Targeted supervised toothbrushing reduces caries increment

Abstract

Design Randomised Controlled TrialIntervention Supervised toothbrushing on schooldays with 1000 ppm fluoride toothpaste with toothpaste and brushes supplied for home use one class in each school was allocated to intervention and compared to a within-school control over a 2-year period. Dental examinations were performed by a single-blinded examiner at 6-monthly intervals.Outcome measure Visual examinations of caries at D1 level (all visible cavitated and non-cavitated lesions in enamel and dentine). Approximal and occlusal surfaces were also examined using Fibre-optic transillumination (FOTI).Results 86% of those examined at baseline completed study. At baseline children in both groups had similar levels of oral cleanliness; however, children from the more deprived areas had poorer levels of cleanliness. There was no significant difference between the groups in the caries increment in the deciduous teeth after 2 years. Dental immaturity had a significant effect on subsequent caries development. After 2 years there was a significantly less caries in the permanent molars in the intervention group, with 32% fewer D1 lesions (95% CI 4–60%) and 56% fewer D3 lesions (95% CI 13–101%).Conclusions A targeted supervised toothbrushing programme with support for home use resulted in a significant reduction in caries increment.