Comparison of brushing regimens on caries progression over one year

The role of brushing regimen in caries clinical trials potentially has a profound effect on caries experience over the course of a trial. Objectives: This study was conducted to assess the effects of brushing regimen on caries progression over a one year period. Methods: A total of 963 children, ages 5-16, were enrolled in three schools in Guatemala City, Guatemala. Caries examinations were performed at baseline and one year by a calibrated examiner using a visual tactile examination method performed with the aid of an artificial light, mouth mirror, compressed air, and a dental explorer employing a modified Radike criteria. Subjects were assigned by school to one of three brushing regimens; supervised brushing twice a day with 1100 ppm sodium fluoride dentifrice, unsupervised brushing with 1100 ppm sodium fluoride dentifrice, or a no treatment regimen. Results: The adjusted baseline mean DMFS in the 779 children that completed the study was 7.42, 7.66, and 7.12 for the no treatment, unsupervised, and supervised brushing groups, respectively, and were not significantly different (p>0.05). After 1 year, the adjusted mean gross DMFS increment was 1.48, 1.34, and 0.93 for the no treatment, unsupervised, and supervised brushing groups, respectively. The increment in the supervised group was statistically significantly lower relative to both the no treatment and unsupervised treatment groups with p=0.0009 and p=0.004, respectively. The unsupervised brushing and no treatment groups were not statistically significantly different. Conclusions: Supervised brushing results in a significant reduction in caries increment relative to unsupervised brushing and a no treatment regimens and imparts a caries benefit in the absolute. Supported by the Procter & Gamble Company.