Focus on fighting childhood caries
British Society of Paediatric Dentistry conference updated on FiCTION trial to prevent, detect and treat dental caries
The management of dental caries in children was one of the key topics discussed at the British Society of Paediatric Dentistry (BSPD) annual conference held in Dundee in September.
Delegates were told that the results of the FiCTION (Filling Children’s Teeth: indicated or not?) trial set up to test three approaches to managing dental caries in children would be made publicly available in the near future.
It’s believed that, among other things, the results confirm that the trust engendered by the dentist providing care and delivering preventive advice is critical to any outcome.
Similarly, once a child has developed caries, they are likely to experience pain and/or infection, and intensive prevention should be targeted at the child and its parents.
Professor Jan Clarkson, chair of the conference organising committee as well as a lead investigator for the FiCTION trial, said: “Our findings will now feed through into advice for the dental profession. We are working to ensure it is included in updates of the Scottish Dental Clinical Effectiveness Programme (SDCEP) and Delivering Better Oral Health.”
The FiCTION trial involved seven locations (Cardiff, Glasgow, Leeds, Newcastle, Sheffield, London and Dundee) and 1,144 children aged three to seven. More than 70 general dentists across the UK tested three approaches:
- Conventional (drill and fill) with prevention
- Biological management (sealing in)
- Best practice prevention alone.
Public health dentist Professor Zoe Marshman from Sheffield was one of the core team and led on the patient and parent perspectives. She said of the findings: “As well as looking at the clinical perspective, we also focused on pain, infection, anxiety, quality of life and health economics. We interviewed children, parents and dental professionals about their views on the acceptability of treatment and found that, with the child-centred patient management, all treatments were considered acceptable.”
Professor Nicola Innes, Dundee-based and a lead investigator along with Professors Anne Maguire, Gail Douglas and Jan Clarkson, said: “Successfully delivering this complex research is a testament to collaboration across the paediatric dental community and the willingness of general practitioners to participate in research and contribute to improving patient care.”
Professor Maguire from the Centre for Oral Health Research, School of Dental Sciences, Newcastle University, said: “FiCTION was conceived back in 2007, so it has been a long but interesting journey for everyone involved at each stage.
We thank all the ‘FiCTIONEERS’ who took part: the children, their families, the general dental practice teams and the researchers.”
Claire Stevens, BSPD spokeswoman said: “One of the key messages of this trial is the importance of evidence-based prevention which must underpin any approach to caries.
“As soon as early caries is identified, clinicians need to be re-evaluating the child’s caries risk status and providing enhanced prevention in line with Delivering Better Oral Health and SDCEP guidance.”
The preventive approach was amplified by Professor Douglas, Honorary Consultant in Dental Public Health at the University of Leeds whose research interests include caries detection and prevention.
“It’s saddening that caries is such a common disease in children. There is much that the dental team can do to help but prevention at home from the first tooth erupting is key. Avoiding sugary drinks and snacks helps, and toothbrushing with fluoride toothpaste is vital, especially last thing at night.
“An important thing many people may not know is that the fluoride from toothpaste keeps working long after the teeth have been brushed so it’s best to avoid rinsing with water after brushing.”