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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  
 
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 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
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 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
Institutional Ethics Committee BVDU DCH, PUNE  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: O00-O9A||Pregnancy, childbirth and the puerperium,  
 
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. 
 
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 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   Sequentially numbered, sealed, opaque envelopes 
Blinding/Masking   Outcome Assessor Blinded 
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. 
 
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 
 
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
  1. 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.

  2. 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
  3. 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.

  4. For what types of analyses will this data be available?
    Response (Others) -  The analyses thata will help achieve aims of the approved proposal

  5. By what mechanism will data be made available?
    Response (Others) -  Link to the publication will be accessible indefinitely

  6. 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

  7. 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.

 

 
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