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Splash!: a prospective birth cohort study of the impact of environmental, social and family-level influences on child oral health and obesity related risk factors and outcomes

Andrea M de Silva-Sanigorski12*, Elizabeth Waters1, Hanny Calache2, Michael Smith3, Lisa Gold4, Mark Gussy5, Anthony Scott6, Kathleen Lacy7 and Monica Virgo-Milton1

Author Affiliations

1 McCaughey Centre, Melbourne School of Population Health, The University of Melbourne, Carlton Australia

2 Dental Health Services Victoria, Carlton, Australia

3 Oral Health Services, Barwon Health, Geelong Australia

4 Health Economics, Deakin University, Burwood Australia

5 School of Dental Science, LaTrobe University, Bendigo Australia

6 Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Carlton Australia

7 WHO Collaborating Centre for Obesity Prevention, Deakin University, Geelong, Australia

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BMC Public Health 2011, 11:505  doi:10.1186/1471-2458-11-505

Published: 27 June 2011



Dental caries (decay) is the most prevalent disease of childhood. It is often left untreated and can impact negatively on general health, and physical, developmental, social and learning outcomes. Similar to other health issues, the greatest burden of dental caries is seen in those of low socio-economic position. In addition, a number of diet-related risk factors for dental caries are shared risk factors for the development of childhood obesity. These include high and frequent consumption of refined carbohydrates (predominately sugars), and soft drinks and other sweetened beverages, and low intake of (fluoridated) water. The prevalence of childhood obesity is also at a concerning level in most countries and there is an opportunity to determine interventions for addressing both of these largely preventable conditions through sustainable and equitable solutions. This study aims to prospectively examine the impact of drink choices on child obesity risk and oral health status.


This is a two-stage study using a mixed methods research approach. The first stage involves qualitative interviews of a sub-sample of recruited parents to develop an understanding of the processes involved in drink choice, and inform the development of the Discrete Choice Experiment analysis and the measurement instruments to be used in the second stage. The second stage involves the establishment of a prospective birth cohort of 500 children from disadvantaged communities in rural and regional Victoria, Australia (with and without water fluoridation). This longitudinal design allows measurement of changes in the child's diet over time, exposure to fluoride sources including water, dental caries progression, and the risk of childhood obesity.


This research will provide a unique contribution to integrated health, education and social policy and program directions, by providing clearer policy relevant evidence on strategies to counter social and environmental factors which predispose infants and children to poor health, wellbeing and social outcomes; and evidence-based strategies to promote health and prevent disease through the adoption of healthier lifestyles and diet. Further, given the absence of evidence on the processes and effectiveness of contemporary policy implementation, such as community water fluoridation in rural and regional communities it's approach and findings will be extremely informative.