The Monitor Dental Practice Program - Recruitment and Standardization

Background: This research is being undertaken to establish the cost-effectiveness of a structured preventive program compared to standard care within private dental practices. Objectives: 1. To recruit dental practices from a cross-section of locations in NSW 2. To define, quantify, and analyze standard care within recruited practices Methods: This is a multi-centre, clustered randomized controlled trial. Sample size calculations were generated on a practice rather than patient basis. Sixteen practices providing 50 patients will generate 80% power (α= 0.05) to detect an absolute reduction in the DMFS increment of 25% in a 5-year period between the two arms of the trial. Recruitment was facilitated with the support of key stakeholders and included oral presentations at divisional meetings of the ADA. A detailed time-in-motion study (420 dental procedures) and background questionnaire was undertaken in order to define the parameters of standard care. The reliability study involved each dentist reading a series of 12 pairs of bitewing radiographs produced and reviewed under standardized conditions. Assessment of kappa was undertaken blind to allocation status of the dentist. Results: Recruitment ceased three months into the planned six-month period; thirty-one practices having approached the researchers. Six suburban, five CBD, five rural (fluoride), and four rural (non-fluoride) practices have been recruited. Standard care did not differ significantly between intervention and control practices (Mann-Whitney U: z = - 1.154; P= 0.25). Bitewing kappa: Intervention = 0.789 Control = 0.772 (t₁₈ = -0.87; P=0.40) Conclusion: The involvement of private dental practices in research is feasible and well supported by the profession. Standard care does not differ significantly between intervention and control practices. Inter- observer reliability was good, and not statistically different between the two arms of the trial.

Acknowledgements: •Oral Health Foundation •Australian Dental Association (NSW) •Colgate •Australian Healthcare Management •Halas