The Monitor Practice Program (MPP) is a multicentre clustered randomised controlled trial of preventive intervention according to the Caries Management System (CMS). The CMS is a risk-specific non-surgical intervention designed to arrest and remineralise non-cavitated carious lesions and prevent new incident lesions. At three years, the mean DMFT increment was 35% less among patients attending intervention practices compared with those attending control practices (p<0.001). The aim was to determine whether the outcome achieved at three years would be sustained.
Method:
Following publicity about the MPP, 22 dental practices were recruited and randomly assigned to the control group where patients received usual care or the intervention group. During the first three years, investigators established frequent contacts with practices to monitor diagnostic standards at all practices and to facilitate the implementation of the CMS protocol at the intervention practices. Contacts with practices during years 4-7 were much less frequent.
Result:
The mean DMFT increments at year 7 for the intervention and control patients were 4.98 and 6.86 respectively (p<0.0160) as per the intention to treat principle. In a sensitivity analysis in which one intervention practice was excluded because the CMS protocol was not, the respective control and intervention mean DMFT increments 4.11 and 6.86 (p=0.0035), indicating a reduction in caries risk of 40%.
Conclusion:
Decreased caries risk at three years was sustained at seven years.