Caries-preventive efficacy of a supervised school toothbrushing programme in Northland,New Zealand

Background: Toothbrushing with fluoride toothpaste reduces the incidence of dental caries. Objective: To evaluate a supervised school toothbrushing programme to reduce dental caries experience in children. Basic Research Design: Quasi-experimental study. All children had routine dental examinations at baseline using the ICDAS to record dental caries, along with bitewing radiographs. Half of the children were involved in a supervised toothbrushing programme. Examinations were repeated at the end of the school year. Clinical setting: Northland, New Zealand. Participants: 335 10-13-year-old New Zealand children with high caries experience. Interventions: Half of the children participated in the supervised toothbrushing session each school day; the other half had no intervention. Main outcome measures: Caries increment, determined by comparing the baseline and follow-up status of each tooth surface. Results: At baseline, there were 335 children, of whom 240 (71.6%) were followed up. The ICDAS net caries increment for those in the toothbrushing group was a mean of 11.7 surfaces improved; the control group had a mean of 8.6 surfaces which had deteriorated. Caries incidence for those in the toothbrushing group was 7.3%; that for the control group was 71.5%. Multivariate analysis showed that membership of the brushing group was the only statistically significant predictor of a lower net caries increment. Conclusion: A supervised school toothbrushing programme can reduce caries increment in a population experiencing high levels of dental disease.