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.
Methods
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.
Results
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).
Conclusions
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.
Comments