Projects per year
Objective: To compare the clinical effectiveness and cost benefit of different frequencies of scale and polish (S&P) treatments in combination with different types of oral hygiene advice (OHA).
Design: Multi-centre, multi-level cluster randomised factorial open trial with blinded outcome evaluation. UK dental practices were cluster randomised to deliver OHA as usual or personalised. In a separate randomisation, patients were allocated to receive S&P 6-monthly, 12-monthly or never.
Setting: UK primary dental care.
Participants: Practices providing NHS care and adults who had received regular dental check-ups.
Main outcome measures: The percent of sites with bleeding on probing, patient confidence in self-care, incremental net benefits (INB) over three years.
Results: Sixty-three practices and 1,877 adult patients were randomised and 1,327 analysed (clinical outcome). There was no statistically significant or clinically important difference in gingival bleeding between the three S&P groups (for example, six-monthly versus none: difference 0.87% sites, 95% CI: 1.6 to 3.3, p = 0.48) or between personalised or usual OHA groups (difference -2.5% sites, -95%CI: -8.3 to 3.3, p = 0.39), or oral hygiene self-efficacy (cognitive impact) between either group (for example, six-monthly versus none: difference -0.028, 95% CI -0.119 to 0.063, p = 0.543). The general population place a high value on, and are willing to pay for, S&P services. However, from a dental health perspective, none of the interventions were cost-effective.
Conclusion: Results suggest S&P treatments and delivering brief personalised OHA provide no clinical benefit and are therefore an inefficient approach to improving dental health (38% of sites were bleeding whatever intervention was received). However, the general population value both interventions.
Improving the Quality of Dentistry (IQuaD): A Randomised Controlled Trial Comparing Oral Hygiene Advice and Periodontal Instrumentation for the Prevention and Management of Periodontal Disease in Dentate Adults Attending Dental Primary Care (Joint with Universities of Newcastle, Glasgow, Manchester, Aberdeen and Edinburgh and Kings College London and NHS Education for Scotland)
1/04/11 → 1/01/17