The Tayside Brushing Study - Adult Follow up
Condition: Dental Caries
MeSH terms: Dental Caries
Study type: Observational

Summary: 
      Historically dental health of Scottish children had been poor for many years. Evidence form
      clinical trials of fluoride toothpaste identified a route to improving prevention. Those who
      had poor dental health used fluoride toothpaste infrequently at home. The investigators
      hypothesised that this disadvantage could be overcome by supplying toothpaste to
      disadvantaged families and supervising child toothbrushing at school. In 1997, 534 children
      5.3 years were recruited in 12 primary schools in Tayside; randomly assigned to one of two
      groups - test group followed a home-to-school toothbrushing programme with fluoride
      toothpaste; control group: usual care. Children in test group were provided with toothbrushes
      and toothpaste (1,000ppmF as sodium monofluorophosphate) for home use; also brushed their
      teeth school daily. After 2 years, children participating in the supervised brushing
      programme developed significantly less caries (tooth decay).

      Permission was given for longitudinal follow up of children and dental records. The original
      intervention lasted 30 months and children were re-examined at 36 months after baseline, 48,
      60 and 84 months. At 84 month examination, 77% were available, found prolonged benefits of
      brushing programme. This was 4.5 years after the end of the programme; children were aged
      11.5 years. At age 14 years, 6.5 years after intervention end, 65% of children were
      reexamined; benefit was still evident at 20-26% less caries experience. However, there had
      been greater subject loss and insufficient funds available to undertake a more individual
      followup of participants.

      Since then, records have been followed; up-to-date contact details identified. Using this new
      data, the investigators seek to reconsent the participants, now aged 23 to invite them to
      attend a followup dental examination. This study has the potential to provide unique
      information on longterm costs and benefits of a home-to-school toothbrushing programme.
    

Detailed description: 
      Participants on the original trial will be sent an information letter and information leaflet
      and consent form in the post. The letter will provide contact details for the chief
      investigator (CI) should they wish to discuss the study before making a decision about
      whether they would like to take part. The letter will ask participants to complete the
      informed consent form and return it to the Chief Investigator in the pre-paid envelope
      provided. If participants do not respond to the first letter a second will be sent two weeks
      later. No further letters will be sent.

      The consent form will ask participants to give details of which days and times are most
      convenient for them to attend an appointment (evening and weekend appointments will be
      offered). The letter will advise people that attendance does not replace their usual dental
      care visits. For those who do not have a dentist and wish to find one, appropriate advice and
      assistance will be provided by the CI, or a member of the Dental Team.

      Participants who return their consent forms will be contacted by telephone by a member of the
      NHS Tayside dental team to arrange an appointment at a time convenient to them. If
      participants are unable to travel to the two centres (Broxden Dental Centre in Perth or Kings
      Cross Dental Department in Dundee) they may be offered a home visit.

      When participants attend for their appointment they will be asked to confirm their consent
      verbally. Dr Morag Curnow (the same dentist that examined the participants when they were in
      School on the original toothbrushing trial) or another appropriately trained Dentist (named
      on the study delegation log) will conduct a short dental examination, recording the presence
      of plaque on anterior teeth and the caries status of each tooth surface using dental lighting
      and fibre-optic transillumination. The examining dentist will be unaware of which study group
      the adults belonged to when they were child participants in the trial. Participants will also
      be asked to complete oral health related questionnaires. Questionnaires will be analysed by a
      statistician.

      Participants will be asked to give consent for their dental records to be accessed using
      health service records to record dental treatment history. Consent will be recorded in
      writing. Approval has already been provided by Information Services Division (ISD), NHS
      National Services Scotland to access the dental treatment records.
    

Intervention name(s): No intervention given
Intervention type(s): Other
Intervention description(s): Participants will have a full dental examination but no operative intervention
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Adults aged 25 who were enrolled on the Tayside Brushing Study Randomised Controlled Trial