IADR Abstract Archives
Effectiveness of a single annual intervention for prevention of childhood caries in a remote Indigenous community. Part 2.
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: One year later all children screened were invited back for the first follow-up assessment and 58% complied. Of the children screened in the first follow-up, 132 (49%) were from the intervention group and 135 (51%) from the control group. At follow up, children in the intervention group had 3.4 non-cavitated and 0.74 cavitated carious lesions on average; compared to 5.6 non-cavitated and 1.6 cavitated carious lesions in the control group.
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: One year later all children screened were invited back for the first follow-up assessment and 58% complied. Of the children screened in the first follow-up, 132 (49%) were from the intervention group and 135 (51%) from the control group. At follow up, children in the intervention group had 3.4 non-cavitated and 0.74 cavitated carious lesions on average; compared to 5.6 non-cavitated and 1.6 cavitated carious lesions in the control group.
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.