This study will evaluate the effectiveness of oral health promotion in the prevention of ECC (early childhood caries) in bottle-fed children. Half of the patient will receive oral health promotion which emphasizing more on the benefit of stopping the bottle feeding habit, a free-flow cup and oral hygiene kit which include a toothbrush, toothpaste (1000ppm fluoride). The other half of the patient will receive standard of care oral hygiene promotion and oral hygiene kit which include a toothbrush, toothpaste (1000ppm fluoride)

In Malaysia, even though there are decreasing trend in caries prevalence from a survey conduct in 1995 to 2015 (87.1% 1995, 76.2% 2005 and 71.3% 2015) [NOHPS 2015], yet the difference is just 15.8% in a period of 20 years. One of the factors which contribute to the development of ECC in children in prolonged bottle-feeding. Many literatures had mentioned association of bottle feeding and ECC however there are no controlled studies done on the effect of bottle feeding and ECC. Despite antenatal oral health promotion program done by Ministry of Health Malaysia and incorporation of oral hygiene education and oral hygiene instruction during dental visit, the prevalence of ECC remains high. This study will provide evidence regarding the effectiveness of oral health promotion in preventing early childhood caries by early termination of bottle feeding in toddlers.

Inclusion Criteria:

• Malaysian citizen
• Child age 12 to 24 months old
• Child with bottle feeding habit (patients from Klinik Kesihatan Ibu & Anak (KKIA))
• Having at least 2 upper and 2 lower incisors at the time of recruitment
• A child is taken care of predominantly by their mother (housewife) or a single carer (maid/ grandmother)
• The parent who can read and write in Bahasa Melayu
• Full Term baby

Exclusion Criteria:

• Patient with medical problems
• Cleft lip or cleft palate or both
• Patient with a craniofacial anomaly