Journal article
Atraumatic restorative treatments in Australian Aboriginal Communities: A Cluster-randomized trial
JDR Clinical & Translational Research
2020
Abstract
Introduction:
The management of early childhood caries (ECC) is challenging.
Objectives:
A model of care based on Atraumatic Restorative Treatment and the Hall Technique (ART-HT) to manage ECC was evaluated among remote Aboriginal communities in Australia.
Methods:
Aboriginal communities in the North-West of Western Australia were invited to participate and consenting communities were randomized into early or delayed intervention for the management of ECC. Children were examined at baseline and at the 11-mo follow-up. The early intervention group (test) was provided with the ART-based dental care at baseline while the delayed intervention group (control) was advised to seek care through the usual care options available within the community. At follow-up, both groups were examined by calibrated examiners, and were offered care using the ART-HT approach. Changes from baseline to follow-up in caries experience were tested using paired tests. Multivariate analysis after multiple imputation of missing data used generalised estimating equation (GEE) controlling for clustering within communities.
Results:
A total of 25 communities and 338 children (mean age = 3.6 y, SD 1.7) participated in the study (test = 177). At follow-up, 231 children were examined (68% retention, test = 125). At follow-up, children in the test group had more filled teeth (test filled teeth = 1.2, control filled teeth = 0.2, P < 0.001) and decreased levels of decayed teeth (mean test = 0.7 fewer teeth with decay, mean control = 1.0 more tooth with decay, P < 0.001). GEE analysis controlled for baseline caries experience, age, sex, and community water fluoride levels found increased rates of untreated decayed teeth (RR = 1.4, P = 0.02) and decreased rates of filled teeth (RR = 0.2, P < 0.001) at follow-up among the control group.
Conclusion:
A model of care relying on the principles of minimally invasive atraumatic approaches enabled the delivery of effective dental services to young children (<6 y) in remote Aboriginal Australian communities resulting in increased levels of care and improved oral health.
Details
- Title
- Atraumatic restorative treatments in Australian Aboriginal Communities: A Cluster-randomized trial
- Authors/Creators
- P. Arrow (Author/Creator) - The University of AdelaideS. Piggott (Author/Creator) - Western HealthS. Carter (Author/Creator) - Western HealthR. McPhee (Author/Creator) - Kimberley Aboriginal Medical ServicesD. Atkinson (Author/Creator) - The University of Western AustraliaT. Mackean (Author/Creator) - Flinders UniversityS. Kularatna (Author/Creator) - Queensland University of TechnologyU. Tonmukayakul (Author/Creator) - Deakin UniversityD. Brennan (Author/Creator) - The University of AdelaideS. Nanda (Author/Creator) - Government of Western Australia Department of HealthD. Palmer (Author/Creator) - Murdoch UniversityL. Jamieson (Author/Creator) - The University of Adelaide
- Publication Details
- JDR Clinical & Translational Research
- Publisher
- SAGE Publications
- Identifiers
- 991005541523607891
- Copyright
- © 2020 by International Association of Dental Research
- Murdoch Affiliation
- Creative Media, Arts and Design
- Language
- English
- Resource Type
- Journal article
UN Sustainable Development Goals (SDGs)
This output has contributed to the advancement of the following goals:
Source: InCites
Metrics
104 Record Views