Literature DB >> 21985746

Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services.

Martin Tickle1, Keith M Milsom, Michael Donaldson, Seamus Killough, Ciaran O'Neill, Grainne Crealey, Matthew Sutton, Solveig Noble, Margaret Greer, Helen V Worthington.   

Abstract

BACKGROUND: Dental caries is a persistent public health problem with little change in the prevalence in young children over the last 20 years. Once a child contracts the disease it has a significant impact on their quality of life. There is good evidence from Cochrane reviews including trials that fluoride varnish and regular use of fluoride toothpaste can prevent caries. The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education) with dental health education alone in young children. METHODS/
DESIGN: A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years), fluoride toothpaste (1,450 ppm F) (supplied twice per year), a toothbrush (supplied twice a year) or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit). 1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group.The primary end-point is whether the child develops caries (cavitation into dentine) or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs which will be obtained from parental questionnaires. DISCUSSION: This is a pragmatic trial conducted in general dental practice. It tests a composite caries prevention intervention, which represents an evidence based approach advocated by current guidance from the English Department of Health which is feasible to deliver to all low risk (caries free) children in general dental practice. The trial will provide valuable information to policy makers and clinicians on the costs and effects of caries prevention delivered to young children in general dental practice. TRIAL REGISTRATION: EudraCT No: 2009 - 010725 - 39 ISRCTN: ISRCTN36180119 Ethics Reference No: 09/H1008/93:

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Year:  2011        PMID: 21985746      PMCID: PMC3196725          DOI: 10.1186/1472-6831-11-27

Source DB:  PubMed          Journal:  BMC Oral Health        ISSN: 1472-6831            Impact factor:   2.757


  23 in total

Review 1.  Risk factors for dental caries in young children: a systematic review of the literature.

Authors:  Rebecca Harris; Alison D Nicoll; Pauline M Adair; Cynthia M Pine
Journal:  Community Dent Health       Date:  2004-03       Impact factor: 1.349

2.  Exploring the content of the advice provided by general dental practitioners to help prevent caries in young children.

Authors:  A G Threlfall; K M Milsom; C M Hunt; M Tickle; A S Blinkhorn
Journal:  Br Dent J       Date:  2007-01-26       Impact factor: 1.626

3.  Proposed changes for nurse education in England (UK) as a result of the Darzi report (DoH, 2008a) Health Quality Care for All--NHS next stage review final report: some initial observations.

Authors:  Karen Holland
Journal:  Nurse Educ Pract       Date:  2008-09       Impact factor: 2.281

4.  Is dental health education effective? A systematic review of current evidence.

Authors:  E J Kay; D Locker
Journal:  Community Dent Oral Epidemiol       Date:  1996-08       Impact factor: 3.383

5.  The influences on preventive care provided to children who frequently attend the UK General Dental Service.

Authors:  M Tickle; K M Milsom; D King; A S Blinkhorn
Journal:  Br Dent J       Date:  2003-03-22       Impact factor: 1.626

Review 6.  Fluoride toothpastes for preventing dental caries in children and adolescents.

Authors:  V C Marinho; J P Higgins; A Sheiham; S Logan
Journal:  Cochrane Database Syst Rev       Date:  2003

7.  A cluster randomised, controlled trial of the value of dental health educators in general dental practice.

Authors:  A S Blinkhorn; D Gratrix; P J Holloway; Y M Wainwright-Stringer; S J Ward; H V Worthington
Journal:  Br Dent J       Date:  2003-10-11       Impact factor: 1.626

Review 8.  Combinations of topical fluoride (toothpastes, mouthrinses, gels, varnishes) versus single topical fluoride for preventing dental caries in children and adolescents.

Authors:  V C C Marinho; J P T Higgins; A Sheiham; S Logan
Journal:  Cochrane Database Syst Rev       Date:  2004

Review 9.  Fluoride varnishes for preventing dental caries in children and adolescents.

Authors:  V C Marinho; J P Higgins; S Logan; A Sheiham
Journal:  Cochrane Database Syst Rev       Date:  2002

10.  A randomised controlled trial of the effectiveness of providing free fluoride toothpaste from the age of 12 months on reducing caries in 5-6 year old children.

Authors:  G M Davies; H V Worthington; R P Ellwood; E M Bentley; A S Blinkhorn; G O Taylor; R M Davies
Journal:  Community Dent Health       Date:  2002-09       Impact factor: 1.349

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