Dentists invited to join child tooth decay study

Hundreds of dental practices across the UK will be invited to participate in a major trial to assess the benefits of three different methods of managing tooth decay in children.

Distribution of letters to 300 practices in Cardiff, Dundee, Glasgow, Leeds, London, Newcastle and Sheffield will begin over the next month, asking them if they are prepared to join the FiCTION trial, which has been commissioned by the National Institute for Health Research Health Technology Assessment (NIHR HTA).

Dental decay is one of the most common childhood diseases, with over 40% of children in the UK already experiencing obvious decay in their primary (baby) teeth by five years of age, and this statistic has remained largely unchanged for the past 20 years.

Only around 12% of obviously decayed baby teeth in five year olds are treated with fillings, while the vast majority are left untreated, and dental extractions remain the most common reason for children in the UK to receive an out-patient general anaesthetic.

The FiCTION trial is led by the University of Dundee and the University of Leeds, working with colleagues at the Universities of Cardiff, Glasgow, London, Newcastle and Sheffield.

It is examining the benefits of three different methods of managing tooth decay in baby teeth:
• Using only preventive techniques recommended in national guidance (better toothbrushing, less sugar in the diet, application of high fluoride varnish and fissure sealants) to stop the decay.
• Conventional fillings (numbing with local anaesthetic injections then drilling away decay before placing a filling in the cavity) with preventive techniques
• Biological treatment of the decay (sealing the decay into teeth with filling materials or under crowns, generally without the need to use injections or dental drills) with preventive techniques

The study is also examining what the children, all aged between three and seven, think of the different types of treatments.

Dr Nicola Innes, of the University of Dundee Dental School and one of the lead researchers for the
FiCTION trial, says: ‘Dental decay is one of the most common diseases of childhood, with a large health and economic impact.

‘Conventional clinical opinion is that baby teeth showing decay should be filled, yet the majority of cavities in young children are left unrestored. There is, as yet, no conclusive evidence for the most effective approach to managing decay in baby teeth. With this trial we are looking to provide that evidence.’

A pilot study preceding the main trial has been running in Tayside, Sheffield and Newcastle and is in the closing stages of recruitment of 200 child patients.

The main trial is expected to begin early in 2012 and will involve around 200 dentists across the UK.

Participating dentists will be from general dental practices throughout the UK where children who attend for regular dental care will be invited to take part.

In addition to the preventive treatment for all children in the trial, they will be randomly assigned to one of the three treatment groups.

The children will be asked to rate on a special scale any discomfort they felt during each treatment and asked about what they think of the different ways of treating their teeth.

All children in the trial will be seen by their dentist up to four times per year and checked for any problems which require care.

For more information on the FiCTION trial, visit www.fictiontrial.info.

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