The Effectiveness of Dental Health Home Visits on Caries Prevention in Young Children
Condition: Dental Caries in Children
MeSH terms: Dental Caries
Study type: Interventional

Summary: 
      Tooth decay affects 75% of Malaysian preschool children, most of which remain untreated.
      Untreated decay can cause pain, and impair nutritional status and physical growth. In 2012,
      nearly 4,000 children in Malaysia were referred for hospital paediatric dental services
      because of early childhood caries. The realistic management of these children would have been
      treatment under general anaesthesia or sedation, at considerable cost to the state, and
      distress to the children and families. The amount of dental disease in young children who
      have been referred to the hospital children's dentistry service for severe caries is
      disturbing, particularly given the fact that each district has a dental clinic and that the
      water is very likely to be fluoridated. It is unlikely that there will ever be enough dental
      clinics and dental practitioners to manage the amount of disease. Clearly, existing health
      services need to be supplemented with a population-based approach to promote child oral
      health. The investigators, therefore, propose a community trial study to investigate the
      effectiveness of a dental health visiting service for caries control in young children. It is
      likely that such a home-based intervention is influenced by the family dynamics in which the
      child lives. The investigators further propose to assess the cost-effectiveness of dental
      home visits (DHVs). Health economic evaluation can be used to assess health services to
      ensure there is cost-efficient resource allocation. Economic evaluation is defined as the
      comparative analysis of alternative courses of action in terms of both their costs and
      consequences. A health intervention is considered cost-effective when it produces acceptable
      costs and health benefits. Economic data are now recognized as important due to the fact that
      dental disease is very common and expensive for the health care system.

      This study was conducted in collaboration with the National Oral Health of Pre-school Survey
      (NOHPS), in which a sub-sample will be followed up for two years. The NOHPS is a national
      survey of the oral health of 5-year-olds that takes place every 10 years.

      This is a randomized controlled trial to assess the cost-effectiveness of home-based DHVs
      with families of children at high risk of caries in caries prevention compared to children
      receiving oral health information in the form of an education leaflet (ELs) alone. A
      collaborative project with the Oral Health Division (OHD) at the Ministry of Health is
      proposed. The OHD will provide access to a sub-sample from the National Oral Health Preschool
      Survey (NOHPS), with clinical dental health data.
    


Intervention name(s): Intervention Group (Dental Home Visits + Dental Home Education Leaflets); Control Group (Dental Home Education Leaflets)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): No drugs were given in the Intervention. The intervention group received Dental Home Visits consisted of 6 monthly home visits by oral health therapists/dental home visitors where they deliver dental care advice to the parents for durations of approximately 30 minutes until follow-up at two years. Dental Home Education Leaflets (DHELs) and oral health messages were delivered through a personalized approach that avoids direct persuasion. These messages included information on daily tooth brushing with fluoride toothpaste, controlling dietary sugar intake, and the need for regular dental check-ups. The families were also be provided with information about local dental services available in their vicinity and how to access these services.; Only Dental Home Education Leaflets were provided every six months for 2 years.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Dental Caries; Dental Health Home Visits; Young Children; Dental Decay