Something beginning with 'c'

Hancocks, Stephen

doi:10.1038/s41415-020-1483-0

Cited by 4 publications

(3 citation statements)

References 2 publications

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“…While the previous proposal for the study was a RCT which would compare CCI with standard care, the COVID-19 pandemic obliged a change of plan for this study to only one intervention group and to test an adapted CCI, without AGP and reduced in-office appointments' time. Children have the right to receive an effective dental care even during the pandemic [16,44,45]. The CCI system is a comprehensive caries care system focused in improving oral health outcomes through a patient-centred risk-based friendly management for the practice [9].…”

Section: Discussionmentioning

confidence: 99%

CariesCare International adapted for the pandemic in children: Caries OUT multicentre single-group interventional study protocol

et al. 2021

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Background Comprehensive caries care has shown effectiveness in controlling caries progression and improving health outcomes by controlling caries risk, preventing initial-caries lesions progression, and patient satisfaction. To date, the caries-progression control effectiveness of the patient-centred risk-based CariesCare International (CCI) system, derived from ICCMS™ for the practice (2019), remains unproven. With the onset of the COVID-19 pandemic a previously planned multi-centre RCT shifted to this “Caries OUT” study, aiming to assess in a single-intervention group in children, the caries-control effectiveness of CCI adapted for the pandemic with non-aerosols generating procedures (non-AGP) and reducing in-office time. Methods In this 1-year multi-centre single-group interventional trial the adapted-CCI effectiveness will be assessed in one single group in terms of tooth-surface level caries progression control, and secondarily, individual-level caries progression control, children’s oral-health behaviour change, parents’ and dentists’ process acceptability, and costs exploration. A sample size of 258 3–5 and 6–8 years old patients was calculated after removing half from the previous RCT, allowing for a 25% dropout, including generally health children (27 per centre). The single-group intervention will be the adapted-CCI 4D-cycle caries care, with non-AGP and reduced in-office appointments’ time. A trained examiner per centre will conduct examinations at baseline, at 5–5.5 months (3 months after basic management), 8.5 and 12 months, assessing the child’s CCI caries risk and oral-health behaviour, visually staging and assessing caries-lesions severity and activity without air-drying (ICDAS-merged Epi); fillings/sealants; missing/dental-sepsis teeth, and tooth symptoms, synthetizing together with parent and external-trained dental practitioner (DP) the patient- and tooth-surface level diagnoses and personalised care plan. DP will deliver the adapted-CCI caries care. Parents’ and dentists’ process acceptability will be assessed via Treatment-Evaluation-Inventory questionnaires, and costs in terms of number of appointments and activities. Twenty-one centres in 13 countries will participate. Discussion The results of Caries OUT adapted for the pandemic will provide clinical data that could help support shifting the caries care in children towards individualised oral-health behaviour improvement and tooth-preserving care, improving health outcomes, and explore if the caries progression can be controlled during the pandemic by conducting non-AGP and reducing in-office time. Trial registration: Retrospectively-registered-ClinicalTrials.gov-NCT04666597-07/12/2020: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000AGM4&selectaction=Edit&uid=U00019IE&ts=2&cx=uwje3h. Protocol-version 2: 27/01/2021.

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Section: Discussionmentioning

confidence: 99%

CariesCare International adapted for the pandemic in children: Caries OUT multicentre single-group interventional study protocol

et al. 2021

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“…This should facilitate adoption in both education and practice and will aid future research • Following the impact of the COVID-19 pandemic, there has been a growing realisation that preventive caries management not only reduces the disease burden at the patient level but also reduces the need for aerosol generating procedures/exposures (AGPs/AGEs). 32 Although the contamination potential of these AGPs/AGEs with proper infection control measures is still debated in the literature as this paper is being submitted, this situation has shown to professionals that these approaches are both compatible and desirable with their daily practice. An international group within CCI has been adapting CCI 4D protocols for postpandemic use in the 'Caries OUT' study.…”

Section: Next Steps In the Journeymentioning

confidence: 99%

From 'ICDAS' to 'CariesCare International': the 20-year journey building international consensus to take caries evidence into clinical practice

et al. 2021

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This paper charts the 20-year collaborative journey made by international teams of dental researchers, educators and practitioners. Following the initial development of the International Caries Detection and Assessment System (ICDAS) in 2002, the International Caries Classification and Management System (ICCMS) was collaboratively developed between 2010-2017 with several dental research and practice organisations, and influenced by best evidence judged via SIGN methodology, the UNEP Minamata Treaty (and linked phasing down of dental amalgam), three Dental Policy Labs and an international movement in operative dentistry to move towards minimally invasive dentistry. The FDI World Dental Federation publicised and advocated the ICCMS in 2019, when the 'CariesCare International' Consensus Guide and 4D caries management system was published to aid the delivery of ICCMS into practice. This system, which is designed to help practitioners deliver optimal caries care for patients, is now being adapted internationally for post-pandemic use in the 'Caries OUT' study. It is also being used as a vehicle for implementing the updated Delivering better oral health guidance on caries, as part of the minimum intervention oral healthcare delivery framework in the UK.

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“…Back in April my editorial entitled 'Something beginning with c' mentioned caries but didn't explicitly cast it as one of the words on which I was focussing. 1 This time it is.…”

mentioning

confidence: 96%