| CTRI Number |
CTRI/2026/02/102990 [Registered on: 04/02/2026] Trial Registered Prospectively |
| Last Modified On: |
04/02/2026 |
| Post Graduate Thesis |
No |
| Type of Trial |
Interventional |
|
Type of Study
|
Preventive Screening Dentistry Process of Care Changes Behavioral |
| Study Design |
Randomized, Parallel Group, Active Controlled Trial |
|
Public Title of Study
|
Effect of combined maternal and child oral health care during and after pregnancy on preventing early childhood tooth decay |
|
Scientific Title of Study
|
Effectiveness of multi-disciplinary pre and postnatal interventions in first-time expectant mothers and their children for the prevention of early childhood caries: A Randomized Controlled Trial |
| Trial Acronym |
NIL |
|
Secondary IDs if Any
|
| Secondary ID |
Identifier |
| NIL |
NIL |
|
|
Details of Principal Investigator or overall Trial Coordinator (multi-center study)
|
| Name |
Gandhali Malgaonkar Joshi |
| Designation |
Assistant Professor |
| Affiliation |
Bharati Vidyapeeth Dental College and Hospital,Pune |
| Address |
Room No 208, Department of Pediatric and Preventive Dentistry,
Bharati Vidyapeeth Dental College and Hospital,BVDU,Pune #001, Seven Star Bldg, Brahman Society
Naupada, Thane (W), 400602 Pune MAHARASHTRA 411006 India |
| Phone |
9004512886 |
| Fax |
|
| Email |
dr.gandhali.dm@gmail.com |
|
Details of Contact Person Scientific Query
|
| Name |
Gandhali Malgaonkar Joshi |
| Designation |
Assistant Professor |
| Affiliation |
Bharati Vidyapeeth Dental College and Hospital,Pune |
| Address |
Room No 208, Department of Pediatric and Preventive Dentistry,
Bharati Vidyapeeth Dental College and Hospital,BVDU,Pune #001, Seven Star Bldg, Brahman Society
Naupada, Thane (W), 400602 Pune MAHARASHTRA 411006 India |
| Phone |
9004512886 |
| Fax |
|
| Email |
dr.gandhali.dm@gmail.com |
|
Details of Contact Person Public Query
|
| Name |
Gandhali Malgaonkar Joshi |
| Designation |
Assistant Professor |
| Affiliation |
Bharati Vidyapeeth Dental College and Hospital,Pune |
| Address |
Room No 208, Department of Pediatric and Preventive Dentistry,
Bharati Vidyapeeth Dental College and Hospital,BVDU,Pune #001, Seven Star Bldg, Brahman Society
Naupada, Thane (W), 400602 Pune MAHARASHTRA 411006 India |
| Phone |
9004512886 |
| Fax |
|
| Email |
dr.gandhali.dm@gmail.com |
|
|
Source of Monetary or Material Support
|
| Bharati hospital, Pune - Satara Rd, Bharati Vidyapeeth Campus, Dhankawadi, Pune, Maharashtra, India 411043
|
| Bharati Vidyapeeth ( Deemed to be University) Dental
College and Hospital, Dhankawdi, Pune, Maharashrta, India, 411043
|
|
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Primary Sponsor
|
| Name |
Bharati Vidyapeeth ( Deemed to be University) Dental College and Hospital, Pune |
| Address |
Bharati Vidyapeeth Educational Campus, Pune – Satara Road, Pune – 411 043 Maharashtra |
| Type of Sponsor |
Research institution and hospital |
|
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Details of Secondary Sponsor
|
|
|
Countries of Recruitment
|
India |
|
Sites of Study
|
| No of Sites = 3 |
| Name of Principal
Investigator |
Name of Site |
Site Address |
Phone/Fax/Email |
| Dr Gandhali Malgaonkar Joshi |
Bharati hospital, Pune |
Department of Obstetrics and Gynecology
Bharati Hospital
Pune-Satara Road, Dhankawdi,Pune-411043 Pune MAHARASHTRA |
9004512886
gandhali.mjoshi@bharatividyapeeth.edu |
| Dr Gandhali Malgaonkar Joshi |
Bharati hospital, Pune |
Department of Pediatrics,
Bharati Hospital Pune-Satara Road, Dhankawdi,Pune-411043 Pune MAHARASHTRA |
9004512886
dr.gandhali.dm@gmail.com |
| Dr Gandhali Malgaonkar Joshi |
Bharati Vidyapeeth (Deemed to be University)Dental College and Hospital, Pune |
Room No 212, Second Floor, Department of Pediatric Dentistry, Bharati Vidyapeeth Dental College and Hospital, Pune-Satara Road, Dhankwadi, Pune - 411 043. Pune MAHARASHTRA |
9004512886
gandhali.mjoshi@bharatividyapeeth.edu |
|
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Details of Ethics Committee
|
| No of Ethics Committees= 1 |
| Name of Committee |
Approval Status |
| Institutional Ethics Committee BVDU DCH, PUNE |
Approved |
|
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Regulatory Clearance Status from DCGI
|
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Health Condition / Problems Studied
|
| Health Type |
Condition |
| Patients |
(1) ICD-10 Condition: O00-O9A||Pregnancy, childbirth and the puerperium, |
|
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Intervention / Comparator Agent
|
| Type |
Name |
Details |
| Intervention |
Educational and Therapeutic Intervention in the Study Group |
A) Educational Interventions like:
1. Oral Health Education for improving and maintaining oral health of the pregnant mothers and their children, at baseline, using oral health information pamphlets and an oral health educational video that will be created for the study and through verbal information by the primary investigator (pediatric dentist)
2. Pre-natal referrals of mothers by Gynaecologists to Pediatric dentists in the second trimester
3. Post-natal referrals of children by Pediatricians to Pediatric dentists at 1 month after birth
4. Pre and post-natal sustained anticipatory guidance of mothers by Pediatric dentists after the referrals
B) Therapeutic Interventions like:
1. Providing Fluoridated toothpastes to mothers throughout the study (At baseline and during subsequent follow-ups)
2. Need based dental treatment referrals of mothers to oral health professionals for oral prophylaxis and caries stabilisation
3. The children in the study group will be treated for any signs of carious lesions if seen.
C)There will be periodic re-enforcements of all the sessions by means of follow-up with phone calls and reminder messages twice monthly
Interventions |
| Comparator Agent |
Educational and Therapeutic Interventions in the Control Group |
A) Educational Interventions like:
1. The mothers will undergo one episode of oral health education at baseline, similar to the study group
2. Pre and post-natal anticipatory guidance by paediatric dentists at baseline
3. There will not be any pre and post-natal referrals to paediatric dentists from the gynaecologists and paediatricians respectively
B) Therapeutic Interventions like:
1. Providing Fluoridated toothpastes to mothers at baseline
2. Need based dental treatment referrals of mothers to oral health professionals for oral prophylaxis and caries stabilisation
3. The children in the control group will also be treated for any signs of carious lesions if seen.
C)There will not be any re-enforcements or follow-up of either the educational or the therapeutic sessions in this group. |
|
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Inclusion Criteria
|
| Age From |
25.00 Year(s) |
| Age To |
35.00 Year(s) |
| Gender |
Female |
| Details |
1. Healthy women, aged 25-35 years reporting to the Gynaecology OPD of Bharati Vidyapeeth Medical Hospital, Pune
2. Women in their second trimester of pregnancy
3. First Time Mothers
4. Women residing in Pune city and planning on residing here for next 3 years |
|
| ExclusionCriteria |
| Details |
1. Expectant Mothers with a high risk of pregnancy due to any known systemic disorders
2. Pregnant Women on long term antibiotics/ steroids/ antihistaminics/antiepileptics
3. Pregnant Women who do not consent to study
4. Newborns with any congenital conditions |
|
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Method of Generating Random Sequence
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Computer generated randomization |
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Method of Concealment
|
Sequentially numbered, sealed, opaque envelopes |
|
Blinding/Masking
|
Outcome Assessor Blinded |
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Primary Outcome
|
| Outcome |
TimePoints |
1. Occurrence of new carious lesions (Incidence of ECC) in children after multi-disciplinary pre and postnatal interventions
2. Occurrence of new carious lesions in first-time expectant mothers after multi-disciplinary pre and postnatal interventions
3. Changes in Caries risk of children after multi-disciplinary pre and postnatal interventions
4. Changes in Caries risk of first-time expectant mothers after multi-disciplinary pre and postnatal interventions
5. Association of caries risk between first-time expectant mothers and children after multi-disciplinary pre and postnatal interventions |
1.DMFT scores and Caries Risk Assessment for the mothers will be done at baseline, 9 months pre-partum and at 6 and 12 months post-delivery
2.Caries Risk Assessment for children will be done at baseline, 6 and 12 months after birth
3.Occurrence of ECC will be assessed at 12 months after birth
1.Carious lesions will be detected according to ICDAS (The International Caries Detection and Assessment System) method for caries detection and staging
2.Caries risk of the mothers will be determined using CAMBRA (Caries Management by Risk Assessment) 123 CRA Tool. |
|
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Secondary Outcome
|
| Outcome |
TimePoints |
1. Compliance of participants to this study design and protocol
2. Effect of various confounding variables like socio-economic factors, diet and feeding practices, effect of pre-term delivery and/or low birth weight on development of early childhood caries |
It will be assessed at 9 months pre-partum and at 6,12,18 months after birth of children |
|
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Target Sample Size
|
Total Sample Size="200" Sample Size from India="200"
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" |
|
Phase of Trial
|
Phase 4 |
|
Date of First Enrollment (India)
|
19/02/2026 |
| Date of Study Completion (India) |
Applicable only for Completed/Terminated trials |
| Date of First Enrollment (Global) |
Date Missing |
| Date of Study Completion (Global) |
Applicable only for Completed/Terminated trials |
|
Estimated Duration of Trial
|
Years="2" Months="0" Days="0" |
|
Recruitment Status of Trial (Global)
|
Not Applicable |
| Recruitment Status of Trial (India) |
Not Yet Recruiting |
|
Publication Details
|
N/A |
|
Individual Participant Data (IPD) Sharing Statement
|
Will individual participant data (IPD) be shared publicly (including data dictionaries)?
Response - YES
- What data in particular will be shared?
Response (Others) - De-identified individual participant data (IPD) underlying the results of the study will be shared upon reasonable request after publication of the primary results.
- What additional supporting information will be shared?
Response - Study Protocol Response - Statistical Analysis Plan Response (Others) - any other flow-charts or diagrams describing the study better
- Who will be able to view these files?
Response (Others) - Researchers needing any additional information apart from that mentioned above will be provided the needful after they contact the corresponding author.
- For what types of analyses will this data be available?
Response (Others) - The analyses thata will help achieve aims of the approved proposal
- By what mechanism will data be made available?
Response (Others) - Link to the publication will be accessible indefinitely
- For how long will this data be available start date provided 01-12-2028 and end date provided 01-12-2046?
Response (Others) - There will be no end date
- Any URL or additional information regarding plan/policy for sharing IPD?
Additional Information - NIL
|
|
Brief Summary
|
Need for Research: The prevalence of Early Childhood Caries (ECC) in India is quite high (49.6%). Treatment of ECC involves both, increased expenses as well as health risks. There is also an associated high rate of recurrence after such treatments. The major risk factors for Severe-ECC are often attributed to various pre, peri and post-natal causes like Maternally Derived S.Mutans Disease (MDSMD) and developmental defects in enamel due to low birth weight infants. It is well established that primary preventive intervention and oral-health instruction can significantly inhibit the MS levels of mothers and prevent caries in their children during the early years of life. This makes perinatal counselling one of the key elements of infant oral health care. Both, World Dental Federation (FDI) as well as the Indian Association of Paediatric Dentistry (IAPD) recommend a multidisciplinary approach for management of multiple risk factors associated with ECC. Apart from the dental personnel, it includes their parents, pediatricians and medical specialists, as well as any primary caregiver of the child. Hence addressing this issue with evidence- based oral health is of utmost importance. Besides, the data for such studies from India is lacking. Brief Resume of the Proposed Research Background The major risk factors for Early Childhood Caries(ECC) are often attributed to various pre, peri and post-natal causes. Hence, the aim of this prospective study is to assess the effectiveness of multi-disciplinary perinatal behavioural and therapeutic interventions by maternal and child health care providers along with oral health professionals in expectant mothers and their children for prevention of ECC. Methodology This study will be conducted on 200 mother-child pairs who will be randomly allocated into either a study group or a control group (n 55 each). Mothers in the study group will be provided behavioural interventions such as 1) Oral Health Education at baseline, 2) pre-natal referrals by gynaecologists to paediatric dentists in the second trimester, 3) post-natal referrals by paediatricians to paediatric dentists at 1 month after birth, 4) pre and post-natal sustained anticipatory guidance by paediatric dentists. Therapeutic interventions will include oral examination of mothers and determination of their treatment needs, providing fluoride toothpastes, referrals to dentists for oral prophylaxis and caries stabilisation and any urgent dental care if necessary. There will be periodic re-enforcements of all the sessions by means of follow-up with phone calls and reminder messages twice monthly. Those in the control group will undergo one episode of oral health education and pre and post-natal anticipatory guidance by paediatric dentists at baseline. There will not be any pre and post-natal referrals from to paediatric dentists from the gynaecologists and paediatricians respectively. Therapeutic interventions will remain the same as the study group. However, there will not be any re-enforcements or follow-up of either the educational or the therapeutic sessions in this group. Caries Risk Assessment for both the groups will be done at baseline, 9 months pre-partum and at 6,12,18 months post-delivery for the mothers using the cariogram tool and at 6, 12 and 18 months after birth for children using the CRAFT tool. Novelty This will be one of the first studies to evaluate the effectiveness of inter-disciplinary perinatal interventions in India. Expected Outcome Based on the results of previous studies, such interventions in pregnant mothers are expected to prevent caries in children in early years of their life. |