Abstractobjectives To evaluate how an intervention, which combined hand washing promotion aimed at 5-year-olds with provision of free soap, affected illnesses among the children and their families and children's school absenteeism.methods We monitored illnesses, including diarrhoea and acute respiratory infections (ARIs), school absences and soap consumption for 41 weeks in 70 low-income communities in Mumbai, India (35 communities per arm).results Outcomes from 847 intervention households (containing 847 5-year-olds and 4863 subjects in total) and 833 control households (containing 833 5-year-olds and 4812 subjects) were modelled using negative binomial regression. Intervention group 5-year-olds had fewer episodes of diarrhoea (À25%, 95% confidence intervals [CI] = À37%, À2%), ARIs (À15%, 95% CI = À30%, À8%), school absences due to illnesses (À27%, 95% CI = À41%, À18%) and eye infections (À46%, 95% CI = À58%, À31%). Further, there were fewer episodes of diarrhoea and ARIs in the intervention group for 'whole families' (À31%, 95% CI = À37%, À5%; and À14%, 95% CI = À23%, À6%, respectively), 6-to 15-year-olds (À30%, 95% CI = À39%, À7%; and À15%, 95% CI = À24%, À6%) and under 5 s (À32%, 95% CI = À41%, À4%; and À20%, 95% CI = À29%, À8%).conclusions Direct-contact hand washing interventions aimed at younger school-aged children can affect the health of the whole family. These may be scalable through public-private partnerships and classroom-based campaigns. Further work is required to understand the conditions under which health benefits are transferred and the mechanisms for transference.keywords hand washing with soap, diarrhoea, acute respiratory infection, hygiene, school absence
Conventional caries trials last from 24 to 36 months. This study evaluated whether the previously established difference in efficacy between 1000- and 2500-ppm-fluoride dentifrices could be detected after 12 months. Caries was assessed by clinical visual assessment (CVA-simplified version of Dundee Selectable Threshold Method - DSTM), bitewing radiography, and Fiber Optic Transillumination (FOTI). Changes in status for individual surfaces were classified by means of pre-prepared matrices as 0 (unchanged), +1 (initiation or progression), or -1 (regression) and summed for each subject to yield an event score. Mean group event scores were calculated for each product. DSTM at the D(1) [enamel and dentin] threshold showed significant inter-group differences in mean event scores (p < 0.003) and D(1)MFS increment (< 0.007) at 12 months; these were confirmed at 24 months by traditional increment analysis (CVA & FOTI at the D(3) (dentin only) threshold + radiography, p < 0.03). This study confirms the validity of an abbreviated trial protocol.
Objectives: To compare the stain removal and prevention efficacy of a whitening toothpaste (White System) and a standard silica toothpaste and to determine if any increase in tooth whitening benefits caused an increase in enamel abrasive wear. Methods: The products were evaluated in a laboratory‐cleaning test and in a clinical study evaluating the removal and prevention of natural extrinsic stain over a four‐week period. Enamel abrasive wear was determined using an in situ model where enamel blocks were placed on a denture worn in the mouth for four weeks and brushed twice daily. Results: The White System gave a statistically (p<0.001) higher level of in vitro stain removal as compared to the standard silica toothpaste. The White System was significantly superior to the standard silica toothpaste in the clinical study in terms of extrinsic stain removal (p<0.03) and prevention (p<0.02). The product difference in the in situ enamel wear for these two toothpastes was not of statistical significance. Conclusions: The White System toothpaste was shown to be more effective in stain removal and prevention than a standard silica toothpaste. These enhanced tooth‐whitening benefits did not give rise to a concomitant statistically significant increase in the level of wear to enamel.
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