Dental Caries Clinical Trial
Official title:
Assessing the Long-term Effects of a School-to-home Childhood Supervised Brushing Programme in Young Adults From High Caries Risk Groups - The Tayside Brushing Study Adult Follow up
Historically dental health of Scottish children had been poor for many years. Evidence form
clinical trials of fluoride toothpaste identified a route to improving prevention. Those who
had poor dental health used fluoride toothpaste infrequently at home. The investigators
hypothesised that this disadvantage could be overcome by supplying toothpaste to
disadvantaged families and supervising child toothbrushing at school. In 1997, 534 children
5.3 years were recruited in 12 primary schools in Tayside; randomly assigned to one of two
groups - test group followed a home-to-school toothbrushing programme with fluoride
toothpaste; control group: usual care. Children in test group were provided with toothbrushes
and toothpaste (1,000ppmF as sodium monofluorophosphate) for home use; also brushed their
teeth school daily. After 2 years, children participating in the supervised brushing
programme developed significantly less caries (tooth decay).
Permission was given for longitudinal follow up of children and dental records. The original
intervention lasted 30 months and children were re-examined at 36 months after baseline, 48,
60 and 84 months. At 84 month examination, 77% were available, found prolonged benefits of
brushing programme. This was 4.5 years after the end of the programme; children were aged
11.5 years. At age 14 years, 6.5 years after intervention end, 65% of children were
reexamined; benefit was still evident at 20-26% less caries experience. However, there had
been greater subject loss and insufficient funds available to undertake a more individual
followup of participants.
Since then, records have been followed; up-to-date contact details identified. Using this new
data, the investigators seek to reconsent the participants, now aged 23 to invite them to
attend a followup dental examination. This study has the potential to provide unique
information on longterm costs and benefits of a home-to-school toothbrushing programme.
Participants on the original trial will be sent an information letter and information leaflet
and consent form in the post. The letter will provide contact details for the chief
investigator (CI) should they wish to discuss the study before making a decision about
whether they would like to take part. The letter will ask participants to complete the
informed consent form and return it to the Chief Investigator in the pre-paid envelope
provided. If participants do not respond to the first letter a second will be sent two weeks
later. No further letters will be sent.
The consent form will ask participants to give details of which days and times are most
convenient for them to attend an appointment (evening and weekend appointments will be
offered). The letter will advise people that attendance does not replace their usual dental
care visits. For those who do not have a dentist and wish to find one, appropriate advice and
assistance will be provided by the CI, or a member of the Dental Team.
Participants who return their consent forms will be contacted by telephone by a member of the
NHS Tayside dental team to arrange an appointment at a time convenient to them. If
participants are unable to travel to the two centres (Broxden Dental Centre in Perth or Kings
Cross Dental Department in Dundee) they may be offered a home visit.
When participants attend for their appointment they will be asked to confirm their consent
verbally. Dr Morag Curnow (the same dentist that examined the participants when they were in
School on the original toothbrushing trial) or another appropriately trained Dentist (named
on the study delegation log) will conduct a short dental examination, recording the presence
of plaque on anterior teeth and the caries status of each tooth surface using dental lighting
and fibre-optic transillumination. The examining dentist will be unaware of which study group
the adults belonged to when they were child participants in the trial. Participants will also
be asked to complete oral health related questionnaires. Questionnaires will be analysed by a
statistician.
Participants will be asked to give consent for their dental records to be accessed using
health service records to record dental treatment history. Consent will be recorded in
writing. Approval has already been provided by Information Services Division (ISD), NHS
National Services Scotland to access the dental treatment records.
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