title: Effectiveness, cost-effectiveness and cost-benefit of a single annual professional intervention for the prevention of childhood dental caries in a remote rural Indigenous community.
abstract: BACKGROUND
  The aim of the study is to reduce the high prevalence of tooth decay in children in a remote, rural Indigenous community in Australia, by application of a single annual dental preventive intervention. The study seeks to (1) assess the effectiveness of an annual oral health preventive intervention in slowing the incidence of dental caries in children in this community, (2) identify the mediating role of known risk factors for dental caries and (3) assess the cost-effectiveness and cost-benefit of the intervention.
  
  
  METHODS
  The intervention is novel in that most dental preventive interventions require regular re-application, which is not possible in resource constrained communities. While tooth decay is preventable, self-care and healthy habits are lacking in these communities, placing more emphasis on health services to deliver an effective dental preventive intervention. Importantly, the study will assess cost-benefit and cost-effectiveness for broader implementation across similar communities in Australia and internationally.
  
  
  CONCLUSIONS
  There is an urgent need to reduce the burden of dental decay in these communities, by implementing effective, cost-effective, feasible and sustainable dental prevention programs. Expected outcomes of this study include improved oral and general health of children within the community; an understanding of the costs associated with the intervention provided, and its comparison with the costs of allowing new lesions to develop, with associated treatment costs. Findings should be generalisable to similar communities around the world. The research is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12615000693527; date of registration: 3rd July 2015.
authors: Population and Social Health Research Program, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia. rati.lalloo@adelaide.edu.au.|School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia. rati.lalloo@adelaide.edu.au.|Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, Australia. rati.lalloo@adelaide.edu.au.
authors: Ratilal
authors: R
authors: Lalloo
authors: Population and Social Health Research Program, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia. j.kroon@griffith.edu.au.|School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia. j.kroon@griffith.edu.au.
authors: Jeroen
authors: J
authors: Kroon
authors: Population and Social Health Research Program, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia. o.tut@griffith.edu.au.
authors: Ohnmar
authors: O
authors: Tut
authors: Population and Social Health Research Program, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia. s.kularatna@griffith.edu.au.|School of Medicine, Griffith University, Logan, Australia. s.kularatna@griffith.edu.au.
authors: Sanjeewa
authors: S
authors: Kularatna
authors: Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, Australia. lisa.jamieson@adelaide.edu.au.
authors: Lisa M
authors: LM
authors: Jamieson
authors: School of Indigenous Australian Studies, James Cook University, Townsville, Australia. valda.wallace@jcu.edu.au.
authors: Valda
authors: V
authors: Wallace
authors: School of Dentistry, James Cook University, Cairns, Australia. robyn.boase@jcu.edu.au.
authors: Robyn
authors: R
authors: Boase
authors: Population and Social Health Research Program, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia. surani.fernando@griffith.edu.au.
authors: Surani
authors: S
authors: Fernando
authors: School of Indigenous Australian Studies, James Cook University, Townsville, Australia. yvonne.cadetjames@jcu.edu.au.
authors: Yvonne
authors: Y
authors: Cadet-James
authors: Population and Social Health Research Program, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia. p.scuffham@griffith.edu.au.|School of Medicine, Griffith University, Logan, Australia. p.scuffham@griffith.edu.au.
authors: Paul A
authors: PA
authors: Scuffham
authors: Population and Social Health Research Program, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia. n.johnson@griffith.edu.au.
authors: Newell W
authors: NW
authors: Johnson
mesh_terms: D000293:Adolescent; D000891:Anti-Infective Agents, Local / Q000191:economics / Q000627:therapeutic use; D058491:Bacterial Load; D002327:Cariostatic Agents / Q000191:economics / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D004245:DMF Index; D003731:Dental Caries / Q000191:economics / Q000517:prevention & control*; D005260:Female; D005460:Fluorides, Topical / Q000191:economics / Q000627:therapeutic use; D006267:Health Education, Dental / Q000191:economics / Q000379:methods; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006801:Humans; D007778:Lactobacillus / Q000302:isolation & purification; D008297:Male; D009910:Oral Hygiene / Q000191:economics / Q000193:education; D010895:Pit and Fissure Sealants / Q000191:economics / Q000627:therapeutic use; D011206:Povidone-Iodine / Q000191:economics / Q000627:therapeutic use; D011322:Primary Prevention / Q000191:economics / Q000379:methods; D011788:Quality of Life; D012307:Risk Factors; D012423:Rural Health / Q000191:economics; D012463:Saliva / Q000382:microbiology; D013295:Streptococcus mutans / Q000302:isolation & purification; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D002327:Cariostatic Agents; D005460:Fluorides, Topical; D010895:Pit and Fissure Sealants; D011206:Povidone-Iodine