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Article ; Online: What influences the provision and reception of oral health education? A narrative review of the literature.

Barnes, Emma / Bullock, Alison / Chestnutt, Ivor Gordon

Community dentistry and oral epidemiology

2021 Volume 50, Issue 5, Page(s) 350–359

Abstract: Objectives: Most common diseases of the mouth are preventable through behavioural changes, oral hygiene routines and regular professional care. Research suggests dental professionals may prioritize clinical experience, personal values and preferences ... ...

Abstract	Objectives: Most common diseases of the mouth are preventable through behavioural changes, oral hygiene routines and regular professional care. Research suggests dental professionals may prioritize clinical experience, personal values and preferences over evidence when delivering such interventions. Research also suggests variable rates of patient behaviour change following oral health education (OHE) interactions. This review explores the literature to answer the question: what factors influence the provision and reception of OHE messages and the wider OHE process? Methods: A structured search of literature was carried out with databases covering a range of academic disciplines (healthcare sciences, social sciences, education). Key words/terms were searched to elicit papers published since 1998. Citation mining (relevant citations within papers) and citation tracking (papers citing relevant papers) were also used. Recurring themes within the papers were identified and coded using NVivo12 and presented in a conceptual model. Results: The studies analysed tended to employ small-scale surveys, larger-scale surveys (some with low response rates), or interview studies of varying sizes. There was also a limited number of review papers. However, several key messages were identified regarding dental professionals' and patients' views on OHE and the factors that influence its provision. Factors that were identified related to the wider social and policy context (macro), community-level factors (meso), the individual practitioner and patient (micro), factors that influenced the nature of OHE interaction and any resulting behaviour change, and how the outcomes of the process influence future OHE interactions for both parties. Conclusions: The literature highlighted how factors influence the OHE process before, during and after the educational interaction. The resultant conceptual model acknowledges the influence of wider 'upstream' factors alongside interpersonal and individual influences which should be taken into consideration when developing OHE interventions.
MeSH term(s)	Delivery of Health Care ; Health Education, Dental ; Humans ; Oral Hygiene ; Surveys and Questionnaires
Language	English
Publishing date	2021-09-14
Publishing country	Denmark
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	189172-8
ISSN	1600-0528 ; 0301-5661
ISSN (online)	1600-0528
ISSN	0301-5661
DOI	10.1111/cdoe.12698
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Article ; Online: Time to complete contemporary dental procedures - estimates from a cross-sectional survey of the dental team.

Bannister, Christian / Cope, Anwen Louise / Karki, Anup / Harper, Paul / Peddle, Sarah / Walters, Brenda / Allen, Michael / Chestnutt, Ivor Gordon

BMC oral health

2023 Volume 23, Issue 1, Page(s) 926

Abstract: Background: There are few contemporary studies on the time taken to complete dental procedures, those most heavily relied on in the United Kingdom date back to 1999.: Objectives: This work aimed to establish how long members of the dental team took ... ...

Abstract	Background: There are few contemporary studies on the time taken to complete dental procedures, those most heavily relied on in the United Kingdom date back to 1999. Objectives: This work aimed to establish how long members of the dental team took to complete specific dental procedures, relevant to their scope of practice. Methods: Data were collected via a purposive sample of 96 dentists, dental hygienists/therapists and dental nurses. Via an online survey, participants were asked to state the mean, minimum and maximum time they estimated that they took to complete individual dental procedures. Results: The mean time taken to complete procedures common to both dentists and dental hygienists/therapists ranged from 3.7 to 4 min respectively for clinical note reading prior to seeing patients to 30.1 and 28 min to undertake root surface debridement. There were no significant differences between the time taken by dentists and dental hygienists/therapists to treat adult patients. However, in all but one procedure, dental hygienists/therapists reported taking longer (p = 0.04) to treat child patients. Conclusions: The data provided here represent an up to date assessment of the time taken to complete specific tasks by different members of the dental team. These data will be of value to service planners and commissioners interested in evolving a dental care system that employs a greater degree of skill-mix and preventively oriented care.
MeSH term(s)	Adult ; Child ; Humans ; Cross-Sectional Studies ; Dental Hygienists ; Dental Care ; United Kingdom ; Surveys and Questionnaires ; Dentists
Language	English
Publishing date	2023-11-25
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2091511-1
ISSN	1472-6831 ; 1472-6831
ISSN (online)	1472-6831
ISSN	1472-6831
DOI	10.1186/s12903-023-03671-y
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Article ; Online: The development and application of a chairside oral health risk and need stratification tool in general dental services.

Cope, Anwen Louise / Bannister, Christian / Karki, Anup / Harper, Paul / Allen, Michael / Jones, Rhiannon / Peddle, Sarah / Walters, Brenda / Chestnutt, Ivor Gordon

Journal of dentistry

2022 Volume 123, Page(s) 104206

Abstract: Objective: To describe the development and application of the Assessment of Clinical Oral Risks and Needs (ACORN) stratification tool based on a traffic light system in National Health Service (NHS) general dental services (GDS) Wales, UK.: Materials ... ...

Abstract	Objective: To describe the development and application of the Assessment of Clinical Oral Risks and Needs (ACORN) stratification tool based on a traffic light system in National Health Service (NHS) general dental services (GDS) Wales, UK. Materials and methods: This was a secondary analysis of routinely-collected dental care data. All courses of treatment provided in dental practices participating in NHS GDS Reform Programme between July 2018 and September 2019, in which an ACORN assessment and age were recorded were included in the analysis. Results: A total of 236,490 subjects contributed 339,933 courses of treatment during the study period. 'Amber' and 'red' ACORN outcomes were associated with more courses of treatment per annum than 'green' outcomes. Outcomes indicating an increased risk of decay or other dental problems were associated with a greater likelihood of several operative treatment items. Patients at greater risk of poor periodontal health were more likely to receive extractions and dentures than low-risk patients. Patients were most likely to either remain in the same ACORN outcome categories or move to a healthier state between assessments. Conclusion: More research is required to understand the utility of the ACORN tool in risk communication and behaviour change.
MeSH term(s)	Dental Care ; Dental Caries ; Humans ; Oral Health ; State Medicine ; Wales
Language	English
Publishing date	2022-06-22
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	186068-9
ISSN	1879-176X ; 0300-5712
ISSN (online)	1879-176X
ISSN	0300-5712
DOI	10.1016/j.jdent.2022.104206
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Article ; Online: Parental decisions about children's oral health behaviour: relative or absolute?

Trubey, Rob J / Moore, Simon C / Chestnutt, Ivor Gordon

Community dentistry and oral epidemiology

2016 Volume 45, Issue 1, Page(s) 35–42

Abstract: Objectives: To test the extent to which parents' judgements about their children's oral health behaviour conform to the principles of a specific theory of cognitive decision making - Range-frequency Theory.: Methods: Experimental study with an ... ...

Abstract	Objectives: To test the extent to which parents' judgements about their children's oral health behaviour conform to the principles of a specific theory of cognitive decision making - Range-frequency Theory. Methods: Experimental study with an opportunity sample of 121 parents of young children (3-6 years old) living in areas of relative deprivation in South Wales. Parents were allocated to four different experimental groups, and each completed a pen-and-paper exercise, which involved being presented with (and rating) how often other parents brushed their children's teeth. The brushing frequencies presented varied between the groups, directly test the rank and range principle of Range-frequency Theory. Results: Parents' ratings of other toothbrushing frequencies were predicted by the range and rank principle of Range-frequency Theory. A comparison between Group 1 and Group 2 showed that parents' ratings of similar brushing frequencies were affected by their relative rank among other brushing frequencies presented. A comparison between Group 3 and Group 4 showed that parents in a group who were presented with a very high brushing frequency (21 times a week) rated all other brushing frequencies as relatively less healthy than the comparison group. Conclusions: The principles of Range-frequency Theory predicted parents' judgement about children's oral health behaviour - specifically toothbrushing frequency. These findings provide a theoretical framework on which to develop future oral health education and interventions aimed at promoting twice-daily toothbrushing to parents of young children.
Language	English
Publishing date	2016-09-19
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	189172-8
ISSN	1600-0528 ; 0301-5661
ISSN (online)	1600-0528
ISSN	0301-5661
DOI	10.1111/cdoe.12256
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Article ; Online: The impact of a reduction in fluoride concentration in the Malaysian water supply on the prevalence of fluorosis and dental caries.

Mohd Nor, Nor Azlida / Chadwick, Barbara L / Farnell, Damian J J / Chestnutt, Ivor Gordon

Community dentistry and oral epidemiology

2018 Volume 46, Issue 5, Page(s) 492–499

Abstract: Objective: To assess the prevalence and severity of dental fluorosis and caries among Malaysian children following the reduction in fluoride concentration from 0.7 to 0.5 parts per million (ppm) in the public water supply.: Methods: This study ... ...

Abstract	Objective: To assess the prevalence and severity of dental fluorosis and caries among Malaysian children following the reduction in fluoride concentration from 0.7 to 0.5 parts per million (ppm) in the public water supply. Methods: This study involved lifelong residents aged 9- and 12-year-olds in fluoridated and nonfluoridated areas in Malaysia (n = 1155). In the fluoridated area, children aged 12 years and 9 years were exposed to 0.7 and 0.5 ppm, respectively, at the times when maxillary central incisors developed. Standardized photographs of maxillary central incisors were blind scored for fluorosis using Dean's criteria. Dental caries was examined using ICDAS-II criteria. Results: The prevalence of fluorosis (Dean's score ≥ 2) among children in the fluoridated area (35.7%, 95% CI: 31.9%-39.6%) was significantly higher (P < 0.001) than children in the nonfluoridated area (5.5%, 95% CI: 3.6%-7.4%). Of those in the fluoridated area, the prevalence of fluorosis decreased from 38.4% (95% CI: 33.1%-44.3%) for 12-year-olds to 31.9% (95% CI: 27.6%-38.2%) for 9-year-olds, although this difference was not statistically significant (P = 0.139). The mean caries experience in the permanent dentition was significantly lower in the fluoridated area than in the nonfluoridated area for both age groups (P < 0.05). In the multivariate models, the difference in the differences of caries experience between fluoridated and nonfluoridated areas remained statistically significant. This suggests that caries-preventive effect is still maintained at 0.5 ppm. Conclusion: Findings indicate that the change in fluoride level from 0.7 to 0.5 ppm has reduced fluorosis and maintains a caries-preventive effect. Although there is a reduction in fluorosis prevalence, the difference was not statistically significant.
MeSH term(s)	Child ; Dental Caries/epidemiology ; Dental Caries/prevention & control ; Fluoridation/statistics & numerical data ; Fluorides/analysis ; Fluorosis, Dental/epidemiology ; Fluorosis, Dental/etiology ; Humans ; Malaysia/epidemiology ; Prevalence ; Water Supply/statistics & numerical data
Chemical Substances	Fluorides (Q80VPU408O)
Language	English
Publishing date	2018-07-18
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	189172-8
ISSN	1600-0528 ; 0301-5661
ISSN (online)	1600-0528
ISSN	0301-5661
DOI	10.1111/cdoe.12407
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Article ; Online: Brushing RemInder 4 Good oral HealTh (BRIGHT) trial: does an SMS behaviour change programme with a classroom-based session improve the oral health of young people living in deprived areas? A study protocol of a randomised controlled trial.

Marshman, Zoe / Ainsworth, Hannah / Chestnutt, Ivor Gordon / Day, Peter / Dey, Donna / El Yousfi, Sarab / Fairhurst, Caroline / Gilchrist, Fiona / Hewitt, Catherine / Jones, Claire / Kellar, Ian / Pavitt, Sue / Robertson, Mark / Shah, Sarwat / Stevens, Katherine / Torgerson, David / Innes, Nicola

Trials

2019 Volume 20, Issue 1, Page(s) 452

Abstract: Background: Almost one-half of 12-15 year olds living in deprived areas of the UK have dental caries (tooth decay) with few oral health promotion programmes aimed at children of this age. Mobile phone-based interventions such as short messaging service ( ...

Abstract	Background: Almost one-half of 12-15 year olds living in deprived areas of the UK have dental caries (tooth decay) with few oral health promotion programmes aimed at children of this age. Mobile phone-based interventions such as short messaging service (SMS) interventions have been found effective at changing certain behaviours and improving health outcomes. This protocol describes the BRIGHT Trial, investigating the clinical and cost-effectiveness of a behaviour change intervention-classroom-based session (CBS) embedded in the curriculum and a series of SMS delivered to participants twice daily to remind them to brush their teeth, compared to usual curriculum and no SMS-to reduce the prevalence of dental caries in young people from deprived areas. Objectives: To investigate the clinical and cost-effectiveness of a complex intervention to improve the oral health of young people living in deprived areas. Methods/design: This is a school-based, assessor-blinded, two-arm cluster-randomised controlled trial with an internal pilot trial. Overall, the trial will involve approximately 5040 11-13 year olds in 42 schools with a 3-year follow-up. The trial will take place in secondary schools in England, Scotland and Wales. The primary outcome is the presence of carious lesions in permanent teeth at 3 years. Secondary outcomes are: number of carious teeth, frequency of twice-daily toothbrushing, plaque levels, gingivitis, child health-related quality of life and oral health-related quality of life. A cost-utility analysis will be conducted. Discussion: The findings of the trial have implications for embedding oral health interventions into school curricula guidance produced by national bodies, including departments for education and dental public health and guideline-development organisations. Trial registration: ISRCTN registry, ISRCTN12139369 . Registered on 10 May 2017.
MeSH term(s)	Adolescent ; Adolescent Behavior ; Age Factors ; Cell Phone ; Child ; Child Behavior ; Cost-Benefit Analysis ; Dental Caries/economics ; Dental Caries/epidemiology ; Dental Caries/prevention & control ; Female ; Health Behavior ; Health Care Costs ; Health Education, Dental/economics ; Health Education, Dental/methods ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Multicenter Studies as Topic ; Oral Hygiene ; Poverty Areas ; Prevalence ; Randomized Controlled Trials as Topic ; School Dentistry ; Text Messaging/economics ; Time Factors ; United Kingdom/epidemiology
Language	English
Publishing date	2019-07-23
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2040523-6
ISSN	1745-6215 ; 1468-6694 ; 1468-6708
ISSN (online)	1745-6215 ; 1468-6694
ISSN	1468-6708
DOI	10.1186/s13063-019-3538-6
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Article ; Online: Brushing RemInder 4 Good oral HealTh (BRIGHT) trial

Zoe Marshman / Hannah Ainsworth / Ivor Gordon Chestnutt / Peter Day / Donna Dey / Sarab El Yousfi / Caroline Fairhurst / Fiona Gilchrist / Catherine Hewitt / Claire Jones / Ian Kellar / Sue Pavitt / Mark Robertson / Sarwat Shah / Katherine Stevens / David Torgerson / Nicola Innes

Trials, Vol 20, Iss 1, Pp 1-

does an SMS behaviour change programme with a classroom-based session improve the oral health of young people living in deprived areas? A study protocol of a randomised controlled trial

2019 Volume 12

Abstract: Abstract Background Almost one-half of 12–15 year olds living in deprived areas of the UK have dental caries (tooth decay) with few oral health promotion programmes aimed at children of this age. Mobile phone-based interventions such as short messaging ... ...

Abstract	Abstract Background Almost one-half of 12–15 year olds living in deprived areas of the UK have dental caries (tooth decay) with few oral health promotion programmes aimed at children of this age. Mobile phone-based interventions such as short messaging service (SMS) interventions have been found effective at changing certain behaviours and improving health outcomes. This protocol describes the BRIGHT Trial, investigating the clinical and cost-effectiveness of a behaviour change intervention—classroom-based session (CBS) embedded in the curriculum and a series of SMS delivered to participants twice daily to remind them to brush their teeth, compared to usual curriculum and no SMS—to reduce the prevalence of dental caries in young people from deprived areas. Objectives To investigate the clinical and cost-effectiveness of a complex intervention to improve the oral health of young people living in deprived areas. Methods/design This is a school-based, assessor-blinded, two-arm cluster-randomised controlled trial with an internal pilot trial. Overall, the trial will involve approximately 5040 11–13 year olds in 42 schools with a 3-year follow-up. The trial will take place in secondary schools in England, Scotland and Wales. The primary outcome is the presence of carious lesions in permanent teeth at 3 years. Secondary outcomes are: number of carious teeth, frequency of twice-daily toothbrushing, plaque levels, gingivitis, child health-related quality of life and oral health-related quality of life. A cost-utility analysis will be conducted. Discussion The findings of the trial have implications for embedding oral health interventions into school curricula guidance produced by national bodies, including departments for education and dental public health and guideline-development organisations. Trial registration ISRCTN registry, ISRCTN12139369. Registered on 10 May 2017.
Keywords	Dental caries ; Caries prevention ; Prevention ; Behaviour change ; Randomised controlled trial ; Child dental health ; Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2019-07-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
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Article: Characteristics attributed to individuals with dental fluorosis.

Williams, David Michael / Chestnutt, Ivor Gordon / Bennett, Paul David / Hood, Kerenza / Lowe, Rob

Community dental health

2006 Volume 23, Issue 4, Page(s) 209–216

Abstract: Background: Previous investigations of the public perception of dental fluorosis have focused mainly on aesthetics. Other characteristics which could potentially be ascribed to fluorosis, such as perceived personality traits, have not been examined.: ... ...

Abstract	Background: Previous investigations of the public perception of dental fluorosis have focused mainly on aesthetics. Other characteristics which could potentially be ascribed to fluorosis, such as perceived personality traits, have not been examined. Objectives: This study aimed to identify personal characteristics (descriptors) attributed to people with fluorosis of varying degrees of severity, as depicted in standardised photographs viewed from different perspectives. Method: Extra-oral (full face) and intra-oral images of male and female subjects were digitally manipulated to represent normal dental enamel, mild, moderate, and severe fluorosis. The images were then scored by 90 members of the public (45M, 45F), under different experimental conditions, which varied the level of cueing to the teeth. Participants were asked (i) to record their spontaneous descriptors, (ii) select relevant descriptors from a predefined list of 50 descriptors and traits. Results: 170 different word or phrase descriptors were spontaneously attributed to the images. Characteristics used to describe fluorosis varied with the degree of severity. However, endorsements were significantly influenced by whether participants viewed extra or intraoral images and the degree of cueing. Conditions which most accurately mirrored everyday social interactions, that is viewing extraoral images without cueing to pay particular attention to the mouth, were least likely to result in the attribution of characteristics that varied with levels of fluorosis. Conclusions: While characteristics varying with severity of dental fluorosis were ascribed, more sophisticated attitudinal measures are required to ascertain the wider social impact of fluorosis beyond the aesthetic.
MeSH term(s)	Attitude to Health ; Esthetics, Dental ; Female ; Fluorosis, Dental/psychology ; Human Characteristics ; Humans ; Male ; Personality ; Photography, Dental ; Social Desirability ; Terminology as Topic
Language	English
Publishing date	2006-12
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	631156-8
ISSN	0265-539X
ISSN	0265-539X
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Article ; Online: Seal or Varnish? A randomised controlled trial to determine the relative cost and effectiveness of pit and fissure sealant and fluoride varnish in preventing dental decay.

Chestnutt, Ivor Gordon / Hutchings, Simon / Playle, Rebecca / Morgan-Trimmer, Sarah / Fitzsimmons, Deborah / Aawar, Nadine / Angel, Lianna / Derrick, Sharron / Drew, Cheney / Hoddell, Ceri / Hood, Kerenza / Humphreys, Ioan / Kirby, Nigel / Lau, Tin Man Mandy / Lisles, Catherine / Morgan, Maria Zeta / Murphy, Simon / Nuttall, Jacqueline / Onishchenko, Kateryna /

Phillips, Ceri / Pickles, Timothy / Scoble, Charlotte / Townson, Julia / Withers, Beverley / Chadwick, Barbara Lesley

Health technology assessment (Winchester, England)

2017 Volume 21, Issue 21, Page(s) 1–256

Abstract: Background: Fissure sealant (FS) and fluoride varnish (FV) have been shown to be effective in preventing dental caries when tested against a no-treatment control. However, the relative clinical effectiveness and cost-effectiveness of these interventions ...

Abstract	Background: Fissure sealant (FS) and fluoride varnish (FV) have been shown to be effective in preventing dental caries when tested against a no-treatment control. However, the relative clinical effectiveness and cost-effectiveness of these interventions is unknown. Objective: To compare the clinical effectiveness and cost-effectiveness of FS and FV in preventing dental caries in first permanent molars (FPMs) in 6- and 7-year-olds and to determine their acceptability. Design: A randomised controlled allocation-blinded clinical trial with two parallel arms. Setting: A targeted population programme using mobile dental clinics (MDCs) in schools located in areas of high social and economic deprivation in South Wales. Participants: In total, 1016 children were randomised, but one parent subsequently withdrew permission and so the analysis was based on 1015 children. The randomisation of participants was stratified by school and balanced for sex and primary dentition baseline caries levels using minimisation in a 1 : 1 ratio for treatments. A random component was added to the minimisation algorithm, such that it was not completely deterministic. Of the participants, 514 were randomised to receive FS and 502 were randomised to receive FV. Interventions: Resin-based FS was applied to caries-free FPMs and maintained at 6-monthly intervals. FV was applied at baseline and at 6-month intervals over the course of 3 years. Main outcome measures: The proportion of children developing caries into dentine (decayed, missing, filled teeth in permanent dentition, i.e. D Results: At 36 months, 835 (82%) children remained in the trial: 417 in the FS arm and 418 in the FV arm. The proportion of children who developed caries into dentine on a least one FPM was lower in the FV arm (73; 17.5%) than in the FS arm (82, 19.6%) [odds ratio (OR) 0.84, 95% confidence interval (CI) 0.59 to 1.21; Limitations: There are no important limitations to this study. Conclusions: In a community oral health programme utilising MDCs and targeted at children with high caries risk, the twice-yearly application of FV resulted in caries prevention that is not significantly different from that obtained by applying and maintaining FSs after 36 months. FV proved less expensive. Future work: The clinical effectiveness and cost-effectiveness of FS and FV following the cessation of active intervention merits investigation. Trial registration: EudraCT number 2010-023476-23, Current Controlled Trials ISRCTN17029222 and UKCRN reference 9273. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in
MeSH term(s)	Budgets ; Cariostatic Agents/administration & dosage ; Cariostatic Agents/economics ; Cariostatic Agents/therapeutic use ; Child ; Cost-Benefit Analysis ; Dental Care for Children/economics ; Dental Care for Children/methods ; Dental Caries/prevention & control ; Female ; Fluorides, Topical/administration & dosage ; Fluorides, Topical/economics ; Fluorides, Topical/therapeutic use ; Health Services/statistics & numerical data ; Humans ; Male ; Models, Econometric ; Patient Acceptance of Health Care ; Pit and Fissure Sealants/economics ; Pit and Fissure Sealants/therapeutic use ; Quality-Adjusted Life Years ; Single-Blind Method ; State Medicine/economics ; United Kingdom
Chemical Substances	Cariostatic Agents ; Fluorides, Topical ; Pit and Fissure Sealants
Language	English
Publishing date	2017-06-14
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2006765-3
ISSN	2046-4924 ; 1366-5278
ISSN (online)	2046-4924
ISSN	1366-5278
DOI	10.3310/hta21210
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Zs.A 5162: Show issues

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Article ; Online: Protocol for "Seal or Varnish?" (SoV) trial: a randomised controlled trial to measure the relative cost and effectiveness of pit and fissure sealants and fluoride varnish in preventing dental decay.

Chestnutt, Ivor Gordon / Chadwick, Barbara Lesley / Hutchings, Simon / Playle, Rebecca / Pickles, Timothy / Lisles, Catherine / Kirkby, Nigel / Morgan, Maria Zeta / Hunter, Lindsay / Hodell, Ceri / Withers, Beverely / Murphy, Simon / Morgan-Trimmer, Sarah / Fitzsimmons, Deborah / Phillips, Ceri / Nuttall, Jacqueline / Hood, Kerenza

BMC oral health

2012 Volume 12, Page(s) 51

Abstract: Background: Dental caries remains a significant public health problem, prevalence being linked to social and economic deprivation. Occlusal surfaces of first permanent molars are the most susceptible site in the developing permanent dentition. Cochrane ... ...

Abstract	Background: Dental caries remains a significant public health problem, prevalence being linked to social and economic deprivation. Occlusal surfaces of first permanent molars are the most susceptible site in the developing permanent dentition. Cochrane reviews have shown pit and fissure sealants (PFS) and fluoride varnish (FV) to be effective over no intervention in preventing caries. However, the comparative cost and effectiveness of these treatments is uncertain. The primary aim of the trial described in this protocol is to compare the clinical effectiveness of PFS and FV in preventing dental caries in first permanent molars in 6-7 year-olds. Secondary aims include: establishing the costs and the relative cost-effectiveness of PFS and FV delivered in a community/school setting; examining the impact of PFS and FV on children and their parents/carers in terms of quality of life/treatment acceptability measures; and examining the implementation of treatment in a community setting. Methods/design: The trial design comprises a randomised, assessor-blinded, two-arm, parallel group trial in 6-7 year old schoolchildren. Clinical procedures and assessments will be performed at 66 primary schools, in deprived areas in South Wales. Treatments will be delivered via a mobile dental clinic. In total, 920 children will be recruited (460 per trial arm). At baseline and annually for 36 months dental caries will be recorded using the International Caries Detection and Assessment System (ICDAS) by trained and calibrated dentists. PFS and FV will be applied by trained dental hygienists. The FV will be applied at baseline, 6, 12, 18, 24 and 30 months. The PFS will be applied at baseline and re-examined at 6, 12, 18, 24, and 30 months, and will be re-applied if the existing sealant has become detached/is insufficient. The economic analysis will estimate the costs of providing the PFS versus FV. The process evaluation will assess implementation and acceptability through acceptability scales, a schools questionnaire and interviews with children, parents, dentists, dental nurses and school staff. The primary outcome measure will be the proportion of children developing new caries on any one of up to four treated first permanent molars. Discussion: The objectives of this study have been identified by the National Institute for Health Research as one of importance to the National Health Service in the UK. The results of this trial will provide guidance on which of these technologies should be adopted for the prevention of dental decay in the most susceptible tooth-surface in the most at risk children. Trial registrations: ISRCTN ref: ISRCTN17029222 EudraCT: 2010-023476-23 UKCRN ref: 9273.
MeSH term(s)	Bisphenol A-Glycidyl Methacrylate/therapeutic use ; Cariostatic Agents/economics ; Cariostatic Agents/therapeutic use ; Child ; Clinical Protocols ; Community Dentistry ; Cost-Benefit Analysis ; DMF Index ; Dental Caries/epidemiology ; Dental Caries/prevention & control ; Female ; Fluorides, Topical/economics ; Fluorides, Topical/therapeutic use ; Humans ; Incidence ; Interviews as Topic ; Linear Models ; Male ; Mobile Health Units ; Outcome and Process Assessment, Health Care ; Pit and Fissure Sealants/economics ; Pit and Fissure Sealants/therapeutic use ; Quality of Life ; School Dentistry ; Single-Blind Method ; Sodium Fluoride/therapeutic use ; Surveys and Questionnaires ; United Kingdom ; Vulnerable Populations ; Wales
Chemical Substances	Cariostatic Agents ; Fluorides, Topical ; Pit and Fissure Sealants ; sodium fluoride topical preparation ; Bisphenol A-Glycidyl Methacrylate (454I75YXY0) ; Sodium Fluoride (8ZYQ1474W7)
Language	English
Publishing date	2012-11-20
Publishing country	England
Document type	Comparative Study ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2091511-1
ISSN	1472-6831 ; 1472-6831
ISSN (online)	1472-6831
ISSN	1472-6831
DOI	10.1186/1472-6831-12-51
Database	MEDical Literature Analysis and Retrieval System OnLINE

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