Title: A comparison of community based preventative services to improve child dental health
Funder: Department of Health (England)

Abstract: Background Children in the north-west have the highest prevalence of tooth decay in England; and Salford has the sixth highest in the north-west. More than half of all Salford children have decay experience by age 5. Every month about 19 children in Salford are admitted to hospital to have teeth extracted under general anaesthesia which is the principal reason for planned hospital admissions for children under 10. Salford PCT and Salford City Council have produced an oral health strategy with 8 aims This study is addressing 4 of those including reducing the prevalence of dental decay in young children in a partnership with Children’s Centres, parents, general practitioners and the health promotion team to provide and evaluate new preventive dental services. Aims To compare the costs to the NHS and the benefits to child dental health of three new dental services. Working in partnership with Children’s Centres in Salford, a new dental service will be established of linking a local dental practice to each Children’s Centre and offering dental care to the families using the Centre (Control Group). This service will be compared to one that delivers in addition, a Centre-based preventive programme to families to support establishing two key dental behaviours: a sugar-free bedtime routine and twice daily brushing with fluoridated toothpaste (Test Group 1). The new service will also be compared to one that delivers in addition, a Centre-based dental professional-applied series of fluoride varnish applications (Test Group 2). Plan of Investigation This study is a randomised clinical trial to compare costs to the NHS and benefits to child dental health of three new dental services. Parents of babies will be recruited at 8-10 months and will be randomly allocated. Those in the new standard service (Control Group) will be offered dental care at a practice local to their Children’s Centre. Children in Test Group 1 will additionally attend 10 group sessions from age 12 to 30 months to support establishing toothbrushing and a sugar-free bedtime routine. Children in Test Group 2 will additionally to control group attend individual sessions at their Children’s Centre to apply fluoride varnish. Dental health at 3 will be measured and economic analysis undertaken. Parents and general practioners will inform design and delivery of services. Potential Impact Reducing the prevalence of dental caries in young children leads to a reduction in the numbers of children with the disease and in the severity of the disease for those affected. Either intervention has been shown in trials of school-aged children to reduce decay by 30 to 60%. As over half of all children in Salford have decay experience by 5, many hundreds of children can benefit within a single PCT. Establishing healthy behaviours in young children can last for many years leading to significant savings in dental acre and enhanced quality of life.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: ORAL AND GASTROINTESTINAL