Ramasubbu Darshini, Lewney Jonathan
Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland.
Independent Researcher and UK Specialist in Dental Public Health, Paris, France.
Evid Based Dent. 2025 Mar;26(1):34-35. doi: 10.1038/s41432-024-01066-8. Epub 2024 Sep 18.
The Brushing RemInder 4 Good oral HealTh (BRIGHT) multi-centre randomized controlled trial was based in state-funded secondary schools in England, Wales and Scotland. It had two arms, aiming to assess the clinical and cost effectiveness of a 50 min education session and twice daily brush reminder text messages on toothbrushing and caries rates, compared to the normal education curriculum and no SMS. Outcomes were assessed at intervals over 2.5 years and were assessor-blinded.
Pupils aged 11-13 were recruited from participating schools, and in each school randomised via year group to either the intervention or control group following baseline assessments by calibrated dental professionals. Exclusion criteria included not having a functioning mobile phone.
The primary outcome, D MFT (Decayed, Missing and Filled Teeth), was analysed using mixed-effect logistic regression and sensitivity analyses were conducted. A cost-utility analysis was also undertaken.
In total 42 schools, containing 84 year groups were randomised, and 4680 pupils were in the final sample. 663 pupils withdrew from follow up. At 6 months, there was evidence that intervention group pupils were more likely to report brushing at least twice per day However, by 2.5 years this effect was no longer evident. 2383 participants had a valid dental assessment at both baseline and 2.5 years, with 514 children in the intervention and 529 children in the control group presenting with obvious decay experience in at least one permanent tooth after 2.5 years. The intervention was estimated to have a 7% chance of being cost-effective. Over the 2.5-year follow-up, there were no significant differences in QALYs and costs between groups.
The findings from the BRIGHT trial indicate no evidence of a statistically significant difference between the intervention and control groups for the prevalence of caries after 2.5-years. The behaviour change intervention did not translate into a reduction in caries rates.
“促进口腔健康刷牙提醒”（BRIGHT）多中心随机对照试验以英格兰、威尔士和苏格兰由国家资助的中学为基础。该试验有两个分支，旨在评估与正常教育课程及无短信提醒相比，50分钟的教育课程以及每天两次的刷牙提醒短信对刷牙和龋齿率的临床及成本效益。在2.5年的时间里定期评估结果，且评估人员设盲。
从参与试验的学校招募11至13岁的学生，在每所学校中，经过校准的牙科专业人员进行基线评估后，按年级将学生随机分为干预组或对照组。排除标准包括没有可用的手机。
使用混合效应逻辑回归分析主要结果——龋失补牙数（DMFT），并进行敏感性分析。还进行了成本效用分析。
总共42所学校、84个年级被随机分组，最终样本中有4680名学生。663名学生退出随访。在6个月时，有证据表明干预组学生更有可能报告每天至少刷牙两次。然而，到2.5年时，这种效果不再明显。2383名参与者在基线和2.5年时都有有效的牙科评估，2.5年后，干预组有514名儿童、对照组有529名儿童至少有一颗恒牙出现明显的龋齿情况。估计该干预措施有7%的可能性具有成本效益。在2.5年的随访中，两组之间的质量调整生命年和成本没有显著差异。
BRIGHT试验的结果表明，2.5年后干预组和对照组之间龋齿患病率没有统计学上的显著差异。行为改变干预并未转化为龋齿率的降低。
