Effect of health promotion and fluoride varnish on dental caries among Australian Aboriginal children: results from a community-randomized controlled trial.
OBJECTIVE
We tested a dental health program in remote Aboriginal communities of Australia's Northern Territory, hypothesizing that it would reduce dental caries in preschool children.


METHODS
In this 2-year, prospective, cluster-randomized, concurrent controlled, open trial of the dental health program compared to no such program, 30 communities were allocated at random to intervention and control groups. All residents aged 18-47 months were invited to participate. Twice per year for 2 years in the 15 intervention communities, fluoride varnish was applied to children's teeth, water consumption and daily tooth cleaning with toothpaste were advocated, dental health was promoted in community settings, and primary health care workers were trained in preventive dental care. Data from dental examinations at baseline and after 2 years were used to compute net dental caries increment per child (d₃mfs). A multi-level statistical model compared d₃mfs between intervention and control groups with adjustment for the clustered randomization design; four other models used additional variables for adjustment.


RESULTS
At baseline, 666 children were examined; 543 of them (82%) were re-examined 2 years later. The adjusted d₃mfs increment was significantly lower in the intervention group compared to the control group by an average of 3.0 surfaces per child (95% CI = 1.2, 4.9), a prevented fraction of 31%. Adjustment for additional variables yielded caries reductions ranging from 2.3 to 3.5 surfaces per child and prevented fractions of 24-36%.


CONCLUSIONS
These results corroborate findings from other studies where fluoride varnish was efficacious in preventing dental caries in young children.
Slade
Gary D
GD
Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA. gary_slade@dentistry.unc.edu
Bailie
Ross S
RS
Roberts-Thomson
Kaye
K
Leach
Amanda J
AJ
Raye
Iris
I
Endean
Colin
C
Simmons
Bruce
B
Morris
Peter
P
D002327:Cariostatic Agents / Q000627:therapeutic use; D016000:Cluster Analysis; D003731:Dental Caries / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D005460:Fluorides, Topical / Q000627:therapeutic use*; D015438:Health Behavior; D006267:Health Education, Dental; D006293:Health Promotion / Q000458:organization & administration*; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D016014:Linear Models; D008297:Male; D015876:Northern Territory / Q000453:epidemiology; D011446:Prospective Studies
D002327:Cariostatic Agents; D005460:Fluorides, Topical