In general, behavioral changes strategies have been shown successful in altering intermediate outcomes such as parent’s cognition, hygiene and feeding practices or presence of plaque, but not in reducing the incidence of dental caries (27–29). An example is the Promotion of Breastfeeding Intervention Trial (29), in which 13 889 mother–child pairs were randomized and accompanied for 6 years in Belarus. Although this large randomized trial led to a clinically important increase in
exclusive and total breastfeeding duration, no significant effects on dental caries were observed. In the other hand, Weinstein et al. (30) did find a lower incidence of early childhood caries among children whose parents had been given advice, from 6 to 18 months, on feeding and hygiene practices and counseled to seek professional help for fluoride use.