Examining the effectiveness of different dental recall strategies on maintenance of optimum oral health: the INTERVAL dental recalls randomised controlled trial

Jan E. Clarkson, Nigel B. Pitts, Patrick A. Fee (Lead / Corresponding author), Beatriz Goulao, Dwayne Boyers, Craig R. Ramsay, Ruth Floate, Hazel J. Braid, Fiona S. Ord, Helen V. Worthington, Marjon van der Pol, Linda Young, Ruth Freeman, Jill Gouick, Gerry M. Humphris, Fiona E. Mitchell, Alison M. McDonald, John D. T. Norrie, Kirsty Sim, Gail DouglasDavid Ricketts

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To compare the clinical effectiveness of different frequencies of dental recall over a four-year period.

Design: A multi-centre, parallel-group, randomised controlled trial with blinded clinical outcome assessment. Participants were randomised to receive a dental check-up at six-monthly, 24-monthly or risk-based recall intervals. A two-strata trial design was used, with participants randomised within the 24-month stratum if the recruiting dentist considered them clinically suitable. Participants ineligible for 24-month recall were randomised to a risk-based or six-month recall interval.

Setting: UK primary dental care.

Participants: Practices providing NHS care and adults who had received regular dental check-ups.

Main outcome measures: The percentage of sites with gingival bleeding on probing, oral health-related quality of life (OHRQoL), cost-effectiveness.

Results: In total, 2,372 participants were recruited from 51 dental practices. Of those, 648 were eligible for the 24-month recall stratum and 1,724 participants were ineligible. There was no evidence of a significant difference in the mean percentage of sites with gingival bleeding on probing between intervention arms in any comparison. For those eligible for 24-month recall stratum: the 24-month versus six-month group had an adjusted mean difference of -0.91%, 95% CI (-5.02%, 3.20%); the 24-month group versus risk-based group had an adjusted mean difference of 0.07%, 95% CI (-3.99%, 4.12%). For the overall sample, the risk-based versus six-month adjusted mean difference was 0.78%, 95% CI (-1.17%, 2.72%). There was no evidence of a difference in OHRQoL (0-56 scale, higher score for poorer OHRQoL) between intervention arms in any comparison. For the overall sample, the risk-based versus six-month effect size was -0.35, 95% CI (-1.02, 0.32). There was no evidence of a clinically meaningful difference between the groups in any comparison in either eligibility stratum for any of the secondary clinical or patient-reported outcomes.

Conclusion: Over a four-year period, we found no evidence of a difference in oral health for participants allocated to a six-month or a risk-based recall interval, nor between a 24-month, six-month or risk-based recall interval for participants eligible for a 24-month recall. However, patients greatly value and are willing to pay for frequent dental check-ups.

Original languageEnglish
Pages (from-to)236-243
Number of pages8
JournalBritish Dental Journal
Volume230
Issue number4
DOIs
Publication statusPublished - 26 Feb 2021

Keywords

  • Clinical trials
  • Evidence-based dentistry
  • Oral health
  • Dental recall
  • Primary care

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