Researchers at Queen Mary University of London have identified a low-cost and low-intensity intervention technique that could prevent tooth decay for thousands of children both across the United Kingdom and around the world.
Nearly a quarter of 5-year-olds in the United Kingdom experience tooth decay, the school reports. In 2017 and 2018, 33,779 children were admitted to the hospital to have teeth extracted because of decay. It is the single highest reason for children to be admitted to the hospital, and each extraction costs the National Health Service around £1,000.
However, a single therapeutic conversation by trained dental nurses with families of children who have had their teeth extracted has led to a 29% reduction in the risk of those children having new tooth decay, according to the researchers.
The researchers developed a “talking” intervention and trained dental nurses to have a therapeutic conversation with parents of children admitted to the hospital to have their teeth extracted. The Dental Recur Brief Negotiated Interview (DR-BNI) is based on two methods, motivational interviewing and behavior change techniques.
The trial ran in 12 centers in the United Kingdom with more than 200 families of 5- to 7-year-old children who were having baby teeth extracted. Families had an equal chance of having the DR-BNI or a control conversation about new adult teeth.
DR-BNI focuses on how families can prevent tooth decay in the future. Rather than telling families what to do, they choose goals they feel they can achieve, like swapping sweet drinks for unsweetened ones or brushing their child’s teeth at bedtime. The control conversation families were advised to visit the dentist as usual.
“This trial is important because we found that if we change how we talk to parents about prevention, their children go on to develop many fewer cavities,” said Cynthia Pine, BDS, MBA, PhD, professor of dental public health and leader of the study.
“The key is helping parents to choose one or two behaviors they feel they can change for their child, rather than us telling parents what to do, that makes the difference,” said Pine.
Children from the most deprived areas have more than twice the level of decay, 34%, than those from the least deprived, 14%, the researchers said. The main causes of tooth decay in children are excessive sugary snacks and drinks and failure to brush their teeth with fluoride toothpaste daily.
In a wide range of high-risk children across the UK, this single, low-cost, low-intensity intervention succeeded in significantly reducing the risk of new decay experience, the researchers said.
DR-BNI also provides opportunities for dental nurses to go beyond clinical prevention to facilitate behavior change and to support oral health improvements for children at high risk of developing tooth decay, the researchers said.
Health Education North West has invited the researchers to develop DR-BNI into a training module for dental nurses in the National Health Service. The researchers plan to have the DR-BNI available by early spring 2020.
The study, “Dental RECUR Randomized Trial to Prevent Caries Recurrence in Children,” was published by the Journal of Dental Research.
