Impact of Atraumatic Restorative Treatment and Oral Health Promotion on Psychological and Salivary Aspects of Children
Condition: Dental Caries
MeSH terms: Dental Caries
Study type: Interventional

Summary: 
      This study evaluated the impact of atraumatic restorative treatment associated with oral
      health educational strategy on dental anxiety, oral health-related quality of life and
      salivary biochemical and microbiological characteristics of Brazilian schoolchildren.
    

Detailed description: 
      Children aged six- to eight years-old, both gender, were selected from public schools of
      Piracicaba, SP, Brazil, and were divided in three groups: caries-free children (control
      group, GC), children with at least one primary molar with dentin caries lesion submitted to
      oral health educational strategy followed by ART (GS+ART), and the other group was directly
      submitted to ART (GART). Oral hygiene was assessed by the presence of biofilm and gingivitis
      in buccal surfaces of primary and/or permanent upper incisors. Oral health educational
      strategy consisted of four consecutive sessions (once a week) about etiological factors of
      caries (using visual aids), oral hygiene instructions (using models), supervised
      toothbrushing and explanation of ART (indications and stages). ART was performed using hand
      instruments for opening and cleaning the cavities and a high-viscosity glass-ionomer for
      restoration. Dental anxiety was assessed by measuring the cognitive (modified Venham Picture
      Test, m-VPT), behavioral (modified Venham Anxiety Scale, m-VAS) and physiological (heart
      rate, HR; salivary cortisol and alpha-amylase, SC and SAA) aspects in the following days and
      moments: D1 - baseline, a day preceding ART (SC and SAA); D2 - day of treatment, before
      strategy (m-VPT), before ART (m-VPT, HR, SC, SAA), during the explanation of procedure (HR,
      m-VAS), at the moment of deepest excavation (HR, m-VAS), at the moment the restoration was
      applied (HR, m-VAS), after ART (m-VPT, HR, SC, SAA). The following variables were evaluated
      in three moments: T1 - baseline, T2 - one week after strategy (for both GC and GART) and T3 -
      one month after the strategy or ART for GC and GART, respectively. Oral health-related
      quality of life was assessed using Brazilian short version of the Child Perceptions
      Questionnaire (16-CPQ8-10) with 16 items. Salivary flow rate was estimated by chewing 0.3g of
      an inert and tasteless material, for approximately 70 cycles/min and spitting all the saliva
      produced for five minutes into a cooled tube. Salivary pH was determined immediately after
      collection, using a portable pH-meter. Salivary buffer capacity was performed by adding 1.5
      ml of HCl/5 mM to a tube containing 0.5 mL of stimulated saliva. For detection and
      quantification of S. mutans, the microbial DNA in unstimulated saliva samples was isolated
      and subjected to quantitative PCR reactions (qPCR).
    

Intervention name(s): Oral health educational strategy; Atraumatic Restorative Treatment
Intervention type(s): Other; Procedure
Intervention description(s): Oral health educational strategy consisted of four consecutive sessions (once a week) about etiological factors of caries (using visual aids), oral hygiene instructions (using models), supervised toothbrushing and explanation of atraumatic restorative treatment (indications and stages).; Atraumatic Restorative Treatment was performed using hand instruments for opening and cleaning the cavities and a high-viscosity glass-ionomer for restoration.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: alpha-amylases; child; cortisol; dental anxiety; dental atraumatic restorative treatment; health education; microbiota; oral hygiene; quality of life; saliva