Skip to main content
Top
Published in: BMC Oral Health 1/2015

Open Access 01-12-2015 | Study protocol

Comparison of the caries-protective effect of fluoride varnish with treatment as usual in nursery school attendees receiving preventive oral health support through the Childsmile oral health improvement programme — the Protecting Teeth@3 Study: a randomised controlled trial

Authors: William Wright, Stephen Turner, Yulia Anopa, Emma McIntosh, Olivia Wu, David I. Conway, Lorna M. D. Macpherson, Alex D. McMahon

Published in: BMC Oral Health | Issue 1/2015

Login to get access

Abstract

Background

The Scottish Government set out its policy on addressing the poor oral health of Scottish children in 2005. This led to the establishment of Childsmile, a national programme designed to improve the oral health of children in Scotland. One element of the programme promotes daily tooth brushing in all nurseries in Scotland (Childsmile Core). A second targeted component (Childsmile Nursery) offers twice-yearly application of fluoride varnish to children attending nurseries in deprived areas. Studies suggest that fluoride varnish application can reduce caries in both adult and child populations. This trial aims to explore the effectiveness and cost-effectiveness of additional preventive value fluoride varnish application compared to Childsmile Core.

Methods/Design

The Protecting Teeth@3 Study is an ongoing 2 year parallel group randomised treatment as usual controlled trial. Three-year-old children attending the ante pre-school year are randomised (1:1) to the intervention arm (fluoride varnish & treatment as usual) or the control arm (treatment as usual). Children in the intervention arm will have Duraphat® fluoride varnish painted on the primary tooth surfaces and will continue to receive treatment as usual: the core Childsmile Nursery intervention. Children in the treatment as usual arm will receive the same series of contacts, without the application of varnish and will also continue with the Childsmile Core intervention. Interventions are undertaken by Childsmile trained extended duty dental nurses at six-monthly intervals. Participants receive a baseline dental inspection in nursery and an endpoint inspection in Primary 1 at the age of 5 years old.
We will use primary and secondary outcome measures to compare the effectiveness of Duraphat® fluoride varnish plus treatment as usual with treatment as usual only in preventing any further dental decay. We will also undertake a full economic evaluation of the trial.

Trial registration

This study is registered at ClinicalTrials.gov. Number: NCT01674933 (24 August 2012).
Appendix
Available only for authorised users
Literature
1.
go back to reference Abanto J, Tsakos G, Ardenghi TM, Paiva SM, Raggio DP, Sheiham A, et al. Responsiveness to change for the Brazilian Scale of Oral Health Outcomes for 5-year-old children (SOHO-5). Health Qual Life Outcomes. 2013;11(1):137.PubMedCentralPubMedCrossRef Abanto J, Tsakos G, Ardenghi TM, Paiva SM, Raggio DP, Sheiham A, et al. Responsiveness to change for the Brazilian Scale of Oral Health Outcomes for 5-year-old children (SOHO-5). Health Qual Life Outcomes. 2013;11(1):137.PubMedCentralPubMedCrossRef
2.
go back to reference Blair Y, Macpherson LMD, McCall DR, McMahon AD, Stephen KW. Glasgow nursery-based caries experience, before and after a community development-based oral health programme's implementation. Community Dent Health. 2004;21:291–8.PubMed Blair Y, Macpherson LMD, McCall DR, McMahon AD, Stephen KW. Glasgow nursery-based caries experience, before and after a community development-based oral health programme's implementation. Community Dent Health. 2004;21:291–8.PubMed
3.
go back to reference Blair YI, Macpherson LMD, McCall DR, McMahon AD. Dental health of 5-year-olds following community-based oral health promotion in Glasgow, Scotland. Int J Paediatr Dent. 2006;16:388–98.PubMedCrossRef Blair YI, Macpherson LMD, McCall DR, McMahon AD. Dental health of 5-year-olds following community-based oral health promotion in Glasgow, Scotland. Int J Paediatr Dent. 2006;16:388–98.PubMedCrossRef
4.
go back to reference Borutta A, Reuscher G, Hufnagl S, Möbius S. Caries prevention with fluoride varnishes among preschool children. Gesundheitwesen. 2006;68:731–4. Article in German.CrossRef Borutta A, Reuscher G, Hufnagl S, Möbius S. Caries prevention with fluoride varnishes among preschool children. Gesundheitwesen. 2006;68:731–4. Article in German.CrossRef
5.
go back to reference Chestnutt IG, Chadwick BL, Hutchings S, Playle R, Pickles T, Lisles C, et al. Protocol for "Seal or Varnish?" (SoV) trial: a randomised controlled trial to measure the relative cost and effectiveness of pit and fissure sealants and fluoride varnish in preventing dental decay. BMC Oral Health. 2012;12(1):51.PubMedCentralPubMedCrossRef Chestnutt IG, Chadwick BL, Hutchings S, Playle R, Pickles T, Lisles C, et al. Protocol for "Seal or Varnish?" (SoV) trial: a randomised controlled trial to measure the relative cost and effectiveness of pit and fissure sealants and fluoride varnish in preventing dental decay. BMC Oral Health. 2012;12(1):51.PubMedCentralPubMedCrossRef
7.
go back to reference Hardman MC, Davies GM, Duxbury JT, Davies RM. A cluster randomised controlled trial to evaluate the effectiveness of fluoride varnish as a public health measure to reduce caries in children. Caries Res. 2007;41:371–6.PubMedCrossRef Hardman MC, Davies GM, Duxbury JT, Davies RM. A cluster randomised controlled trial to evaluate the effectiveness of fluoride varnish as a public health measure to reduce caries in children. Caries Res. 2007;41:371–6.PubMedCrossRef
8.
go back to reference Hollis S, Campbell F. What is meant by intention to treat analysis? Survey of published randomised controlled trials. Br Med J. 1999;319:670–4.CrossRef Hollis S, Campbell F. What is meant by intention to treat analysis? Survey of published randomised controlled trials. Br Med J. 1999;319:670–4.CrossRef
9.
go back to reference Marinho VCC, Higgins JPT, Logan S, Sheiham A. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2002;Issue 1:Art No: CD002279. Marinho VCC, Higgins JPT, Logan S, Sheiham A. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2002;Issue 1:Art No: CD002279.
10.
go back to reference Milsom KM, Blinkhorn AS, Walsh T, Worthington HV, Kearney-Mitchell P, Whitehead H, et al. A cluster-randomized controlled trial: fluoride varnish in school children. J Dent Res. 2011;90:1306–11.PubMedCrossRef Milsom KM, Blinkhorn AS, Walsh T, Worthington HV, Kearney-Mitchell P, Whitehead H, et al. A cluster-randomized controlled trial: fluoride varnish in school children. J Dent Res. 2011;90:1306–11.PubMedCrossRef
11.
go back to reference McMahon AD. Study control, violators, inclusion criteria, and defining explanatory and pragmatic trials. Stat Med. 2002;21(10):1365–76.PubMedCrossRef McMahon AD. Study control, violators, inclusion criteria, and defining explanatory and pragmatic trials. Stat Med. 2002;21(10):1365–76.PubMedCrossRef
16.
go back to reference Scottish Dental Epidemiology Co-ordinating Committee. National Dental Inspection Programme of Scotland. Report of the 2004 Survey of P1 Children. 2004. Scottish Dental Epidemiology Co-ordinating Committee. National Dental Inspection Programme of Scotland. Report of the 2004 Survey of P1 Children. 2004.
21.
go back to reference Skold UM, Petersson LG, Lith A, Birkhed D. Effect of school-based fluoride varnish programmes on approximal caries in adolescents from different carries risk areas. Caries Res. 2005;39:273–9.CrossRef Skold UM, Petersson LG, Lith A, Birkhed D. Effect of school-based fluoride varnish programmes on approximal caries in adolescents from different carries risk areas. Caries Res. 2005;39:273–9.CrossRef
22.
go back to reference Steele MM, Steele RG, Varni JW. Reliability and validity of the PedsQL™ oral health scale: measuring the relationship between child oral health and health-related quality of life. Child Health Care. 2009;38(3):228–44.CrossRef Steele MM, Steele RG, Varni JW. Reliability and validity of the PedsQL™ oral health scale: measuring the relationship between child oral health and health-related quality of life. Child Health Care. 2009;38(3):228–44.CrossRef
23.
go back to reference Stevens K. The Child Health Utility 9D (CHU9D). A new, paediatric, preference-based measure of health related quality of life. PRO Newsletter. 2010;43:11–2. Stevens K. The Child Health Utility 9D (CHU9D). A new, paediatric, preference-based measure of health related quality of life. PRO Newsletter. 2010;43:11–2.
25.
go back to reference Tsakos G. Oral health-related quality of life (OHRQoL) measurement in 5-year-olds in Glasgow: developing and evaluating a new OHRQoL measure: final report. London: University College London; 2010. Tsakos G. Oral health-related quality of life (OHRQoL) measurement in 5-year-olds in Glasgow: developing and evaluating a new OHRQoL measure: final report. London: University College London; 2010.
26.
go back to reference Tsakos G, Blair YI, Yusuf H, Wright W, Watt RG, Macpherson LM. Developing a new self-reported scale of oral health outcomes for 5-year-old children (SOHO-5). Health Qual Life Outcomes. 2012;10:62.PubMedCentralPubMedCrossRef Tsakos G, Blair YI, Yusuf H, Wright W, Watt RG, Macpherson LM. Developing a new self-reported scale of oral health outcomes for 5-year-old children (SOHO-5). Health Qual Life Outcomes. 2012;10:62.PubMedCentralPubMedCrossRef
28.
go back to reference Van Hout BA, Al MJ, Gordon GS, Rutten FS. Costs, effects and C/E-ratios alongside a clinical trial. Health Econ. 1994;1994(3):309–19.CrossRef Van Hout BA, Al MJ, Gordon GS, Rutten FS. Costs, effects and C/E-ratios alongside a clinical trial. Health Econ. 1994;1994(3):309–19.CrossRef
29.
go back to reference Varni J, Limbers C, Burwinkle T. Parent proxy-report of their children's health-related quality of life: an analysis of 13,878 parents' reliability and validity across age subgroups using the PedsQLTM 4.0 Generic Core Scales. Health Qual Life Outcomes. 2007;5(1):2.PubMedCentralPubMedCrossRef Varni J, Limbers C, Burwinkle T. Parent proxy-report of their children's health-related quality of life: an analysis of 13,878 parents' reliability and validity across age subgroups using the PedsQLTM 4.0 Generic Core Scales. Health Qual Life Outcomes. 2007;5(1):2.PubMedCentralPubMedCrossRef
30.
go back to reference World Health Organisation [WHO]. The Ottawa Charter for Health Promotion. Ottawa: World Health Organization and Canadian Public Health Association; 1986. World Health Organisation [WHO]. The Ottawa Charter for Health Promotion. Ottawa: World Health Organization and Canadian Public Health Association; 1986.
Metadata
Title
Comparison of the caries-protective effect of fluoride varnish with treatment as usual in nursery school attendees receiving preventive oral health support through the Childsmile oral health improvement programme — the Protecting Teeth@3 Study: a randomised controlled trial
Authors
William Wright
Stephen Turner
Yulia Anopa
Emma McIntosh
Olivia Wu
David I. Conway
Lorna M. D. Macpherson
Alex D. McMahon
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2015
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-015-0146-z

Other articles of this Issue 1/2015

BMC Oral Health 1/2015 Go to the issue