Duane Brett
Department of Public Health, NHS Fife, Cameron Hospital, Windygates, UK.
Evid Based Dent. 2012 Jun;13(2):39-40. doi: 10.1038/sj.ebd.6400853.
Randomisation to intervention groups using Zelen's design with a non-participant community control group recruited at 24 months.
Patients were allocated to either the home visit (HV) group (n=236) or telephone contact (TC) group (n=89). HVs and TCs were conducted at 6,12 and 18 months. Bacterial tests were given to both groups at baseline and 24 months. The HV group had an additional bacterial test at six months. A community control (reference group) was recruited from the same district at 24 months. All three groups (HV, TC and reference) were examined for caries at 24 months.
The primary outcome measure was dental caries (dmft), secondary measures were Streptococcus mutans (MS) and lactobacilli (LB) levels.
There was no statistically significant difference in caries between HVs and TCs . However there were statistically significant differences respectively in caries levels between HV/TC and the reference group. There was a statistically significant difference in MS levels between the HV group and both the TC and reference groups, with fewer children with high MS levels in the HV group(28%) compared with either the TC group(47%) or reference group (35%).
Both HVs and TCs conducted six-monthly from birth are effective in reducing early childhood caries prevalence compared to RC by 24 months. HVs are also associated with fewer children with MS compared with TC and reference group at 24 months.
采用泽伦设计将患者随机分配至干预组，并在24个月时招募非参与性社区对照组。
患者被分配至家访（HV）组（n = 236）或电话联系（TC）组（n = 89）。在6个月、12个月和18个月时进行家访和电话联系。在基线和24个月时对两组进行细菌检测。HV组在6个月时额外进行一次细菌检测。在24个月时从同一地区招募社区对照组（参考组）。在24个月时对所有三组（HV、TC和参考组）进行龋齿检查。
主要观察指标为龋齿（dmft），次要指标为变形链球菌（MS）和乳酸杆菌（LB）水平。
HV组和TC组在龋齿方面无统计学显著差异。然而，HV/TC组与参考组在龋齿水平上分别存在统计学显著差异。HV组与TC组和参考组在MS水平上存在统计学显著差异，HV组中MS水平高的儿童较少（28%），而TC组为（47%），参考组为（35%）。
与24个月时的常规护理相比，从出生起每6个月进行一次家访和电话联系在降低幼儿龋齿患病率方面均有效。在24个月时，与TC组和参考组相比，家访组中MS水平高的儿童也较少。
