Introduction
In 1988, the ‘aks Zahnprophylaxe GmbH’, a special association for preventive and social medicine and health, initiated and conducted the Oral Health Promotion Programme (OHPP) as a regional programme in Vorarlberg, Austria to reduce the caries experience in young children.

Background
In Austria, public health promotion programmes for kindergartens and schools are legally regulated and well implemented. However, traditional dental health education approaches seem to have had limited success in preventing caries in primary dentition and limited access to 0-3 year olds. ‘Aks’ initiated the OHPP by providing new mothers with dental health counselling, so that the children born to the mothers would benefit with good oral health.

Programme Outline
Training the Educators

• Thirty two dental health educators (dental clinic assistants) were trained by aks.
• Following a two day workshop covering early childhood caries (epidemiology, treatment, prevention), the training programme was evaluated through questionnaire.
• Yearly one day follow up meetings for programme refinement and development took place between the Educators and aks.

Programme for the new mothers

• The Educators visited all mothers after birth in the regional hospitals in Vorarlberg.
• Mothers in small groups of 2-3 women were given counselling lasting 30 minutes per group, regarding the oral health of their children as a one-off intervention course.
• Mothers were counselled about the importance of breast feeding, use of baby bottles and pacifiers, diet, caries development and how it can be prevented.
• Each course ended with practical tooth brushing training, where the mothers practised tooth brushing on a model with teeth.
• Each mother received a folder with brief information material with recommendations related to diet, oral hygiene, fluorides and dental examinations.

Achievements
Five years after the introduction of OHPP, the children’s oral health was assessed.

Children (5 year olds) whose mothers participated in the OHPP showed significantly low caries prevalence (33.3%) and experience 3.2 dmfs and 1.5 dmft versus in children whose mothers did not participate in the OHPP showed caries prevalence of 42.6%, 5.2 dmfs and 2.4 dmft.
Mothers who participated in the programme started tooth brushing with children, used fluoride toothpaste and salt and supervised tooth brushing more often than the non- participating mothers.
The cost benefit assessment revealed that with a budget of 1 EURO per child a benefit of 1 sound tooth could be reached.

Conclusion
This Programme confirmed the effectiveness of a one-off intervention at the time of birth was sufficient to improve oral health of young children.

Reference

Wagner Y, Greiner S, Heinrich-Weltzien R. Evaluation of an oral health promotion program at the time of birth on dental caries in 5-year-old children in Vorarlberg, Austria. Community Dent Oral Epidemiol 2013. (http://onlinelibrary.wiley.com/doi/10.1111/cdoe.12072/full)