Innes, N., Fairhurst, C., Whiteside, K. et al. (20 more authors) (2024) Behaviour Change Intervention for Toothbrushing (lesson and text messages) to prevent dental caries in secondary school pupils: The BRIGHT Randomised Control Trial. Community Dentistry and Oral Epidemiology, 52 (4). pp. 469-478. ISSN 0301-5661
Abstract
Objectives
This multicentre, assessor-blinded, two-arm cluster randomized trial evaluated the clinical and cost-effectiveness of a behaviour change intervention promoting toothbrushing for preventing dental caries in UK secondary schools.
Methods
Pupils aged 11–13 years with their own mobile telephone attending secondary schools with above average free school meals eligibility were randomized (at year-group level) to receive a lesson and twice-daily text messages or to usual care. Year-groups (n = 84) from 42 schools including 4680 pupils (intervention, n = 2262; control, n = 2418) were randomized.
Results
In 2383 participants with valid data at baseline and 2.5 years, the primary outcome of presence of at least one treated or untreated carious lesion (D4-6 MFT [Decayed, Missing and Filled Teeth] in permanent teeth using International Caries Detection and Assessment System) was 44.6% in the intervention group and 43.0% in control (odds ratio [OR] 1.04, 95% CI 0.85–1.26, p = .72). There were no statistically significant differences in secondary outcomes of presence of at least one treated or untreated carious lesion (D1-6 MFT), number of D4-6 MFT and D1-6 MFT, plaque and bleeding scores or health-related- (Child Health Utility 9D) or oral health-related- quality of life (CARIES-QC). However, twice-daily toothbrushing, reported by 77.6% of pupils at baseline, increased at 6 months (intervention, 86.9%; control, 83.0%; OR 1.30, 95% CI 1.03–1.63, p = .03), but returned to no difference at 2.5 years (intervention, 81.0%; control, 79.9%; OR 1.05, 95% CI 0.84–1.30, p = .69). Estimated incremental costs and quality-adjusted life-years (QALYs) of the intervention, relative to control, were £1.02 (95% CI −1.29 to 3.23) and −0.003 (95% CI −0.009 to 0.002), respectively, with a 7% chance of being cost-effective (£20 000/QALY gained threshold).
Conclusion
There was no evidence of statistically significant difference for caries prevalence at 2.5-years. The intervention's positive 6-month toothbrushing behaviour change did not translate into caries reduction. (ISRCTN 12139369). COVID-19 pandemic adversly affected follow-up.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2024 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
Keywords: | child, cost–benefit analysis, dental caries, dental health, fluorides, oral health, quality of life, schools, text messaging, toothpaste |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Dentistry (Leeds) > Paediatric Dentistry (Leeds) |
Funding Information: | Funder Grant number NIHR National Inst Health Research 15/166/08 NIHR National Inst Health Research Not Known |
Depositing User: | Symplectic Publications |
Date Deposited: | 21 Dec 2023 11:37 |
Last Modified: | 09 Oct 2024 14:41 |
Status: | Published |
Publisher: | Wiley-Blackwell |
Identification Number: | 10.1111/cdoe.12940 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:206850 |