Scottish children have one of the highest levels of caries experience in Europe. Only 33% of 5-year-old children in Dundee who developed caries in their first permanent molars by 7 brushed their teeth twice a day. High-caries-risk children should benefit if they brush more often with fluoridated toothpaste. The aim of this clinical trial was to determine the reduction in 2-year caries increment that can be achieved by daily supervised toothbrushing on school-days with a toothpaste containing 1,000 ppm fluoride (as sodium monofluorophosphate) and 0.13% calcium glycerophosphate, combined with recommended daily home use, compared to a control group involving no intervention other than 6-monthly clinical examinations. Five hundred and thirty-four children, mean age 5.3, in schools in deprived areas of Tayside were recruited. Each school had two parallel classes, one randomly selected to be the brushing class and the other, the control. Local mothers were trained as toothbrushing supervisors. Children brushed on school-days and received home supplies. A single examiner undertook 6-monthly examinations recording plaque, caries (D₁ level), and used FOTI to supplement the visual caries examination. For children in the brushing classes, the 2-year mean caries increment on first permanent molars was 0.81 at D₁ and 0.21 at D₃ compared to 1.19 and 0.48 for children in the control classes (significant reductions of 32% at D₁ and 56% at D₃). In conclusion, high-caries-risk children have been shown to have significantly less caries after participating in a supervised toothbrushing programme with a fluoridated toothpaste.

Aims/Objectives: To determine the benefit of twice daily toothbrushing on newly erupted first permanent molars. To investigate, through the Health Belief Model, how parents' beliefs influence the likelihood of their children brushing twice a day. To identify aspects of a toothbrushing intervention programme that can be used in general dental practice. Design: Randomised controlled trial. Setting: Schools in deprived communities in Scotland. Participants: 461, 5‐year‐old children. Interventions/methods: Supervised toothbrushing on schooldays with a 1,000ppm chalk‐based fluoride toothpaste for two years. A school and home‐based incentive scheme including toothbrushing charts, 6‐monthly dental examinations and parental questionnaires. Main outcome measures: Caries increment and twice daily toothbrushing. Results: In the control group, children who brushed once a day or less had 64% more caries than those who brushed at least twice a day (P=0.001). In the intervention group this difference in caries was reduced to 16% (P>0.05). The most significant parental belief explaining variation in twice‐daily brushing was whether parents feel strongly that there is time to check their child's toothbrushing (P=0.0001). The odds of these parents reporting that their child brushes twice daily are nearly three times greater. 95% of parents felt that toothbrushing charts would be a good way for dentists in practice to encourage children to brush regularly. Conclusions: The benefit of twice daily toothbrushing on caries development in newly erupted first permanent molar teeth is around 50% compared to brushing once a day or less. Parents' beliefs do influence the likelihood of their children brushing twice a day. Key parts of the intervention programme can be used when children attend general dental practice and would be welcomed by parents.

This study measured dental caries in children after cessation of a 30-month randomised clinical trial in which the intervention group received supervised toothbrushing once a day at school with 1,000 ppm fluoride toothpaste and a home support package encouraging twice-daily toothbrushing. The non-intervention group did not brush at school or receive the home support package. Children were aged 5 years at baseline and were examined every 6 months during the trial, then at 6, 18, 30 and 54 months after the end of the trial. Significantly less caries developed in first permanent molars of intervention children at the end of the trial. Of the 428 children who were examined at the end of the trial 329 (77%) were examined 54 months later when the children were aged 12 years on average. The intervention group still had less caries (D₃FS caries increment 1.62) than the non-intervention children (D₃FS caries increment 2.65, p < 0.05). Prolonged benefits have been found for intervention children principally in less caries in first permanent molars. Further follow-up at an age when the second molars and premolars have all erupted will help determine whether this benefit is due to a long-term behavioural change or a prolonged biological effect.

Paediatric Best Practice Tariff Criteria for Diabetes• Offer a minimum of four clinic appointments per year with a multidisciplinary team (MDT), i.e. a paediatric diabetes specialist nurse, dietician and doctor.• Offer additional contact with the diabetes specialist team e.g. check ups, telephone contacts, school visits, troubleshooting, advice, support etc.  Minimum of eight additional contacts per year.

Qualitative studies contain in-depth information about facilitators and barriers to successful rehabilitation. This systematic review synthesised findings across qualitative studies to inform vocational rehabilitation practices for people who have experienced burn injury. PRISMA guidelines were used to determine inclusion criteria for the review and develop a comprehensive search strategy. Four databases were searched and results screened. Included studies investigated experiences of return to work (RTW) or meaningful activity in a burn injury population. Quality of included articles was examined using the CASP framework for qualitative research. Thematic synthesis was used to analyse the qualitative results. Six studies met inclusion criteria. Five analytic themes were identified regarding experiences of vocational support and ability to RTW after burn injury: addressing the complex impact of burn injury; personal connections as vital support; skilled and specialised healthcare as central to RTW; value of knowledge; and considering the work environment. No included studies investigated meaningful activity other than paid work. Findings support structured vocational rehabilitation, psychological interventions, social support, intensive rehabilitation and patient, clinician and workplace education as key in facilitating RTW after burn injury. Additionally, coordinated care is likely to improve vocational outcomes. Research is needed on supporting return to meaningful activity.