This study examined the 2.5–year outcome of preventive programs – based on the Nexö method – offered to three groups of children from Solntsevsky, a district of Moscow. Study group A consisted of 45 3–year–olds, study group B of 50 6–year–olds, and study group C of 50 11–year–olds. A similar number of children were selected as control groups and they followed the normal dental service provided by the local Health Service System in the district. The caries–preventive programs offered to the study groups were based on: (1) education of the child, parents and teachers in the caries disease, (2) training in toothbrushing. In addition, the children in study groups B and C were offered professional plaque removal, applications of sodium fluoride (2%) and sealant applications according to individual needs. The children in groups B and C were clinically examined in March 1994 (baseline) after 1 and 2.5 years, respectively. Because of the age of the children in group A, these children were only examined once, after the study had been completed. After 2.5 years the children in all three study groups had improved their oral health status significantly compared to the children in the control group. The caries experience among the children in study group A was about half of that observed among children in the control group (4.91 def–s versus 8.60 def–s). The program was highly effective in controlling dental caries in the permanent dentition among the children in the study groups, who finished with a mean DMF–S of 0.28 (group B) and 3.12 (group C) compared to 2.24 and 6.35 among the children in the corresponding control groups. Nearly all the children used fluoridated toothpaste. The mean number of visits to the clinic decreased from year 1 to year 2 (5 versus 3.4 in study group B and 4.5 versus 3.3 in study group C). In conclusion, the preventive programs were highly effective with regard to improving the level of oral hygiene, and thereby reducing or even controlling the plaque–induced disease activity.

The data from this group of Moscow citizens suggest a long-term positive effect of the Nexö-method implemented during childhood.

In order to provide a baseline for planning a caries preventive program for children in a district in Moscow, samples of 6‐, 8‐, 10‐, 12‐, and 14‐yr‐old children were examined. The initial examination included recording of plaque on selected surfaces using a classification from 0 to 2 (thick plaque). After supervised tooth brushing, the children were examined for caries. Each tooth surface was examined and classified in progressive stages of caries involving opaque enamel lesions, increasing stages of cavity formation, fillings with and without caries and extractions due to caries. Gingival status in selected locations was classified from 0 to 2 (severe inflammation). More than 2/3 of the children had surfaces covered with thick plaque (score 2). Gingivitis was observed in one or more places in 2/3 of the children. Caries experience in the primary dentition was high, and low to moderate in the permanent dentition. However, the average number of surfaces with deep dentin cavitation, indicating pulpal involvement in 14‐yr‐olds, was 1.7. Caries on primary molar teeth accounted for about 80% of the accumulated caries experience among the 8‐yr‐olds. Caries on permanent first molars accounted for about 70% of the accumulated caries experience among the 14‐yr‐olds. The occlusal surface on permanent first molars was the most prone to caries in the permanent dentition.

Background Comprehensive caries care has shown effectiveness in controlling caries progression and improving health outcomes by controlling caries risk, preventing initial-caries lesions progression, and patient satisfaction. To date, the caries-progression control effectiveness of the patient-centred risk-based CariesCare International (CCI) system, derived from ICCMS™ for the practice (2019), remains unproven. With the onset of the COVID-19 pandemic a previously planned multi-centre RCT shifted to this “Caries OUT” study, aiming to assess in a single-intervention group in children, the caries-control effectiveness of CCI adapted for the pandemic with non-aerosols generating procedures (non-AGP) and reducing in-office time. Methods In this 1-year multi-centre single-group interventional trial the adapted-CCI effectiveness will be assessed in one single group in terms of tooth-surface level caries progression control, and secondarily, individual-level caries progression control, children’s oral-health behaviour change, parents’ and dentists’ process acceptability, and costs exploration. A sample size of 258 3–5 and 6–8 years old patients was calculated after removing half from the previous RCT, allowing for a 25% dropout, including generally health children (27 per centre). The single-group intervention will be the adapted-CCI 4D-cycle caries care, with non-AGP and reduced in-office appointments’ time. A trained examiner per centre will conduct examinations at baseline, at 5–5.5 months (3 months after basic management), 8.5 and 12 months, assessing the child’s CCI caries risk and oral-health behaviour, visually staging and assessing caries-lesions severity and activity without air-drying (ICDAS-merged Epi); fillings/sealants; missing/dental-sepsis teeth, and tooth symptoms, synthetizing together with parent and external-trained dental practitioner (DP) the patient- and tooth-surface level diagnoses and personalised care plan. DP will deliver the adapted-CCI caries care. Parents’ and dentists’ process acceptability will be assessed via Treatment-Evaluation-Inventory questionnaires, and costs in terms of number of appointments and activities. Twenty-one centres in 13 countries will participate. Discussion The results of Caries OUT adapted for the pandemic will provide clinical data that could help support shifting the caries care in children towards individualised oral-health behaviour improvement and tooth-preserving care, improving health outcomes, and explore if the caries progression can be controlled during the pandemic by conducting non-AGP and reducing in-office time. Trial registration: Retrospectively-registered-ClinicalTrials.gov-NCT04666597-07/12/2020: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000AGM4&selectaction=Edit&uid=U00019IE&ts=2&cx=uwje3h. Protocol-version 2: 27/01/2021.

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