IADR Abstract Archives
Effectiveness of a single annual intervention for prevention of childhood caries in a remote Indigenous community. Part 1.
Objectives: This study aims to reduce the high prevalence of tooth decay in children in a remote rural Indigenous community in Cape York, Northern Queensland by a single annual prevention strategy. We hypothesise this will prove more effective, and cheaper, than treating overt disease if clinicians were available, with better outcomes for residents. We present an interim analysis of the impact of this initiative.
Methods: All children in the community were invited to participate. An oral epidemiological screening (ICDAS-II) of consented children was conducted in 2015 and 2016. In 2015, all children with a treatment need (TN) who consented were made dentally-fit. A “Big-Bang” intervention: swabbing dentition with povidone iodine; fluoride varnish; fissure sealing indicative teeth, was then provided to all consented children, at the end of treatment and to those with no TN.
Results: Of the total child population, 461 consented and were screened at baseline. On average these children experienced 9.1 non-cavitated (ICDAS-II codes 1-3) and 3.1 cavitated (ICDAS-II codes 4-6) carious lesions. All screened children were invited to the intervention phases of the study: either only for the “Big Bang” if dentally fit (n=173; 38%) or for dental treatment for active caries followed by the “Big Bang” (n=288; 62%). 206 (45%) consented to be part of this phase (our intervention group). Non-consenting children were the natural control group. On average, children who entered the intervention phases had 7.4 non-cavitated and 2.9 cavitated carious lesions; compared to 10.6 non-cavitated and 3.3 cavitated carious lesions in those who did not opt for any intervention. During the treatment phase the clinical team provided 109 restorations, 21 extractions and 23 root canal pulp treatments. Follow-up results will be presented in Part 2.
Conclusions: Our “Big-Bang” intervention appears to be clinically effective at one year follow-up. Caution is important as this is an interim finding and the data require the second follow-up; and deeper analyses including comparing incident caries by surface between the two subsets of the intervention group [with and without an initial TN] and the control groups. The full follow-up will inform the critical and central aim to measure the cost-effectiveness and benefit of the preventive intervention.
Methods: All children in the community were invited to participate. An oral epidemiological screening (ICDAS-II) of consented children was conducted in 2015 and 2016. In 2015, all children with a treatment need (TN) who consented were made dentally-fit. A “Big-Bang” intervention: swabbing dentition with povidone iodine; fluoride varnish; fissure sealing indicative teeth, was then provided to all consented children, at the end of treatment and to those with no TN.
Results: Of the total child population, 461 consented and were screened at baseline. On average these children experienced 9.1 non-cavitated (ICDAS-II codes 1-3) and 3.1 cavitated (ICDAS-II codes 4-6) carious lesions. All screened children were invited to the intervention phases of the study: either only for the “Big Bang” if dentally fit (n=173; 38%) or for dental treatment for active caries followed by the “Big Bang” (n=288; 62%). 206 (45%) consented to be part of this phase (our intervention group). Non-consenting children were the natural control group. On average, children who entered the intervention phases had 7.4 non-cavitated and 2.9 cavitated carious lesions; compared to 10.6 non-cavitated and 3.3 cavitated carious lesions in those who did not opt for any intervention. During the treatment phase the clinical team provided 109 restorations, 21 extractions and 23 root canal pulp treatments. Follow-up results will be presented in Part 2.
Conclusions: Our “Big-Bang” intervention appears to be clinically effective at one year follow-up. Caution is important as this is an interim finding and the data require the second follow-up; and deeper analyses including comparing incident caries by surface between the two subsets of the intervention group [with and without an initial TN] and the control groups. The full follow-up will inform the critical and central aim to measure the cost-effectiveness and benefit of the preventive intervention.