The Center for Native Oral Health Research comprised two large scale-clinical trials of behavioral interventions for the prevention of caries in pre-school children of a Southwestern American Indian tribe, and parents of infants in a Northern Plains Tribe.
The first clinical trial was a cluster randomized trial to test the efficacy of an instructional intervention with parents of Head Start children on a large Southwestern Indian Reservation; the intervention was carried out by tribal “Community Oral Health Specialists” who were trained to work within the community and provide fluoride varnish in the Head Start Centers. After two years, children in the program did not have less caries experience or lower scores, although when parents of children participated more actively in the program, their children’s caries scores were lower.
The second randomized trial tested the efficacy of Motivational Interviewing with new mothers of infants in a Northern Plains tribe over a period of three years beginning at the child’s birth. At the end of the trial, there were no differences in the caries experience and scores of the two groups of children.
As indicated above, in neither of the clinical trials did the children of those in the intervention groups differ in caries experience from those in the control groups. The trials highlighted the challenges of decreasing early childhood caries in a group with the highest caries experience of any population group in our country. Additional analyses have led to a better understanding of some of the factors that may be addressed in future programs to improve oral health of these children in the future.