Fluoride Varnish in Nursery Schools: A Randomised Controlled Trial - Protecting Teeth @3
Fluoride Varnish in Nursery Schools: A Randomised Controlled Trial - Protecting Teeth @3
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DOI：
10.1159/000509680
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发表时间：
2020-10-01
期刊：
影响因子：
4.2
通讯作者：
Macpherson, Lorna M. D.
中科院分区：
文献类型：
--
作者：
McMahon, Alex D.;Wright, William;Macpherson, Lorna M. D.
研究表明，氟化物保护漆（FV）的应用可以减少儿童人群的龋齿。苏格兰多组成部分的国家儿童口腔健康改善计划（Childsmile）包括基于托儿所的普遍监督刷牙和针对剥夺的FV应用，以及社区和牙科实践预防干预措施。本试验是一项双盲、两组随机对照试验，旨在评估与单独使用TAU Childsmile干预措施相比，基于托儿所的FV应用加常规治疗（TAU）Childsmile项目干预措施在不接受托儿所FV作为项目一部分的儿童中的有效性和成本效益。参与的儿童在幼儿园的第一年（3岁），有或没有现有的龋齿，被随机分配到FV或TAU，并随访24个月，直到小学的第一年。每6个月进行一次治疗。主要终点是从基线至24个月的"d3mft恶化"。次要终点为d3mfs、d3t、mt和ft恶化。单项记录联系反映了更广泛的方案活动和三级终点。共有1，284名儿童接受随机化，导致1，150名儿童可评价（n = 577 FV，n = 573 TAU，10%脱落）。平均年龄为3.5岁，50%为女性（n = 576），17%在基线时有龋齿（n = 195），两组之间均均衡。大多数儿童接受了3/4次治疗。总体而言，FV组中26.9%（n = 155）的d3mft恶化，TAU组中31.6%（n = 181），比值比（OR）为0.80（0.62 - 1.03），p = 0.078。次要终点恶化的结果为：d3mfs 0.79（0.61 - 1.01）p = 0.063，d3t 0.75（0.57 - 0.99）p = 0.043，mt 1.34（0.75 - 2.39）p = 0.319和ft 0.77（0.53 - 1.14）p = 0.191。我们计算出需要治疗21例患者，预防d3mft单次恶化的成本为686英镑。与TAU相比，托儿所FV组的d3mft恶化程度略有降低，但无显著性差异，这表明这种干预不太可能是对人群口腔健康改善计划的有效或具有成本效益的补充。
Studies suggest that fluoride varnish (FV) application can reduce dental caries in child populations. The multiple-component national child oral health improvement programme in Scotland (Childsmile) includes nursery-based universal supervised toothbrushing and deprivation-targeted FV applications, together with community and dental practice prevention interventions. This trial, a double-blind, two-arm randomised control trial, aimed to assess the effectiveness and cost-effectiveness of the nursery-based FV applications plus treatment-as-usual (TAU) Childsmile programme interventions, compared to TAU Childsmile interventions alone, in children not targeted to receive nursery FV as part of the programme. Participating children in the first year of nursery (aged three), with or without existing caries, were randomised to either FV or TAU and followed up for 24 months until the first year of primary school. Treatments were administered at six-monthly intervals. The primary endpoint was "worsening of d3mft" from baseline to 24 months. Secondary endpoints were worsening of d3mfs, d3t, mt, and ft. Individual record-linkage captured wider programme activities and tertiary endpoints. A total of 1,284 children were randomised, leading to 1,150 evaluable children (n= 577 FV,n= 573 TAU, 10% dropouts). Mean age was 3.5 years, 50% were female (n= 576), 17% had caries at baseline (n= 195), all balanced between the groups. Most children received three/four treatments. Overall, 26.9% (n= 155) had worsened d3mft in the FV group, and 31.6% (n= 181) in the TAU group, with an odds ratio (OR) of 0.80 (0.62-1.03),p= 0.078. The results for worsening of the secondary endpoints were: d3mfs 0.79 (0.61-1.01)p= 0.063, d3t 0.75 (0.57-0.99)p= 0.043, mt 1.34 (0.75-2.39)p= 0.319, and ft 0.77 (0.53-1.14)p= 0.191. We calculated a number needed to treat of 21 and a cost of GBP 686 to prevent a single worsening of d3mft. There was a modest non-significant reduction in the worsening of d3mft in the nursery FV group compared to TAU, suggesting that this intervention is unlikely to represent an effective or cost-effective addition to the population oral health improvement programme.