IQuaD dental trial; improving the quality of dentistry

a multicentre 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

Jan E. Clarkson, Craig R. Ramsay, Paul Averley, Debbie Bonetti, Dwayne Boyers, Louise Campbell, Graham R. Chadwick, Anne Duncan, Andrew Elders, Jill Gouick, Andrew F. Hall, Lynne Heasman, Peter A. Heasman, Penny J. Hodge, Clare Jones, Marilyn Laird, Thomas Lamont (Lead / Corresponding author), Laura A. Lovelock, Isobel Madden, Wendy McCombes & 16 others Giles I. McCracken, Alison M. McDonald, Gladys McPherson, Lorna E. Macpherson, Fiona E. Mitchell, John D. T. Norrie, Nigel B. Pitts, Marjon van der Pol, David N. J. Ricketts, Margaret K. Ross, James G. Steele, Moira Swan, Martin Tickle, Pauline D. Watt, Helen V. Worthington, Linda Young

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

BACKGROUND: Periodontal disease is the most common oral disease affecting adults, and although it is largely preventable it remains the major cause of poor oral health worldwide. Accumulation of microbial dental plaque is the primary aetiological factor for both periodontal disease and caries. Effective self-care (tooth brushing and interdental aids) for plaque control and removal of risk factors such as calculus, which can only be removed by periodontal instrumentation (PI), are considered necessary to prevent and treat periodontal disease thereby maintaining periodontal health. Despite evidence of an association between sustained, good oral hygiene and a low incidence of periodontal disease and caries in adults there is a lack of strong and reliable evidence to inform clinicians of the relative effectiveness (if any) of different types of Oral Hygiene Advice (OHA). The evidence to inform clinicians of the effectiveness and optimal frequency of PI is also mixed. There is therefore an urgent need to assess the relative effectiveness of OHA and PI in a robust, sufficiently powered randomised controlled trial (RCT) in primary dental care.

METHODS/DESIGN: This is a 5 year multi-centre, randomised, open trial with blinded outcome evaluation based in dental primary care in Scotland and the North East of England. Practitioners will recruit 1860 adult patients, with periodontal health, gingivitis or moderate periodontitis (Basic Periodontal Examination Score 0-3). Dental practices will be cluster randomised to provide routine OHA or Personalised OHA. To test the effects of PI each individual patient participant will be randomised to one of three groups: no PI, 6 monthly PI (current practice), or 12 monthly PI.Baseline measures and outcome data (during a three year follow-up) will be assessed through clinical examination, patient questionnaires and NHS databases.The primary outcome measures at 3 year follow up are gingival inflammation/bleeding on probing at the gingival margin; oral hygiene self-efficacy and net benefits.

DISCUSSION: IQuaD will provide evidence for the most clinically-effective and cost-effective approach to managing periodontal disease in dentate adults in Primary Care. This will support general dental practitioners and patients in treatment decision making.

TRIAL REGISTRATION: Protocol ID: ISRCTN56465715.

Original languageEnglish
Article number58
Number of pages12
JournalBMC Oral Health
Volume13
DOIs
Publication statusPublished - 26 Oct 2013

Fingerprint

Dental Care
Oral Hygiene
Periodontal Diseases
Dentistry
Primary Health Care
Tooth
Randomized Controlled Trials
Mouth Diseases
Outcome Assessment (Health Care)
Periodontal Index
Dental Plaque
Gingivitis
Deciduous Tooth
Periodontitis
Health
Calculi
Oral Health
Scotland
Self Efficacy
Self Care

Keywords

  • Adult
  • Aged
  • Counseling
  • Dental calculus
  • Dental care
  • Dental plaque
  • Dental prophylaxis
  • Follow-up studies
  • Gingival hemorrhage
  • Gingivitis
  • Health behavior
  • Health knowledge, Attitudes, Practice
  • Humans
  • Middle aged
  • Oral hygiene
  • Periodontal diseases
  • Periodontal pocket
  • Periodontitis
  • Precision medicine
  • Primary health care
  • Quality of health care
  • Quality of life
  • Self care
  • Self efficacy
  • Single-blind method
  • Toothbrushing
  • Treatment outcome

Cite this

Clarkson, Jan E. ; Ramsay, Craig R. ; Averley, Paul ; Bonetti, Debbie ; Boyers, Dwayne ; Campbell, Louise ; Chadwick, Graham R. ; Duncan, Anne ; Elders, Andrew ; Gouick, Jill ; Hall, Andrew F. ; Heasman, Lynne ; Heasman, Peter A. ; Hodge, Penny J. ; Jones, Clare ; Laird, Marilyn ; Lamont, Thomas ; Lovelock, Laura A. ; Madden, Isobel ; McCombes, Wendy ; McCracken, Giles I. ; McDonald, Alison M. ; McPherson, Gladys ; Macpherson, Lorna E. ; Mitchell, Fiona E. ; Norrie, John D. T. ; Pitts, Nigel B. ; van der Pol, Marjon ; Ricketts, David N. J. ; Ross, Margaret K. ; Steele, James G. ; Swan, Moira ; Tickle, Martin ; Watt, Pauline D. ; Worthington, Helen V. ; Young, Linda. / IQuaD dental trial; improving the quality of dentistry : a multicentre 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. In: BMC Oral Health. 2013 ; Vol. 13.
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abstract = "BACKGROUND: Periodontal disease is the most common oral disease affecting adults, and although it is largely preventable it remains the major cause of poor oral health worldwide. Accumulation of microbial dental plaque is the primary aetiological factor for both periodontal disease and caries. Effective self-care (tooth brushing and interdental aids) for plaque control and removal of risk factors such as calculus, which can only be removed by periodontal instrumentation (PI), are considered necessary to prevent and treat periodontal disease thereby maintaining periodontal health. Despite evidence of an association between sustained, good oral hygiene and a low incidence of periodontal disease and caries in adults there is a lack of strong and reliable evidence to inform clinicians of the relative effectiveness (if any) of different types of Oral Hygiene Advice (OHA). The evidence to inform clinicians of the effectiveness and optimal frequency of PI is also mixed. There is therefore an urgent need to assess the relative effectiveness of OHA and PI in a robust, sufficiently powered randomised controlled trial (RCT) in primary dental care.METHODS/DESIGN: This is a 5 year multi-centre, randomised, open trial with blinded outcome evaluation based in dental primary care in Scotland and the North East of England. Practitioners will recruit 1860 adult patients, with periodontal health, gingivitis or moderate periodontitis (Basic Periodontal Examination Score 0-3). Dental practices will be cluster randomised to provide routine OHA or Personalised OHA. To test the effects of PI each individual patient participant will be randomised to one of three groups: no PI, 6 monthly PI (current practice), or 12 monthly PI.Baseline measures and outcome data (during a three year follow-up) will be assessed through clinical examination, patient questionnaires and NHS databases.The primary outcome measures at 3 year follow up are gingival inflammation/bleeding on probing at the gingival margin; oral hygiene self-efficacy and net benefits.DISCUSSION: IQuaD will provide evidence for the most clinically-effective and cost-effective approach to managing periodontal disease in dentate adults in Primary Care. This will support general dental practitioners and patients in treatment decision making.TRIAL REGISTRATION: Protocol ID: ISRCTN56465715.",
keywords = "Adult, Aged, Counseling, Dental calculus, Dental care, Dental plaque, Dental prophylaxis, Follow-up studies, Gingival hemorrhage, Gingivitis, Health behavior, Health knowledge, Attitudes, Practice, Humans, Middle aged, Oral hygiene, Periodontal diseases, Periodontal pocket, Periodontitis, Precision medicine, Primary health care, Quality of health care, Quality of life, Self care, Self efficacy, Single-blind method, Toothbrushing, Treatment outcome",
author = "Clarkson, {Jan E.} and Ramsay, {Craig R.} and Paul Averley and Debbie Bonetti and Dwayne Boyers and Louise Campbell and Chadwick, {Graham R.} and Anne Duncan and Andrew Elders and Jill Gouick and Hall, {Andrew F.} and Lynne Heasman and Heasman, {Peter A.} and Hodge, {Penny J.} and Clare Jones and Marilyn Laird and Thomas Lamont and Lovelock, {Laura A.} and Isobel Madden and Wendy McCombes and McCracken, {Giles I.} and McDonald, {Alison M.} and Gladys McPherson and Macpherson, {Lorna E.} and Mitchell, {Fiona E.} and Norrie, {John D. T.} and Pitts, {Nigel B.} and {van der Pol}, Marjon and Ricketts, {David N. J.} and Ross, {Margaret K.} and Steele, {James G.} and Moira Swan and Martin Tickle and Watt, {Pauline D.} and Worthington, {Helen V.} and Linda Young",
year = "2013",
month = "10",
day = "26",
doi = "10.1186/1472-6831-13-58",
language = "English",
volume = "13",
journal = "BMC Oral Health",
issn = "1472-6831",
publisher = "Springer Verlag",

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Clarkson, JE, Ramsay, CR, Averley, P, Bonetti, D, Boyers, D, Campbell, L, Chadwick, GR, Duncan, A, Elders, A, Gouick, J, Hall, AF, Heasman, L, Heasman, PA, Hodge, PJ, Jones, C, Laird, M, Lamont, T, Lovelock, LA, Madden, I, McCombes, W, McCracken, GI, McDonald, AM, McPherson, G, Macpherson, LE, Mitchell, FE, Norrie, JDT, Pitts, NB, van der Pol, M, Ricketts, DNJ, Ross, MK, Steele, JG, Swan, M, Tickle, M, Watt, PD, Worthington, HV & Young, L 2013, 'IQuaD dental trial; improving the quality of dentistry: a multicentre 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', BMC Oral Health, vol. 13, 58. https://doi.org/10.1186/1472-6831-13-58

IQuaD dental trial; improving the quality of dentistry : a multicentre 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. / Clarkson, Jan E.; Ramsay, Craig R.; Averley, Paul; Bonetti, Debbie; Boyers, Dwayne; Campbell, Louise; Chadwick, Graham R.; Duncan, Anne; Elders, Andrew; Gouick, Jill; Hall, Andrew F.; Heasman, Lynne; Heasman, Peter A.; Hodge, Penny J.; Jones, Clare; Laird, Marilyn; Lamont, Thomas (Lead / Corresponding author); Lovelock, Laura A.; Madden, Isobel; McCombes, Wendy; McCracken, Giles I.; McDonald, Alison M.; McPherson, Gladys; Macpherson, Lorna E.; Mitchell, Fiona E.; Norrie, John D. T.; Pitts, Nigel B.; van der Pol, Marjon; Ricketts, David N. J.; Ross, Margaret K.; Steele, James G.; Swan, Moira; Tickle, Martin; Watt, Pauline D.; Worthington, Helen V.; Young, Linda.

In: BMC Oral Health, Vol. 13, 58, 26.10.2013.

Research output: Contribution to journalArticle

TY - JOUR

T1 - IQuaD dental trial; improving the quality of dentistry

T2 - a multicentre 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

AU - Clarkson, Jan E.

AU - Ramsay, Craig R.

AU - Averley, Paul

AU - Bonetti, Debbie

AU - Boyers, Dwayne

AU - Campbell, Louise

AU - Chadwick, Graham R.

AU - Duncan, Anne

AU - Elders, Andrew

AU - Gouick, Jill

AU - Hall, Andrew F.

AU - Heasman, Lynne

AU - Heasman, Peter A.

AU - Hodge, Penny J.

AU - Jones, Clare

AU - Laird, Marilyn

AU - Lamont, Thomas

AU - Lovelock, Laura A.

AU - Madden, Isobel

AU - McCombes, Wendy

AU - McCracken, Giles I.

AU - McDonald, Alison M.

AU - McPherson, Gladys

AU - Macpherson, Lorna E.

AU - Mitchell, Fiona E.

AU - Norrie, John D. T.

AU - Pitts, Nigel B.

AU - van der Pol, Marjon

AU - Ricketts, David N. J.

AU - Ross, Margaret K.

AU - Steele, James G.

AU - Swan, Moira

AU - Tickle, Martin

AU - Watt, Pauline D.

AU - Worthington, Helen V.

AU - Young, Linda

PY - 2013/10/26

Y1 - 2013/10/26

N2 - BACKGROUND: Periodontal disease is the most common oral disease affecting adults, and although it is largely preventable it remains the major cause of poor oral health worldwide. Accumulation of microbial dental plaque is the primary aetiological factor for both periodontal disease and caries. Effective self-care (tooth brushing and interdental aids) for plaque control and removal of risk factors such as calculus, which can only be removed by periodontal instrumentation (PI), are considered necessary to prevent and treat periodontal disease thereby maintaining periodontal health. Despite evidence of an association between sustained, good oral hygiene and a low incidence of periodontal disease and caries in adults there is a lack of strong and reliable evidence to inform clinicians of the relative effectiveness (if any) of different types of Oral Hygiene Advice (OHA). The evidence to inform clinicians of the effectiveness and optimal frequency of PI is also mixed. There is therefore an urgent need to assess the relative effectiveness of OHA and PI in a robust, sufficiently powered randomised controlled trial (RCT) in primary dental care.METHODS/DESIGN: This is a 5 year multi-centre, randomised, open trial with blinded outcome evaluation based in dental primary care in Scotland and the North East of England. Practitioners will recruit 1860 adult patients, with periodontal health, gingivitis or moderate periodontitis (Basic Periodontal Examination Score 0-3). Dental practices will be cluster randomised to provide routine OHA or Personalised OHA. To test the effects of PI each individual patient participant will be randomised to one of three groups: no PI, 6 monthly PI (current practice), or 12 monthly PI.Baseline measures and outcome data (during a three year follow-up) will be assessed through clinical examination, patient questionnaires and NHS databases.The primary outcome measures at 3 year follow up are gingival inflammation/bleeding on probing at the gingival margin; oral hygiene self-efficacy and net benefits.DISCUSSION: IQuaD will provide evidence for the most clinically-effective and cost-effective approach to managing periodontal disease in dentate adults in Primary Care. This will support general dental practitioners and patients in treatment decision making.TRIAL REGISTRATION: Protocol ID: ISRCTN56465715.

AB - BACKGROUND: Periodontal disease is the most common oral disease affecting adults, and although it is largely preventable it remains the major cause of poor oral health worldwide. Accumulation of microbial dental plaque is the primary aetiological factor for both periodontal disease and caries. Effective self-care (tooth brushing and interdental aids) for plaque control and removal of risk factors such as calculus, which can only be removed by periodontal instrumentation (PI), are considered necessary to prevent and treat periodontal disease thereby maintaining periodontal health. Despite evidence of an association between sustained, good oral hygiene and a low incidence of periodontal disease and caries in adults there is a lack of strong and reliable evidence to inform clinicians of the relative effectiveness (if any) of different types of Oral Hygiene Advice (OHA). The evidence to inform clinicians of the effectiveness and optimal frequency of PI is also mixed. There is therefore an urgent need to assess the relative effectiveness of OHA and PI in a robust, sufficiently powered randomised controlled trial (RCT) in primary dental care.METHODS/DESIGN: This is a 5 year multi-centre, randomised, open trial with blinded outcome evaluation based in dental primary care in Scotland and the North East of England. Practitioners will recruit 1860 adult patients, with periodontal health, gingivitis or moderate periodontitis (Basic Periodontal Examination Score 0-3). Dental practices will be cluster randomised to provide routine OHA or Personalised OHA. To test the effects of PI each individual patient participant will be randomised to one of three groups: no PI, 6 monthly PI (current practice), or 12 monthly PI.Baseline measures and outcome data (during a three year follow-up) will be assessed through clinical examination, patient questionnaires and NHS databases.The primary outcome measures at 3 year follow up are gingival inflammation/bleeding on probing at the gingival margin; oral hygiene self-efficacy and net benefits.DISCUSSION: IQuaD will provide evidence for the most clinically-effective and cost-effective approach to managing periodontal disease in dentate adults in Primary Care. This will support general dental practitioners and patients in treatment decision making.TRIAL REGISTRATION: Protocol ID: ISRCTN56465715.

KW - Adult

KW - Aged

KW - Counseling

KW - Dental calculus

KW - Dental care

KW - Dental plaque

KW - Dental prophylaxis

KW - Follow-up studies

KW - Gingival hemorrhage

KW - Gingivitis

KW - Health behavior

KW - Health knowledge, Attitudes, Practice

KW - Humans

KW - Middle aged

KW - Oral hygiene

KW - Periodontal diseases

KW - Periodontal pocket

KW - Periodontitis

KW - Precision medicine

KW - Primary health care

KW - Quality of health care

KW - Quality of life

KW - Self care

KW - Self efficacy

KW - Single-blind method

KW - Toothbrushing

KW - Treatment outcome

U2 - 10.1186/1472-6831-13-58

DO - 10.1186/1472-6831-13-58

M3 - Article

VL - 13

JO - BMC Oral Health

JF - BMC Oral Health

SN - 1472-6831

M1 - 58

ER -