IADR Abstract Archives
Impact of a Preventive Caries Intervention in Remote Indigenous Children
Objectives: To compare the incidence of dental caries in remote Indigenous Australian children by degree of compliance with an annual preventive intervention.
Methods: All children were invited to participate in a preventive intervention study to reduce the burden of dental caries after cessation of community water fluoridation. All consented children were epidemiologically examined for caries at baseline in 2015 and re-examined in 2016 and 2017. Children who consented to the treatment phase (treatment of existing dental conditions in 2015) and the annual 'Big Bang' preventive intervention comprising fissure sealant, povidone-iodine and fluoride varnish, comprised the experimental group: Children who did not consent to the treatment phase comprised a natural control group. This analysis compares the 1- and 2-year mean caries incidence (±SD) by these groups, using ICDAS-II criteria.
Results: Of the 408 children examined at baseline 267 and 208 were re-examined in 2016 and 2017 respectively. Caries incidence in the permanent dentition at 1-year follow-up was significantly lower in the experimental (3.2±3.9) compared to control group (5.5±6.4; p=0.001). Caries incidence was lower in the deciduous dentition in the experimental group, but not statistically so. In the 2-year follow-up, caries incidence was statistically different in both dentitions. Permanent dentition mean caries incidence was 4.9(±5.2) in the experimental group compared to 6.3(±4.8) in the control (p=0.041): 2.2(±3.1) compared to 3.5(±3.9) for the deciduous dentition respectively (p=0.043). At baseline, children in both groups had similar self-reported oral hygiene and dietary habits.
Conclusions: Children who were treated for their existing disease and received the annual 'Big Bang' preventive intervention experienced significantly fewer new carious lesions. The intervention was effective in reducing caries incidence compared to the control group. An economic analysis is underway to document how this approach to caries prevention compares with the peripatetic presence of a dentist or a dental therapist in the community.
Methods: All children were invited to participate in a preventive intervention study to reduce the burden of dental caries after cessation of community water fluoridation. All consented children were epidemiologically examined for caries at baseline in 2015 and re-examined in 2016 and 2017. Children who consented to the treatment phase (treatment of existing dental conditions in 2015) and the annual 'Big Bang' preventive intervention comprising fissure sealant, povidone-iodine and fluoride varnish, comprised the experimental group: Children who did not consent to the treatment phase comprised a natural control group. This analysis compares the 1- and 2-year mean caries incidence (±SD) by these groups, using ICDAS-II criteria.
Results: Of the 408 children examined at baseline 267 and 208 were re-examined in 2016 and 2017 respectively. Caries incidence in the permanent dentition at 1-year follow-up was significantly lower in the experimental (3.2±3.9) compared to control group (5.5±6.4; p=0.001). Caries incidence was lower in the deciduous dentition in the experimental group, but not statistically so. In the 2-year follow-up, caries incidence was statistically different in both dentitions. Permanent dentition mean caries incidence was 4.9(±5.2) in the experimental group compared to 6.3(±4.8) in the control (p=0.041): 2.2(±3.1) compared to 3.5(±3.9) for the deciduous dentition respectively (p=0.043). At baseline, children in both groups had similar self-reported oral hygiene and dietary habits.
Conclusions: Children who were treated for their existing disease and received the annual 'Big Bang' preventive intervention experienced significantly fewer new carious lesions. The intervention was effective in reducing caries incidence compared to the control group. An economic analysis is underway to document how this approach to caries prevention compares with the peripatetic presence of a dentist or a dental therapist in the community.