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

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  • Cynthia Pine
    Queen Margaret University
  • Pauline Adair
    Queens University Belfast
  • Girvan Burnside
    University of Liverpool
  • Louise Brennan
    Health Education North West
  • L. Sutton
    University of Liverpool
  • Rhiannon Tudor Edwards
  • Victory Ezeofor
  • Saldos Albadri
    University of Liverpool
  • Morag Curnow
    Broxton Dental Centre
  • Chris Deery
    University of Sheffield
  • Marie-Therese Hosey
    King's College London
  • J. Willis-Lake
    Kent Community Health NHS Foundation Trust
  • J. Lynn
    Belfast Health and Social Care Trust, Belfast
  • Jennifer Parry
    University College Cork
  • F.S.L. Wong
    Queen Mary University of London
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.

Keywords

  • Caries detection/diagnosis/prevention, Caries treatment, Child dentistry, Clinical studies/trials, health services research
Original languageEnglish
Pages (from-to)168-174
JournalJournal of Dental Research
Volume99
Issue number2
Early online date16 Jan 2020
DOIs
Publication statusPublished - Feb 2020
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