• early childhood caries;
  • bottle feeding;
  • fluoride-containing dentifrice;
  • preventive dentistry;
  • sugar consumption


Objectives: This study sought to measure the effect of a community health education program on reported infants' bottle-feeding practices and infants' toothbrushing behavior, with or without distribution of toothpaste and tooth-brushes. Methods: In this quasi-experimental comparison group design study conducted in mother and child health centers in Jerusalem, parents of 727 children were surveyed by telephone at baseline and six months later. The cohort of infants was aged 6–12 months at baseline. The program group received structured health education. The control group received no organized educational intervention. Within the program and control groups, half of the centers were randomly given toothpaste and toothbrushes. Results: Parents' reports revealed a secular 32.5 percent increase in toothbrushing for infants with no intervention, 45.1 percent for infants only receiving toothpaste and toothbrushes, 43.7 percent for infants only receiving the health education program, and a 60.4 percent increase for infants receiving health education together with toothpaste and toothbrushes (chi-square, P=.0002). Modification of bottle-drinking practices, in this program, was unsuccessful. Conclusion: The free distribution of toothpaste and toothbrushes, together with an oral health education program, is recommended as a potentially practical and effective method of promoting early oral hygiene practices.