Exploring the content of the advice provided by general dental practitioners to help prevent caries in young children

Threlfall, Anthony; Milsom, K M; Hunt, Carianne M.; Tickle, Martin; Blinkhorn, Anthony S.

doi:10.1038/bdj.2007.46

Cited by 46 publications

(38 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1 In brief, GDPs practicing in Lancashire, Cheshire, and Greater Manchester in 2003 were selected at random and sent a letter inviting them to participate. This process continued until approximately 100 dentists had agreed to be interviewed.…”

Section: Methodsmentioning

confidence: 99%

“…In a recent study we interviewed 93 GDPs about the care they provide to children and found that all of them reported giving preventive advice and most covered similar themes, but the content of the advice differed among them in terms of specifics and emphasis. 1 The impact of a GDP's preventive advice on the oral health of their child patients will be influenced not only by its content, but also by how and to whom it is delivered. In this study we reanalyse the 93 interview transcripts to identify the principle factors that influence individual GDPs' provision of preventive advice.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Exploring factors that influence general dental practitioners when providing advice to help prevent caries in children

et al. 2007

Self Cite

View full text Add to dashboard Cite

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exploring factors that influence general dental practitioners when providing advice to help prevent caries in children

et al. 2007

Self Cite

View full text Add to dashboard Cite

“…However, the quality and effectiveness of the preventative care delivered at dental visits may have improved. Research that informed the rationale and design of this study suggested that the preventative care provided by GDPs was ineffective and inequitable 58 and that dentists were ill equipped in terms of their knowledge 59 and how they present information to their patients 60 to provide an effective preventative service. In response to the concerns about the quality of prevention in practice, the Department of Health in England developed and distributed DBOH 13 to every dental practice in England.…”

Section: Dental Visiting and Preventionmentioning

confidence: 99%

A randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services: the Northern Ireland Caries Prevention In Practice (NIC-PIP) trial

Tickle

O’Neill

Donaldson

et al. 2016

Health Technol Assess

View full text Add to dashboard Cite

BackgroundDental caries is the most common disease of childhood. The NHS guidelines promote preventative care in dental practices, particularly for young children. However, the cost-effectiveness of this policy has not been established.ObjectiveTo measure the effects and costs of a composite fluoride intervention designed to prevent caries in young children attending dental services.DesignThe study was a two-arm, parallel-group, randomised controlled trial, with an allocation ratio of 1 : 1. Randomisation was by clinical trials unit, using randomised permuted blocks. Children/families were not blinded; however, outcome assessment was blinded to group assessment.SettingThe study took place in 22 NHS dental practices in Northern Ireland, UK.ParticipantsThe study participants were children aged 2–3 years, who were caries free at baseline.InterventionsThe intervention was composite in nature, comprising a varnish containing 22,600 parts per million (p.p.m.) fluoride, a toothbrush and a 50-ml tube of toothpaste containing 1450 p.p.m. fluoride; plus standardised, evidence-based prevention advice provided at 6-monthly intervals over 3 years. The control group received the prevention advice alone.Main outcome measuresThe primary outcome measure was conversion from caries-free to caries-active states. Secondary outcome measures were the number of decayed, missing or filled tooth surfaces in primary dentition (dmfs) in caries-active children, the number of episodes of pain, the number of extracted teeth and the costs of care. Adverse reactions (ARs) were recorded.ResultsA total of 1248 children (624 randomised to each group) were recruited and 1096 (549 in the intervention group and 547 in the control group) were included in the final analyses. A total of 87% of the intervention children and 85% of control children attended every 6-month visit (p = 0.77). In total, 187 (34%) children in the intervention group converted to caries active, compared with 213 (39%) in the control group [odds ratio (OR) 0.81, 95% confidence interval (CI) 0.64 to 1.04;p = 0.11]. The mean number of tooth surfaces affected by caries was 7.2 in the intervention group, compared with 9.6 in the control group (p = 0.007). There was no significant difference in the number of episodes of pain between groups (p = 0.81). However, 164 out of the total of 400 (41%) children who converted to caries active reported toothache, compared with 62 out of 696 (9%) caries-free children (OR 7.1 95% CI 5.1 to 9.9;p < 0.001). There was no statistically significant difference in the number of teeth extracted in caries-active children (p = 0.95). Ten children in the intervention group had ARs of a minor nature. The average direct dental care cost was £155.74 for the intervention group and £48.21 for the control group over 3 years (p < 0.05). The mean cost per carious surface avoided over the 3 years was estimated at £251.00.LimitationsThe usual limitations of a trial such as generalisability and understanding the underlying reasons for the outcomes apply. There is no mean willingness-to-pay threshold available to enable assessment of value for money.ConclusionsA statistically significant effect could not be demonstrated for the primary outcome. Once caries develop, pain is likely. There was a statistically significant difference in dmfs in caries-active children in favour of the intervention. Although adequately powered, the effect size of the intervention was small and of questionable clinical and economic benefit.Future workFuture work should assess the caries prevention effects of interventions to reduce sugar consumption at the population and individual levels. Interventions designed to arrest the disease once it is established need to be developed and tested in practice.Trial registrationCurrent Controlled Trials ISRCTN36180119 and EudraCT 2009-010725-39.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 71. See the NIHR Journals Library website for further project information.

show abstract

“…12 The use of fluoridated milk might be successful, but required further research 13 • The type of dental health education provided in general dental practice was usually about sugar consumption and brushing, varied between practitioners, there was a lack of clarity about the use of fl uorides, 14 lack of visual aids and leafl ets, and was targeted more upon the basis of the dentist's assessment of parental motivation. 15 Preventive care was reactive to disease patterns and does not seem to be particularly effective.…”

Section: Introductionmentioning

confidence: 99%

To screen, or not to screen, - that is the question:-

Baker¹

2007

Br Dent J

View full text Add to dashboard Cite

Exploring the content of the advice provided by general dental practitioners to help prevent caries in young children

Cited by 46 publications

References 3 publications

Exploring factors that influence general dental practitioners when providing advice to help prevent caries in children

Exploring factors that influence general dental practitioners when providing advice to help prevent caries in children

A randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services: the Northern Ireland Caries Prevention In Practice (NIC-PIP) trial

To screen, or not to screen, - that is the question:-

Contact Info

Product

Resources

About