Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henry Dunant Road, Patumwan, Bangkok, 10330, Thailand.
BMC Oral Health. 2020 Apr 19;20(1):119. doi: 10.1186/s12903-020-01107-5.
Intensified preventive regimen based on a 'high-risk' approach has been proposed instead the routine prevention that is generally given to the whole population. The effectiveness of these regimens may still be an issue. Therefore, the aim of this study was to compare two preventive programs carried out in a Public School for kindergarten children.
The data from clinical examinations were used to assess the caries risk for 121 children. Children with at least 2 carious lesions were considered as high risk for dental caries development. These children were randomized into two groups. Half (High risk basic-HRB group) were provided the basic prevention regimen (oral-hygiene instruction and hands-on brushing practice for teachers and caregivers, daytime tooth brushing supervised by teachers at least once a week, newly erupted first permanent molar sealant, provision of toothbrush, fluoride-containing dentifrice, and a guidebook), which was also given to low-risk children (Low risk basic-LRB group). The other half (High risk intensive-HRI group) were additionally given an intensified preventive regimen (F-varnish application, primary molar sealant, and silver diamine fluoride (SDF) application on carious lesions). Clinical examinations were performed semiannually to determine the dmfs caries increment of the three groups.
The 89 children completed the 24-month examination were 3- to 5-year-old with 19, 35, and 35 children in the LRB, HRB, and HRI group, respectively. The new caries development at 24 months of the HRB group (75%) was higher than that of the HRI group (65.7%) and the LRB group (21.1%). One-way analysis of variance (ANOVA) indicated no significant differences of caries increment between the HRB and HRI groups at the end of our study (p = 0.709).
The negligible difference in caries increment between the HRI and HRB groups implies that intensified prevention produced minimal additional benefit. Offering all children only basic prevention could have obtained virtually the same preventive effect with substantially less effort and lower cost.
Thai Clinical Trials Registry (TCTR), TCTR20180124001. Registered 24 January 2018 - Retrospectively registered.
基于“高危”方法的强化预防方案已被提出，以替代通常给予整个人群的常规预防。这些方案的有效性可能仍然是一个问题。因此，本研究的目的是比较在一所公立幼儿园为幼儿实施的两种预防方案。
使用临床检查数据评估 121 名儿童的龋齿风险。至少有 2 个龋齿的儿童被认为有发展龋齿的高风险。这些儿童被随机分为两组。一半（高危基础-HRB 组）接受基础预防方案（对教师和保育员进行口腔卫生指导和手把手刷牙练习、教师每周至少监督一次日间刷牙、新萌出的第一恒磨牙窝沟封闭、提供牙刷、含氟牙膏和指导手册），这也适用于低危儿童（低危基础-LRB 组）。另一半（高危强化-HRI 组）还接受强化预防方案（F-涂料应用、乳磨牙窝沟封闭和银氨溶液（SDF）应用于龋齿）。每半年进行一次临床检查，以确定三组的 dmfs 龋齿增量。
89 名完成 24 个月检查的儿童年龄为 3 至 5 岁，LRB、HRB 和 HRI 组分别有 19、35 和 35 名儿童。HRB 组在 24 个月时的新龋齿发展（75%）高于 HRI 组（65.7%）和 LRB 组（21.1%）。单因素方差分析（ANOVA）表明，在研究结束时，HRB 组和 HRI 组的龋齿增量无显著差异（p=0.709）。
HRI 组和 HRB 组的龋齿增量差异极小，表明强化预防仅产生了最小的额外益处。为所有儿童提供仅基础预防可能会以更少的努力和更低的成本获得几乎相同的预防效果。
泰国临床试验注册中心（TCTR），TCTR20180124001。注册于 2018 年 1 月 24 日-回顾性注册。
