Caries Experience and Increment in Children Attending Kindergartens with an Early Childhood Caries Preventive Program Compared to Basic Prophylaxis Measures—A Retrospective Cohort Study

Amend, Stefanie; Hartmann, Thea; Heinzel‐Gutenbrunner, Monika; Frankenberger, Roland; Krämer, Norbert; Winter, Julia

doi:10.3390/jcm11102864

Cited by 2 publications

(1 citation statement)

References 68 publications

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“…52 At an individual level, tooth brushing with fluoride toothpaste has shown standalone benefit in reducing caries prevalence, while other strategies, such as the application of fluoride varnish, do not appear effective in isolation to reduce caries progression. 53 A Cochrane systematic review evaluating the impact of tooth brushing showed a 24% reduction in caries experience as measured by DFMS scores among children using fluoridated toothpaste versus those using non-fluoridated toothpaste. 54 Given the lack of data regarding the decrease in progression rates using a multipronged approach, we assumed a 30% reduction based on diverse literature.…”

Section: Discussionmentioning

confidence: 99%

Inequalities in oral health: Estimating the longitudinal economic burden of dental caries by deprivation status in six countries

Dunleavy,

Verma,

Raghupathy

et al. 2024

Preprint

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Background The recent World Health Organization (WHO) resolution on oral health urges pivoting to a preventive approach and integration of oral health into the non-communicable diseases agenda. This study aimed to: 1) explore the healthcare costs of managing dental caries between the ages of 12 and 65 years across socioeconomic groups in six countries (Brazil, France, Germany, Indonesia, Italy, UK), and 2) estimate the potential reduction in direct costs from non-targeted and targeted oral health-promoting interventions. Methods A cohort simulation model was developed to estimate direct costs of over time for different socioeconomic groups. National-level DMFT (dentine threshold) data, the relative likelihood of receiving an intervention (such as a restorative procedure, tooth extraction and replacement), and clinically-guided assumptions were used to populate the model. A hypothetical group of upstream and downstream preventive interventions were applied either uniformly across all deprivation groups to reduce caries progression rates by 30% or in a levelled-up fashion with the greatest gains seen in the most deprived group. Results The population level direct costs of caries from 12 to 65 years of age varied between US10.2bn in Italy to US$36.2bn in Brazil. The highest per-person costs were in the UK at US$22,910 and the lowest in Indonesia at US$7,414. The per-person direct costs were highest in the most deprived group across Brazil, France, Italy and the UK. With the uniform application of preventive measures across all deprivation groups, the greatest reduction in per-person costs for caries management was seen in the most deprived group across all countries except Indonesia. With a levelling-up approach, cost reductions in the most deprived group ranged from US$3,948 in Indonesia to US$17,728 in the UK. Conclusion Our exploratory analysis shows the disproportionate economic burden of caries in the most deprived groups and highlights the significant opportunity to reduce direct costs via levelling-up preventive measures. The healthcare burden stems from a higher baseline caries experience and greater annual progression rates in the most deprived. Therefore, preventive measures should be primarily aimed at reducing early childhood caries, but also applied across all ages.

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Section: Discussionmentioning

confidence: 99%

Inequalities in oral health: Estimating the longitudinal economic burden of dental caries by deprivation status in six countries

Dunleavy,

Verma,

Raghupathy

et al. 2024

Preprint

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Toothbrushing programme in Saudi Arabia ‘TOPS’: a study protocol for a cluster randomised controlled trial in kindergartens, Riyadh

Almutairi,

Conway,

Ross

et al. 2024

BMJ Open

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IntroductionDental caries among children is a major global health problem and is a particular public health challenge in Saudi Arabia. Dental caries cause pain, infection and negatively impact quality of life. As part of population oral health improvement efforts in Saudi Arabia, this project aims to evaluate the effectiveness of a supervised toothbrushing programme in kindergartens.Methods and analysisThis study is a cluster randomised controlled trial. Enrolment began in September 2022, for two academic years (2022–2024) on 20 randomly selected kindergartens in Riyadh. The data collection phase will be completed in September 2024. Ten kindergartens are randomly allocated to supervised toothbrushing and 10 to treatment as usual, which is an annual oral health awareness visit. The primary endpoint will be the worsening of obvious decay experience as measured by decayed (into dentine), missing and filled teeth (d3mft) from baseline to the second year of follow-up. The secondary endpoint will be the increase in the number of teeth affected. A priori subgroups of the region of Riyadh, school type (public, private), child sex and presence/absence of prior decay at baseline, will be analysed. We require 244 evaluable endpoints using a power of 80% to meet the sample size requirement. In addition, questionnaires on behaviours, quality of life, process monitoring and cost analysis are being deployed.Ethics and disseminationEthics approval for this study was given by the King Fahad Medical City Institutional Review Board in the Saudi Ministry of Health (22-083E/March 2022). The data analysis has been approved by the University of Glasgow Medical Veterinary and Life Sciences Research Ethical Committee (200220194/March 2023). The results of this study will be disseminated through presentations at scientific conferences and in scientific journals.Trial registration numberNCT05512156.

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Caries Experience and Increment in Children Attending Kindergartens with an Early Childhood Caries Preventive Program Compared to Basic Prophylaxis Measures—A Retrospective Cohort Study

Cited by 2 publications

References 68 publications

Inequalities in oral health: Estimating the longitudinal economic burden of dental caries by deprivation status in six countries

Inequalities in oral health: Estimating the longitudinal economic burden of dental caries by deprivation status in six countries

Toothbrushing programme in Saudi Arabia ‘TOPS’: a study protocol for a cluster randomised controlled trial in kindergartens, Riyadh

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