Delivering dental health promotion in developing countries: should this be carried out by non-dental professionals?

Abstract

Design Three-armed randomised clinical trial.

Study selection The study's aim was to examine the effectiveness of providing oral health promotion, prevention and a restorative programme at mother and child health clinics (MCHs) through a multidisciplinary team. This was studied by collecting data on the participants' caries rates. The study sample consisted of 368 Peruvian children, aged 0-3 years, who were from low socioeconomic areas of Peru and were studied over three different MCHs. The interventions used in this study are split into active intervention group (AG), passive intervention group (PG) and control group (CG). The AG group had multiple interventions, such as multiple training courses for nurses on dental health, oral health-related information cards (OHICs) and atraumatic restorative treatment (ART)-trained dentists. The PG implemented OHICs and ART-trained dentists, and the CG nurses received a 45-minute lecture on the importance of oral health and regular protocols followed.

Data analysis/data extraction and synthesis Caries Assessment Spectrum and Treatment (CAST) scores were used to measure the participants' caries rates. The CAST scores were collected over a three-year period by two calibrated and trained dentists. The CAST scores ranged from 0 (no caries) to 8 (loss of tooth due to caries), although the authors only collected data from scores 3-8 as this was indicating disease presence.

Results The results were gathered for each arm of the study and compared using analysis of variance. The results showed that it was statistically significant (P <0.001) that the AG group had a lower rate of carious dentine compared to the PG and CG groups. The percentage of carious dentine prevalence was 10%, 60.5% and 63.0%, respectively.

Conclusion The conclusion of the paper is that using a multidisciplinary approach - with trained nurses, delivery of oral health inspection and advice - can reduce the rate of caries in 0-3-year-olds.