TY - JOUR

T1 - Dental RECUR randomised trial to prevent caries re-occurrence in children

AU - Pine, Cynthia

AU - Adair, Pauline

AU - Burnside, Girvan

AU - Brennan, Louise

AU - Sutton, L.

AU - Edwards, Rhiannon Tudor

AU - Ezeofor, Victory

AU - Albadri, Saldos

AU - Curnow, Morag

AU - Deery, Chris

AU - Hosey, Marie-Therese

AU - Willis-Lake, J.

AU - Lynn, J.

AU - Parry, Jennifer

AU - Wong, F.S.L.

N1 - Copyright 2019 SAGE. This work is made available online in accordance with the publisher’s policies. Please refer to any applicable terms of use of the publisher

PY - 2020/2

Y1 - 2020/2

N2 - OBJECTIVES: to determine the efficacy of a dental nurse-delivered intervention, the Dental Recur Brief Negotiated Interview for Oral Health (DR-BNI), in reducing the re-occurrence of dental caries in children who had a primary tooth extracted two years previously. METHOD: Two-arm, multi-centre randomised controlled trial (RCT), with blinded outcome assessment. 12 Centres in the UK; n=241, 5-7 year-old children scheduled to have primary teeth extracted. Test intervention (n=119): DR-BNI informed by motivational interviewing (MI). 30-minute structured conversation with parents led by trained dental nurses. Forward focus to prevent caries in future. Preventive goals agreed, review appointment made with general dental practice (GDP). GDP advised to treat child as high caries-risk. Control intervention (n=122): conversation about future eruption of permanent teeth, advised attend GDP as usual. Baseline: mean dmft 6.8 in DR-BNI group, 6.3 in control, median 5 teeth extracted, mainly under general anaesthesia. RESULTS: Final dental assessments by a single examiner visiting 189 schools two years after intervention; 193 (80%) of 241 children examined. 62% in control group developed new caries in teeth that were caries free or unerupted at baseline. In the test group, this was 44%, a significant reduction (p=0.021). The odds of new caries experience occurring were reduced by 51% in the DR-BNI group compared to control. Relative risk: 29% decrease in the risk of new caries experience in the DR-BNI group compared to control. In a wide range of high caries risk children, this single, low cost, low intensity intervention was successful in significantly reducing the risk of new caries experience. CONCLUSION: this trial has implications for changing paediatric dental practice internationally. Training in, and implementation of, an MI-informed brief intervention provides opportunities for dental nurses to go beyond clinical prevention to facilitate behaviour change, and to support oral health improvements for high caries risk children.

AB - OBJECTIVES: to determine the efficacy of a dental nurse-delivered intervention, the Dental Recur Brief Negotiated Interview for Oral Health (DR-BNI), in reducing the re-occurrence of dental caries in children who had a primary tooth extracted two years previously. METHOD: Two-arm, multi-centre randomised controlled trial (RCT), with blinded outcome assessment. 12 Centres in the UK; n=241, 5-7 year-old children scheduled to have primary teeth extracted. Test intervention (n=119): DR-BNI informed by motivational interviewing (MI). 30-minute structured conversation with parents led by trained dental nurses. Forward focus to prevent caries in future. Preventive goals agreed, review appointment made with general dental practice (GDP). GDP advised to treat child as high caries-risk. Control intervention (n=122): conversation about future eruption of permanent teeth, advised attend GDP as usual. Baseline: mean dmft 6.8 in DR-BNI group, 6.3 in control, median 5 teeth extracted, mainly under general anaesthesia. RESULTS: Final dental assessments by a single examiner visiting 189 schools two years after intervention; 193 (80%) of 241 children examined. 62% in control group developed new caries in teeth that were caries free or unerupted at baseline. In the test group, this was 44%, a significant reduction (p=0.021). The odds of new caries experience occurring were reduced by 51% in the DR-BNI group compared to control. Relative risk: 29% decrease in the risk of new caries experience in the DR-BNI group compared to control. In a wide range of high caries risk children, this single, low cost, low intensity intervention was successful in significantly reducing the risk of new caries experience. CONCLUSION: this trial has implications for changing paediatric dental practice internationally. Training in, and implementation of, an MI-informed brief intervention provides opportunities for dental nurses to go beyond clinical prevention to facilitate behaviour change, and to support oral health improvements for high caries risk children.

KW - caries detection

KW - caries treatment

KW - child dentistry

KW - clinical studies

KW - diagnosis

KW - health services research

KW - motivational interviewing

KW - prevention

KW - trials

U2 - 10.1177/0022034519886808

DO - 10.1177/0022034519886808

M3 - Article

VL - 99

SP - 168

EP - 174

JO - Journal of Dental Research

JF - Journal of Dental Research

SN - 1544-0591

IS - 2

ER -