"Strong Teeth": an early-phase study to assess the feasibility of an oral health intervention delivered by dental teams to parents of young children

Abstract

Background Tooth decay (caries) is a significant health burden in young children. There is strong evidence for the benefits of establishing appropriate home-based oral health behaviours in early childhood. Dental teams are well placed to provide this information and there is clear advice on what oral health information should be given to parents. However, research has shown that there is limited guidance, training and resources on how dental teams should deliver this advice. "Strong Teeth" is a complex oral health intervention, using evidence-based resources and training underpinned by behaviour change psychology, to support behaviour change conversations in dental practice. This early phase evaluation aims to assess the feasibility of this intervention, prior to a full-scale trial. Methods The study recruited 15 parents of children aged 0–2-years-old and 21 parents of children aged 3–5 years old, from five NHS dental practices across West Yorkshire. Participant demographics, self-reported brushing behaviours, dietary habits, a dental examination and three objective measures of toothbrushing were collected in a home-setting at baseline, then at 2-weeks and 2-months post-intervention. Recruitment, retention and intervention delivery were analysed as key process outcomes. Brushing habits were compared to national toothbrushing guidelines – the Delivering Better Oral Health toolkit (Public Health England). Results Strong Teeth was feasible to deliver in a General Dental Practice setting in 94% of cases. Feasibility of recruitment (37%) exceeded progression criterion, however retention of participants (75%) was below the progression criterion for the 0–2 age group. More than half of children recruited aged 3–5-years had caries experience (52%). Total compliance to toothbrushing guidance at baseline was low (28%) and increased after the intervention (52%), an improvement that was statistically significant. Dietary habits remained largely unchanged. Plaque scores significantly decreased in the 3–5-year-olds and toothbrushing duration increased in all age groups. Conclusion "Strong Teeth" intervention delivery and data collection in the home setting was feasible. There was a positive indication of impact on reported toothbrushing behaviours. Some amendments to study design, particularly relating to the inclusion of the 0–2-year-old group, should be considered before progression to a full trial. Trial registration ISRCTN Register: ISRCTN10709150. Registered retrospectively 24/7/2019.

HABIT: Health visitors delivering Advice in Britain on Infant Toothbrushing – an early-phase feasibility study of a complex oral health intervention

“…Following feedback, a member of the NHS Trust Research and Development team took over all recruitment responsibilities. Group B had a retention rate of 74% (n=26) at the final data-collection visit, a comparable level to similarly structured feasibility papers 40. The biggest dropout occurred after consent (n=8).…”

“…Group B had a retention rate of 74% (n=26) at the final data-collection visit, a comparable level to similarly structured feasibility papers. 40 The biggest dropout occurred after consent (n=8). Combining the BL data collection and consent visit would streamline future study design and minimise attrition.…”

“…The biggest dropout occurred after consent (n=8). Combining the BL data collection and consent visit would streamline future study design and minimise attrition 40. Parents with young children lead busy and complex lives, which can lead to communication challenges and last-minute cancellations, consequently, generous timelines can provide the required flexibility for home-based data collection.…”

Feasibility and acceptability of home delivery of water for dental caries control in Latinx children—“Sediento por una Sonrisa,” Thirsty for a Smile: Single-arm feasibility study

“…Several interventions have been evaluated for prevention of early childhood dental caries including changes in oral hygiene habits, oral health education, and fluoride treatments ( 40 , 41 ). To prevent early childhood dental caries relapse, our intervention focused on reducing the consumption of sugar sweetened beverages by combining two strategies—a behavioral component and an environmental component: a dietitian was trained to provide counseling at the dental clinic and water bottles were home delivered.…”

“…To prevent early childhood dental caries relapse, our intervention focused on reducing the consumption of sugar sweetened beverages by combining two strategies—a behavioral component and an environmental component: a dietitian was trained to provide counseling at the dental clinic and water bottles were home delivered. Others have used dental professionals to deliver dietary counseling to caregivers—dentists ( 42 ), dental hygienists ( 43 ) or dental teams ( 41 ) at similar settings. Similar to our study, these studies posit the dental office as an appropriate setting to implement this type of program.…”