Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Research
  • Published:

The Bangkok Declaration, DOHaD concepts and early childhood caries: the use of teledentistry for prevention

British Dental Journal (2025)Cite this article

Abstract

Background The Bangkok Declaration and the Developmental Origins of Health and Disease (DOHaD) concept can guide paediatric dentists in promoting oral health during the first 1,000 days of life. Teledentistry can help translate these guidelines into practice, facilitating education for parents.

Aim To evaluate the impact of a teledentistry service as an innovative approach to adopting healthy habits to prevent early childhood caries (ECC).

Design In total, 64 parents of children aged 0–5 received teleconsultations from 118 supervised undergraduate students. The students, working in pairs under a lecturer's supervision, collected caries risk information and educated parents. Fisher's exact test and Wilcoxon rank-sum test assessed associations, while multivariate analysis identified factors influencing habit changes.

Results The parents of 55 children (86%) participated in at least two teleconsultations, with the majority of children (78.2%) aged up to three years. Positive changes in habits were noted, particularly among children with employed and more educated mothers (p = 0.007 and p = 0.019, respectively). Significant improvements included increased use of fluoride toothpaste (p = 0.02), higher brushing frequency (p = 0.0004), and reduced sugar consumption frequency (p = 0.025).

Conclusion Teledentistry can be an important tool for implementing healthy habits in the first years of life, increasing oral hygiene and reducing sugar consumption, thus preventing ECC and chronic non-communicable diseases.

Key points

  • Dental caries is a chronic disease that shares common risk factors with other important non-communicable diseases associated with the excessive consumption of sugar, such as cardiovascular disease, diabetes and obesity.

  • The first 1,000 days of a baby's life is the period of greater plasticity of the phenotype for actions that prevent chronic diseases in the future.

  • Adopting digital health strategies helps increase interaction with patients and their care, as well as being able to reach children living in remote areas.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

The data that support the findings of this study are not publicly available due to privacy and ethical restrictions. The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Suzuki K. The developing world of DOHaD. J Dev Orig Health Dis 2018; 9: 266–269.

  2. Hanson M, Gluckman P. Developmental origins of noncommunicable disease: population and public health implications. Am J Clin Nutr 2011; DOI: 10.3945/ajcn.110.001206.

  3. Anonymous. Early Childhood Caries: IAPD Bangkok Declaration. Int J Paediatr Dent 2019; 29: 384–386.

  4. Bönecker M, Ardenghi T M, Oliveira L B, Sheiham A, Marcenes W. Trends in dental caries in 1- to 4-year-old children in a Brazilian city between 1997 and 2008. Int J Paediatr Dent 2010; 20: 125–131.

  5. Tinanoff N, Baez R J, Diaz Guillory C et al. Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: global perspective. Int J Paediatr Dent 2019; 29: 238–248.

  6. Phantumvanit P, Makino Y, Ogawa H et al. WHO Global Consultation on Public Health Intervention Against Early Childhood Caries. Community Dent Oral Epidemiol 2018; 46: 280–287.

  7. Soares R C, da Rosa S V, Moysés S T et al. Methods for prevention of early childhood caries: Overview of systematic reviews. Int J Paediatr Dent 2021; 31: 394–421.

  8. Oliver K, Manton D J. Contemporary behavior management techniques in clinical pediatric dentistry: Out with the old and in with the new? J Dent Child 2015; 82: 22–28.

  9. Rahman N, Nathwani S, Kandiah T. Teledentistry from a patient perspective during the coronavirus pandemic. Br Dent J 2020; DOI: 10.1038/S41415-020-1919-6.

  10. Wallace C K, Schofield C E, Burbridge L A L, O'Donnell K L. Role of teledentistry in paediatric dentistry. Br Dent J 2021; DOI: 10.1038/S41415-021-3015-y.

  11. Azimi S, Estai M, Patel J, Silva D. The feasibility of a digital health approach to facilitate remote dental screening among preschool children during COVID-19 and social restrictions. Int J Paediatr Dent 2023; 33: 234–245.

  12. Saiso S G, Marti M C, Pascha V M et al. Implementation of telemedicine in the Americas: Barriers and facilitators. Rev Panam Salud Publica 2021; DOI: 10.26633/RPSP.2021.131.

  13. Martignon S, Pitts N B, Goffin G et al. CariesCare practice guide: consensus on evidence into practice. Br Dent J 2019; 227: 353–362.

  14. Ismail A I, Pitts N B, Tellez M et al. The International Caries Classification and Management System (ICCMSTM): an example of a caries management pathway. BMC Oral Health 2015; DOI: 10.1186/1472-6831-15-S1-S9.

  15. Martignon S, Cortes A, Douglas G V A et al. CariesCare International adapted for the pandemic in children: Caries OUT multicentre single-group interventional study protocol. BMC Oral Health 2021; 21: 329.

  16. Bingham S A, Gill C, Welch A et al. Comparison of dietary assessment methods in nutritional epidemiology: weighed records v. 24 h recalls, food-frequency questionnaires and estimated-diet records Br J Nutr 1994; 72: 619–643.

  17. Ccahuana-Vásquez R A, Tabchoury C P M, Tenuta L M A, Del Bel Cury A A, Vale G C, Cury J A. Effect of frequency of sucrose exposure on dental biofilm composition and enamel demineralization in the presence of fluoride. Caries Res 2007; 41: 9–15.

  18. Ministry of Health of Brazil. Dietary Guidelines for the Brazilian Population. 2015. Available at https://bvsms.saude.gov.br/bvs/publicacoes/dietary_guidelines_brazilian_population.pdf (accessed 30 January 2023).

  19. Campos C J G, Turato E R. Content analysis in studies using the clinical-qualitative method: application and perspectives. Rev Lat Am Enferm 2009; 17: 259–264.

  20. Mariño R, Ghanim A. Teledentistry: a systematic review of the literature. J Telemed Telecare 2013; 19: 179–183.

  21. Dagon N, Ratson T, Peretz B, Blumer S. Maternal knowledge of oral health of children aged 1–4 years. J Clin Pediatr Dent 2019; 43: 116–120.

  22. Smith R E, Badner V M, Morse D E, Freeman K. Maternal risk indicators for childhood caries in an inner city population. Community Dent Oral Epidemiol 2002; 30: 176–181.

  23. Agarwal V, Nagarajappa R, Keshavappa S B, Lingesha R T. Association of maternal risk factors with early childhood caries in schoolchildren of Moradabad, India. Int J Paediatr Dent 2011; 21: 382–388.

  24. Finlayson T L, Siefert K, Ismail A I, Sohn W. Maternal self-efficacy and 1–5-year-old children's brushing habits. Community Dent Oral Epidemiol 2007; 35: 272–281.

  25. BaniHani A, Tahmassebi J, Zawaideh F. Maternal knowledge on early childhood caries and barriers to seek dental treatment in Jordan. Eur Arch Paediatr Dent 2021; 22: 433–439.

  26. Foster E, Bradley J. Methodological considerations and future insights for 24-hour dietary recall assessment in children. Nutr Res 2018; 51: 1–11.

  27. Solomons N W. Developmental origins of health and disease: concepts, caveats, and consequences for public health nutrition. Nutr Rev 2009; DOI: 10.1111/j.1753-4887.2009.00152.x.

  28. Haznedaroglu E, Mentes A. The internet versus pediatricians as a source of infant teething information for parents in Turkey. Clinics 2016; 71: 430–434.

  29. Sarrell E M, Horev Z, Cohen Z, Cohen H A. Parents' and medical personnel's beliefs about infant teething. Patient Educ Couns 2005; 57: 122–125.

  30. Riggs E, Kilpatrick N, Slack-Smith L et al. Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries. Cochrane Database Syst Rev 2019; DOI: 10.1002/14651858.CD012155.pub2.

Download references

Funding

This work was supported by Coordination of Improvement of Higher Education Personnel (Capes) and by the National Council for Scientific and Technological Development – CNPq, CNPq/MCTI/FNDCT, 18/2021 - Band A - Emerging Groups. Process number 422896/2021-7 and call CNPQ no 03/2021 - Productivity grant in technological development and innovative extension - DT n. protocol 2036632802873606.

Author information

Authors and Affiliations

  1. PhD Candidate, Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil

    Gabriela Sá & Júlia Mulder

  2. Post Doc, PhD and Professor, Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil

    Marcelo Bönecker & Ana Estela Haddad

  3. Postdoctoral Researcher, Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil

    Deise Garrido

  4. PhD and Professor, Section of Cariology and Endodontics, University of Copenhagen, Copenhagen, Denmark

    Kim Ekstrand

  5. PhD Student, SAS Brasil, São Paulo, Brazil

    Adriana Mallet

Authors
  1. Gabriela Sá
    View author publications

    Search author on:PubMed Google Scholar

  2. Marcelo Bönecker
    View author publications

    Search author on:PubMed Google Scholar

  3. Deise Garrido
    View author publications

    Search author on:PubMed Google Scholar

  4. Kim Ekstrand
    View author publications

    Search author on:PubMed Google Scholar

  5. Júlia Mulder
    View author publications

    Search author on:PubMed Google Scholar

  6. Adriana Mallet
    View author publications

    Search author on:PubMed Google Scholar

  7. Ana Estela Haddad
    View author publications

    Search author on:PubMed Google Scholar

Contributions

GS conceived the research idea, developed the survey, analysed the results and revised the manuscript. MB and AE developed the study design, the questionnaire and revised the manuscript. KE analysed the results and wrote the manuscript. DG and JM collected the data and participated in the clinical evaluations. AM developed the technological and operational support for the study and reviewed the manuscript.

Corresponding author

Correspondence to Gabriela Sá.

Ethics declarations

The authors have no conflicts of interest to disclose. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The study was approved by the Research Ethics Committee of the School of Dentistry, University of São Paulo – following protocol number 4749508 – and conducted in compliance with resolution number 466/12 of the Brazilian National Health Council. The study also conforms to the ethical principles outlined in the Tel Aviv Declaration, adopted by the 51st General Assembly of the World Medical Association in October 1999 and ratified in 2006. All parents provided consent to participate in the clinical study, and consent was also obtained from dental professionals and students for the present study (approved by the Research Ethics Committee of the School of Dentistry at University of São Paulo – following protocol number 4749508).

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sá, G., Bönecker, M., Garrido, D. et al. The Bangkok Declaration, DOHaD concepts and early childhood caries: the use of teledentistry for prevention. Br Dent J (2025). https://doi.org/10.1038/s41415-025-9111-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • DOI: https://doi.org/10.1038/s41415-025-9111-7

Search

Advanced search

Quick links