Early Caries Risk Assessment in Toddlers : A Quasi-Experimental Study to Evaluate the Effectiveness of Capacity Building for Auxiliary Nurse Midwives’ in Goa, India

Early Childhood Caries remains one of the most prevalent chronic diseases among children, largely preventable through early identification of risk factors. Auxiliary Nurse midwives, who have close contact with mothers and children during immunization can play a vital role in the early detection and prevention of dental caries. However, limited training opportunities restrict their ability to assess and counsel families effectively.

Objectives:

1)    To train ANMs in caries risk assessment using the CAMBRA 123 tool through a structured educational intervention.

2)    To evaluate and compare the pre- and post-training knowledge and attitudes of ANMs regarding early childhood caries risk assessment.

3)    To assess the diagnostic accuracy of ANM-performed caries risk assessments compared to a Dentist (gold standard), by calculating sensitivity, specificity and Inter-examiner reliability.

4)    To determine the feasibility and identify common operational challenges of integrating caries risk assessment into routine immunization visits conducted by ANMs in primary health settings

Methodology

This quasi-experimental study aims to evaluate the effectiveness of a structured training program on caries risk assessment tool (CAMBRA 123) for Auxiliary Nurse Midwives. The study will be conducted in two Phases, Phase 1 will be conducted in the Institute of Nursing Education Bambolim, Goa. Participants will undergo pre- and post-training evaluation using a validated questionnaire assessing knowledge, attitudes regarding caries risk assessment. Following the training, in the second phase ANMs will assess the caries risk of Toddlers visiting immunization centers with their mothers. Their assessments will be compared with those made by a dentist (gold standard) who is blinded to the ANMs results to evaluate the Reliability and Feasibility of ANMs performing such assessments in routine practice. Data will be analysed using SPSS software version 26.0,  Descriptive statistics, Kappa statistics for Reliability and Intraclass correlation will be used to assess agreement between ANM and Dentist.