Feasibility of Environmental Dietary Intervention to Reduce Early-childhood Dental Caries

Objectives: Sugar-sweetened beverages (SSBs) are a major risk factor for tooth decay, particularly for Latino children, as they are more likely to drink SSBs and less likely to drink water. Families of young children who received dental treatment under general anesthesia are motivated to reduce SSB consumption but need better capabilities and opportunities to make these changes. Our aim was to test the feasibility, acceptability, and appropriateness of an environmental dietary intervention, designed to promote the consumption of water, in lieu of sugar-sweetened beverages, on dental caries relapse among Latino and non-Latino children.
Methods: We conducted a pilot one-arm trial with 21 child/caregiver dyads at a single study site. Intervention consisted of home delivery of water bottles and patient-centered caregiver counseling by a dietitian. Data was collected on dental caries, height and weight, dietary intake (including water and SSB), mediators, confounders, and process outcomes. A focus group and questionnaire with the caregivers assessed acceptability and appropriateness.
Results: The target enrollment was met, and the retention rate was 95%. Key measures of feasibility were collected from 100% of enrolled participants and key measures of acceptability were collected on 90% of enrolled participants. Internal barriers for enrollment were limited study staff and clinic hours; external barriers included seasonal weather and agricultural work schedules for caregivers. Challenges for intervention delivery included water delivery when caregivers were moving and when caregivers had pregnancy-related events.

Conclusions: The implementation and evaluation of this pilot study indicated that the study is feasible, acceptable and appropriate. Based on this study, investigators adapted the intervention and evaluation procedures to the environment and people who will use it for a future efficacy trial.