Nutrition Intervention to Reduce Mutans Streptococci among Low-income Pregnant Women

Methods: Pregnant women were recruited and screened at a Community Health Center (CHC) for mutans streptococci levels using Dentocult SM. Subjects with high mutans were interviewed at baseline and randomized to an education (EI) or education+nutrition intervention (ENI). All subjects: 1)viewed a video and received materials on caries, nutrition and oral hygiene; 2) received tooth brushes/paste; 3)were reinterviewed and retested for mutans (coded low, medium, high) at 9 months, 6 weeks postpartum and 3 months postpartum; 4) received $25 for each visit. ENI consisted of two 60-minute programs; one before delivery at 9 months/one at 6 weeks postpartum. Sessions included nutrition education on sugar content of common foods, and good nutrition during/after pregnancy. ANOVA assessed changes in mutans levels and group differences.

Results: 126 met criteria (73% of those screened), 121 were randomized and 95 (79%) completed all visits. Mean age was 26.3 years (sd=6), 73% were Hispanic, 29% had lived in the US < 6 years; 48% completed high school; 27% were married; mean total sugar intake in the past week at baseline was 149 grams (sd=85). Most women (85%) had the highest mutans levels. Repeated measures ANOVA showed that mutans levels declined significantly in both groups, but that those in the EI group had significantly lower levels at the final assessment (32% high in EI vs 57% high in ENI). Sugar intake declined significantly, but there were no significant differences between groups in total sugar.

Conclusions: The study demonstrated: 1) the feasibility of conducting the intervention at CHC sites among low-income pregnant women; 2) the effectiveness of education to reduce mutans/sugar intake; 3) the need to improve ENI to obtain additional gains in mutans reduction.

Funding from Connecticut Health Foundation