/show/NCT00097656?term=mouth+and+tooth+diseases&rank=36&show_desc=Y#deschttp://clinicaltrials.gov/ct2/show/NCT00097656?term=mouth+and+tooth+diseases&rank=36&show_desc=Y#deschttp://clinicaltrials.gov/ct2/show/NCT00097656?term=mouth+and+tooth+diseases&rank=36&show_desc=Y#deschttp://clinicaltrials.gov/ct2/show/NCT00097656?term=mouth+and+tooth+diseases&rank=36&show_desc=Y#desc


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New Zealand perspective

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+$*$,'('3* 3 ($%$ '*'*+% (3 %'6', $(*'8 +39&% ,''*+ '* N$ B$,*.

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$>&$'$*8$ 3 $(*'8 3 %38', %9)+39&% 3 36$*.

S!mmary ,oB 6

Highest level of available evidence: T/&$ I S/%($6('8 R$'$

Strength of evidence: M3$($

• P$'33*(, '%$%$ '* &$+**8/ '% %%38'($ '( '+$ '%@ 3 &33 )'( 39(836$% '* 36$*

36 '%*(+$ +39&%.

• T$(6$*( 3 &$'33*(, '%$%$ '* &$+**( 36$* (3 $98$ '%@ 3 &33 )'( 39(836$% '%

89$*(,/ *3( %9&&3($ )/ $'$*8$ 3$$ '% ,'@$,/ (3 )$ )$*$'8',.

• C3*(3, 3 &,


16/54

?!estion &< 2hat is the impact of maternal health and pre and peri-natal events on the

development of developmental defects of enamel

A ,+$ *96)$ 3 %(9'$% $ %3* %'+*''8*( $,('3*%'& )$($$* $$,3&6$*(, $$8(% 3

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6($*, *9('('3* 49%'*+ %'$ 3 +$%(('3*, +$ % &3>/ * $>&3%9$ (3 '*$8('3*%; 9'*+

&$+**8/ $ %%38'($ '( * '*8$%$ '* &$,$*8$ 3 $*(, $$8(% 3$$ ($ %6&,$ %'$ '*

)3( %(9'$% $ $,('$,/ %6,,.


17/54

I* %966/ ,(39+ '( &&$% (( &3),$6% 9'*+ &$+**8/; )'( * 9'*+ ($ *$3-*(, &$'3

83*(')9($ (3 '+$ '*8'$*8$ 3 $*6$, $$8(% '* ($ &'6/ $*('('3*; ($ %&$8''8 $('3,3+'8,

8(3% $%&3*%'),$ $ *3( )$$* '$*(''$ * 6/ &3$ ''89,( (3 '%3,($ 9$ (3 ($ $>'%($*8$ 3

69,('&,$ 83*39*'*+ 8(3%. N$$($,$%% &363('3* 3 6($*, $,( 9'*+ &$+**8/ '* 3$ (3

6'*'6'%$ &33 )'( 39(836$% * $98$ &$'-*(, 63)''(/ '% ,'@$,/ (3 $**8$ '**( 3, $,(;*3( 3*,/ (39+ ($ '*,9$*8$ 3* ($ $$,3&'*+ $*('('3* )9( ,%3 )/ '*8$%'*+ 6($*, $,, )$'*+;

$98'*+ %($%% * $**8'*+ ($' )3$ &$*('*+ )','('$%.

S!mmary ,oB &

Highest level of available evidence: T/&$ IV O)%$('3*, S(9/

Strength of evidence: L3 (3 63$($

• P363('3* 3 +33 &$*(, 6($*, $,( * *9('('3* 6/ ,3$ '%@% 3 $$,3&6$*(, $$8(%

3 $*6$, '* ($' 8',.

• C',$* )3* &$6(9$,/ 3 (3%$ '( '%(3/ 3 %'+*''8*( ',,*$%% '* $,/ '**8/ %39, )$

83*%'$$ '+ '%@ 3 $$,3&6$*(, $$8(% 3 $*6$, * ($$3$ $,/ 8',33 8'$%.


18/54

?!estion 8< 2hat is the infl!ence of maternal >eneral health on the 0CC eBperience in

their offsprin>

M($*, $,(-$,($ &8('8$% * ($ 83'8$% ($/ 6@$ 3 ($' 8',$* ',, '*,9$*8$ 8',

$,( * $,,-)$'*+. M3($% $ 3($* $$$ (3 % ($ @$/ '+9$ '* ($' 8',% +$*$, *

$*(, $,( % ($/ $ 9%9,,/ ($ &'6/ 8$ +'$%. D$*(, $,( 3 8',$* '% $,($ (3 ($'

'$(; 3, /+'$*$ &8('8$% * $*(, (($**8$ &(($*% * (3%$ 3 ($' 63($%. I 63($ '%

'*8&8'(($ 3 */ $%3*; %98 % 83*'8 6$*(, 3 &/%'8, ',,*$%% ('% 839, '6&8( 3* $,(

$,($ &8('8$%; '*8,9'*+ 3, $,(; 3 ($' 8',$*. A %$8 % ($$3$ 83*98($ 3 %(9'$%

(( &3'$ '*36('3* 3* ($ '6&8( 3 &33 6($*, $,( * $,, )$'*+ 3* ECC $>&$'$*8$ '*

($' 8',$* 3$$ $/ $ %(9'$% $$ '$*(''$. O ($ ,'6'($ ,'($(9$ ',),$ (3 $%

$ )$$* $%$8$ 6($*, 6$*(, $,( * &$*(, %63@'*+ &8('8$%.

L'($(9$ 36 *3*-$*(, $,( '$,% %3 (( &33 6$*(, $,( 3 %($%% 6/ '6&' ($ )','(/ 3

63($% (3 $*++$ '* * 6'*('* $,( &363('*+ )$'39%. ; # T$ ,'($(9$ &$('*'*+ (3 3,

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$ )$$* %3* (3 )$ ,$%% ,'@$,/ (3 (@$ ($' 8',$* (3 $*(, &3$%%'3*,. 70 H3$$ ($$ %

)$$* *3 (($6&( (3 $,($ $&$%%'$ %/6&(36% (3 8',$*% 8(9, 8'$% ($. T$$ '% ,%3 %36$

$'$*8$ (( &$*(, %($%% ,$$,% $ %%38'($ '( ECC '* 1- /$ 3,% )9( *3( '* "-5 /$ 3,%

$$ '* 8( &$*(, %($%% &&$% (3 $'($ )$ 9*$,($ (3 71 3 $$* &3($8('$ +'*%( ECC. I( '%

&3%%'),$ (( ' %98 $,('3*%'& 3$% $>'%(; '( '% 6%@$ )/ 3($ 698 %(3*+$ 8(3% %98 %

SES * 8',33 *9('('3*. F9($ %(9'$% $ $&3%9$ (3 %63@$

'*8$%$% ($ '%@ 3 $$,3&'*+ %%38'($ 6$'8, 83*'('3*%; %98 % %(6 3 $%&'(3/

'*$8('3*%. T$%$ 83*'('3*% * ($ 6$'8('3*% 9%$ (3 ($( ($6 6/ '*8$%$ '%@ 3 ECC. 72

S$83*,/; %63@$% 6/ 83*%96$ 63$ %9+ '* ($' 33 * ($ %6$; '+,/ 8'3+$*'8 33% ',,

)$ +'$* (3 ($' 8',$*.# A,(39+ %63@'*+ &8('8$% 6/ ,%3 )$ ,'*@$ (3 SES * 83*(3,,'*+ 3

($ 836&,$> '*,9$*8$ 3 SES 8* )$ ''89,(; (3 %(9'$% (( $ %3* &3%'('$ $,('3*%'&

)$($$* &%%'$ %63@'*+ * 8'$%. I* 3*$ %98 %(9/ &%%'$ %63@'*+ % 39* (3 )$ *

'*$&$*$*( &$'8(3 3 8'$% '* -".5 /$ 3, 8',$* ($ 83*(3,,'*+ 3 SES.#

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N('3*, D'$( * N9('('3* S(9/.7 S'6',,/ *,/%'% 3 ( 36 ($ I3 F,93'$ S(9/ % 39*

%63@'*+ (3 )$ * '6&3(*( &$'8(3 3 8'$% '* '**(% )9( 3*,/ '* 6',$ '*836$ 6','$%.7" F9($

$%$8; 83*(3,,'*+ 3 83*39*'*+ '),$% %98 % SES '% ($$3$ $


19/54

&$,$*8$ '% @*3* (3 )$ '+$ '* M3' * P8''8 &$3&,$. F9($ '( % )$$* $&3($ (( 63

$&$%%'$ ',,*$%%$% 4% $>&$'$*8$ '* NB '* ($ &%( 12 63*(% $ $


20/54

?!estion @< 2hat is the infl!ence of maternal oral health on 0CC eBperience in their

offsprin>

E,/ 8',33 8'$% '% 69,('-8(3', '%$%$ '* '8 6($*, 88($'%('8% 9*39)($,/ &,/

%'+*''8*( 3,$. T'% 6/ )$ '$8(,/ (39+ )8($', (*%$ 3 '*'$8(,/ (39+ ($' 6',/ '$(/

&(($*% * %38', %'(9('3*. A ,+$ *96)$ 3 %(9'$% $ )$$* &9),'%$ '* ($ $*(, ,'($(9$

(( $ '*$%('+($ ($ '*,9$*8$ 3 &$*(, (('(9$% * @*3,$+$ 3 &&3&'($ (33( )9%'*+;

'$( * 9%$ 3 (33(&%($ 3* ($ $*(, $,( 3 ($' 8',$*. H3$$ $,('$,/ ,'((,$ $%$8 %

)$$* 83*98($ (3 '*$%('+($ ($ ,'*@ )$($$* &$*(, 3, $,( %((9% 48'$% * &$'33*(,

'%$%$ * ECC '* ($' 3%&'*+. T),$ " %966'%$% ($ %(9'$% (( $$ '$*(''$ (39+ 39

%$8 * '*8,9$ '* ('% $'$ (( $,($ ($ 8'$% %((9% 3 8',$* '( ($' &$*(% 3,

$,(. $89%$ 3 ,8@ 3 */ '+ %(9'$% 7; 77; 7; 7#; 0; 1 $&3($ $,('3*%'&% 9%'*+ 8,'*'8, 6$%9$%

3 $,( 39(836$% 46(DMFT; &3&3('3* 8'$% $$; &$%$*8$ 3 *($'3 8'$%; 3 *$$ 3

($(6$*( 3 )3( 63($ * 8',. T$$ %(9'$% 2; ; " 836&$ &$*( 43*$ %(9/ ,%3 %9$/$

($% %$,-$&3($ $*(, %((9% '( ($ '*'*+% 36 8,'*'8, $>6'*('3* 3 ($' 8',. A %'*+,$%(9/ 5 9%$ &$*( $&3($ $*(, %((9% 3 )3( 63($ * 8',. T$ 63'(/ 3 %(9'$% 4*7

$$ 83%% %$8('3*,; 3*$ 9%$ &3%&$8('$ 833( * 3*$ 9%$ 8%$ 83*(3, &&38. W'( 3*$

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* 8', 3, $,( %((9% * $ *3( ),$ (3 $%(),'% 89%$ * $$8(.

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3, %((9% 3 &$*(% 463%(,/ 63($% % $,($ (3 (( 3 ($' 8',$*. O*$ %(9/ 39*

%'+*''8*( %%38'('3*% '( 9*''($ *,/%'% )9( *3( '( ,($ 69,(''($ ,3+'%('8 ($%(%.7

I* ,+$; &3%&$8('$ %(9/" +39& 3 1"" &$+**( F'*'% 63($% $$ 3,,3$ 9& 3$ '$ /$%.

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'*($$%('*+ %$83*/ '*'*+ % (( )/ 5 /$% 3 +$ ($ ($% 3, %((9% )$86$ 9%( %

'6&3(*( % (( 3 ($ 63($%.


21/54

T$ 3*$ %(9/ (( ',$ (3 %3 */ %'+*''8*( %%38'('3* )$($$* 63($ * 8', 3, $,(

%((9% '*3,$ '**(% )3* '( 8,$( 3 ($ ,'& *3 &,($. 77 I( '% &3%%'),$ (( ('% %9)+39& 3

8',$* '% 63$ ,'@$,/ (3 $$,3& 8'$% (* * 3($'%$ $,(/ &3&9,('3* 9$ (3 )'$% (3

$6'*('3* 3 ($ '**( '% $&3($; $(',$ 8,'*'8,

$>6'*('3* 3 ($' 63($% 4&$*(% '% *3(. R($ '(($* 3 $), %$,-$&3( &$'$*8$ * 3)$8('$ 8,'*'8, 6$%9$% *3

%9&&3('*+ $'$*8$ 3 ('% % &$%$*($. I* '('3*; 6($*, %$,-$&3( 3 ($' 8',$*%

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$8,, * %38', $%')','(/ )'%$%. 5


22/54

A,(39+ ('% %(9/ % %'+*''8*( ,'6'(('3*% '( 3$% &3'$ %36$ '*%'+( '*(3 &3&9,('3* '* N$

B$,* % $,, % '$*('/'*+ +$( '('3* '* 3, %((9%; )$,'$% * &8('8$% )$($$* ($ '$$*(

P8''8 &3&9,('3*% 4S63*; C33@ I%,* M3' * T3*+*. T'% '+,'+(% ($ $($3+$*$39%

*(9$ 3 ($%$ &3&9,('3* +39&% * %9&&3(% 89('3* '* +$*$,''*+ ($ '*'*+% 36 %(9'$%

83*98($ '* '$$*( 839*('$% 3 83669*'('$% '('* N$ B$,*. I( ,%3 $6&%'$% ($ *$$ 3 %'+*''8*( &$,'6'*/ 83669*'(/ )%$ 83*%9,(('3* * $*++$6$*( '* 3$ (3 '$*('/ +39&-

%&$8''8 )$,'$%; *36% * &8('8$%. T'% '*36('3* '% '6&3(*( $* $$,3&'*+ 89,(9,,/

88$&(),$ '*($$*('3*% * 3 $%(),'%'*+ &&3&'($ 39(836$ 6$%9$% * $,9('3* (33,% (3

%%$%% ($ %988$%% 3 %98 '*($$*('3*%.

S!mmary ,oB @

Highest level of available evidence: T/&$ IV O)%$('3*, S(9/

Strength of Evidence: M3$($

• A,(39+ ($$ '% *3 $/ %(3*+ $'$*8$ 4'$ RCT% $+'*+ ($ $,('3*%'& )$($$* &$*(,

4$%&$8',,/ 6($*, 3, $,( * (( 3 ($' 3%&'*+; ( $'$*8$ 3$% $>'%( '% 83*%'%($*(,/

%9&&3('$.

• I*($$*('3*% '8 '6 (3 '6&3$ ($ 3, $,( 3 &$*(% $ ,'@$,/ (3 $ )$*$'8', $$8(% 3*

($ 3, $,( 3 ($' 3%&'*+.


23/54

?!estion .% How effective are interventions involvin> mothers in red!cin> 0CC in

their infants

I6&3'*+ ($ 3, $,( %((9% 3 63($% 6/ )$*$'( ($' 8',$* '* (3 +$*$, /%. F'%(,/;

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8)3/($ '*(@$ * '6&3'*+ 3, /+'$*$ )'(% $ ,'@$,/ (3 '6&8( 3* 3 ($/ 8$ 3 ($'

'**(% 3, $,(. S$83*,/ * '6&3$6$*( '* 6($*, 3, $,( 6/ $98$ ($ *96)$ 3 S.

mutans &$%$*( '* ($' 3, 8'(/ ($$)/ $98'*+ ($ &3($*(', '%@ 3 (*%6'%%'3* 3 ($%$

8'3+$*'8 )8($' (3 ($' 8',$*. I( '% &3)),$ (( ($ 63'(/ 3 8',$* 8/,'(3, %(9'$%. M3%( 3 ($ %(9'$% %6,, *96)$% 3 %9)$8(% * ($ '*($$*('3*%

'$ '* $>($*(; ,'6'('*+ ($ )','(/ (3 ++$+($ ($ $%9,(% 3 (3 83*8,9%'3*% 3* 3 )$*$'8',

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%3$ (( '6&3'*+ ($ 3, %((9% 3 63($ 3$% '$8(,/ (*%,($ '*(3 ,$%% 8'$% '* ($'

8',$*. M3%( 3 ($ %(9'$% &3'$ 3, /+'$*$ '*%(98('3* * (($6&($ (3 $%(3$ */ 8'39%

,$%'3*% (( $$ &$%$*( '* ($ 63($% 3, 8'(/ (3 $,'6'*($ 3 $98$ 6($*, S. mutans ,$$,%

9'*+ 3 '66$'($,/ ($ &$+**8/. I( '% /&3($%'$ (( ($ &&38$% 9%$ '* ($%$ %'>

%(9'$% 6/ $ $98$ 6($*, S. mutans ,$$,% * %9)%$/,'(3,

%(9'$%; ,(39+ '( '% ,$%% 8,$ '* ($ 3($% % ($/ 9%$ 69,('&,$ %(($+'$% '8 6/ $


24/54

$8($ S. mutans )9( ,%3 839, $ ,$ (3 )$'39, 8*+$% '* 63($% '( $,('3* (3 ($'

8',% '$( 3 3, /+'$*$ &8('8$%.

F39 %(9'$% '*8,9$ '* 39 $'$ $,9($ ($ $$8(% 3 $*(, $,( $98('3* &3'$ (3 ($

63($ 3* ($ ECC '* ($' 3%&'*+. T$ '%( %(9/; 8'$ 39( )/ K3% * 83-3@$% 42000;

($%($ ($ '6&8( 3 36$ '%'(% (3 63($% ,''*+ '* '%*(+$ %9)9)% 3 L$$% '* ($ UK. 7

V/'*+ &&38$% $$ 9%$ '* $,('3* (3 83*($*( 4G39& A '$( 3*,/; G39& 3, /+'$*$ 3*,/ 3

G39& C ),*8$ 3, /+'$*$ * '$(/ '8$ '( 36$ '%'(% %8$9,$ $$/ 63*(% 3

'%( (3 /$% ($* ('8$ '* ($ (' /$. A 39( +39& D % +'$* '$( * OH '*%(98('3* 9'*+

36$ '%'(% 83*98($ 9%( 3*8$ /$ 3 ($ 9,, /$%. A,, 8',$* * 63($% $$ $>6'*$

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%&$@'*+ 83669*'(/ '* '('% C3,96)'; C*. T$ &$*(% * 8',$* $$ *36,/ %%'+*$

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&&,'8('3*% '8 % &363($ (3 )3( +39&% (39+ &6&,$(.

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* '**( '$( 36 ($* /% 9& (3 %'> 63*(% * ($* +'* ( $'+(; ($* * ($,$ 63*(%. T$

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25/54

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26/54

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27/54

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S!mmary ,oB .

Highest level of evidence available: T/&$ II R*36'%$ 83*(3,,$ (',%

Strength of Evidence: M3$($

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28/54

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29/54

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30/54

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31/54

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32/54

AppendiB 6 7 Search Strate>ies

?!estion 6%

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2 $>& G'*+', H$63+$

1 3 2

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* * 7

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11 ,'6'( 10 (3 4$'$ ('8,$% * /1##7 - 200


33/54

?!estion &%

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1. (33( )*36,'('$%

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2. 22 3 25


34/54

?!estion 8

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S$8 S(($+/:

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35/54

?!estion @%

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S$8 S(($+/:

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# $>& H$,( $'3

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17 5 * 1

1 15 * 17

1# ,'6'( 1 (3 $*+,'% ,*+9+$


36/54

?!estion .%

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2 6($*,.6&.

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" $>& D$*(, C'$%

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1 3 2

7 3 " 3 5

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# ($(6$*(.6&.

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37/54

AppendiB & 7 0Bpert Review Panel

1. P3$%%3 A ,'*@3* 4NSW H$,( C'-P3&9,('3* O, $,(; F89,(/ 3 D$*('%(/; U*'$%'(/

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38/54

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40/54

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41/54

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42/54

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43/54

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hy>iene instr!ction" OR 7 odds ration" RC) 7 randomiDed controlled trial" CH5- chlorheBidine" SS 7 statistically si>nificant

Kilpatrick NM, Gussy MG, Mahoney E. Murdoch Children’s Research Institute %!

Septemer !""#


44/54

E'$*8$ T),$- Q9$%('3* 2: W( '% ($ '6&8( 3 6($*, $,( * &$'*(, $$*(% 3* ($ $$,3&6$*( 3 $$,3&6$*(, $$8(% 3 $*6$,

A!thors )ype of

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Health)ooth defect

variables !sed

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Kilpatrick NM, Gussy MG, Mahoney E. Murdoch Children’s Research Institute %$

Septemer !""#


45/54

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wei>ht" 19,2 7 very low birth wei>ht" P) 7 preterm" ,MC 7 bone mineral content

Kilpatrick NM, Gussy MG, Mahoney E. Murdoch Children’s Research Institute %%

Septemer !""#


46/54

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Septemer !""#


47/54

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filled s!rfaces Epermanent teethF" S0S 7 socio-economic stat!s" *) 7 decayed teeth" 0CC 7 early childhood caries

Kilpatrick NM, Gussy MG, Mahoney E. Murdoch Children’s Research Institute %(

Septemer !""#


49/54

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Kilpatrick NM, Gussy MG, Mahoney E. Murdoch Children’s Research Institute %#

Septemer !""#


50/54

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Kilpatrick NM, Gussy MG, Mahoney E. Murdoch Children’s Research Institute %0

Septemer !""#


51/54

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Kilpatrick NM, Gussy MG, Mahoney E. Murdoch Children’s Research Institute &"

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Septemer !""#


54/54

References

maternal infant oral healthv2 aug09

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