The effectiveness of medical nurses in treating children with silver diamine fluoride in a school-based caries prevention program

IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Community dentistry and oral epidemiology Pub Date : 2023-10-24 DOI:10.1111/cdoe.12925
Ryan Richard Ruff, Tamarinda Barry Godín, Richard Niederman
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Abstract

Background

The sustainability of school-based oral health programs depends on the utilization of effective, efficient treatments and the availability of a trained clinical workforce. The objective of this study was to determine whether registered nurses are comparable to dental hygienists in the application and effectiveness of silver diamine fluoride (SDF) and fluoride varnish (FV) for the prevention of dental caries.

Methods

CariedAway was a school-based study of SDF and FV versus dental sealants and atraumatic restorations. Within the SDF + FV arm, participants were treated by either a licensed dental hygienist or a registered nurse, both under the supervision of a paediatric dentist. Although initial treatment assignment in CariedAway was randomized, assignment to provider was not. The proportion of children who remained caries free after 2 years was assessed for non-inferiority using two-group proportion tests, adjusting for the clustering effect of schools.

Results

A total of 417 children with no untreated caries at baseline were analysed including 298 treated by hygienists and 119 by nurses. The proportion of children who remained caries free after 2 years was 0.81 and 0.80 for those treated by hygienists and nurses, respectively, for a difference of 0.01 (95% CI = −0.07, 0.098) and within the pre-determined non-inferiority margin.

Conclusions

Nurses may be effective in treating children with silver diamine fluoride and other fluoride varnishes in school-based oral health programs.

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在学校防龋计划中,医护人员用氟化二胺银治疗儿童的有效性。
背景:学校口腔健康项目的可持续性取决于有效、高效的治疗方法的使用以及训练有素的临床工作人员的可用性。本研究的目的是确定注册护士在氟化二胺银(SDF)和氟化清漆(FV)预防龋齿的应用和有效性方面是否与牙科卫生学家相当。方法:CariedAway是一项基于学校的SDF和FV与牙科密封剂和无创伤修复体的对比研究。SDF内部 + FV组,参与者由持照牙科保健师或注册护士在儿科牙医的监督下进行治疗。虽然最初在CariedAway的治疗分配是随机的,但分配给提供者并不是。2岁后保持无龋的儿童比例 使用两组比例测试来评估年份的非劣效性,并根据学校的集群效应进行调整。结果:共分析了417名基线时未治疗龋齿的儿童,其中298名由卫生学家治疗,119名由护士治疗。2岁后保持无龋的儿童比例 年分别为0.81和0.80,差异为0.01(95%置信区间 = -0.07、0.098)并且在预定的非劣效性界限内。结论:在学校口腔健康计划中,护士使用氟化二胺银和其他含氟清漆治疗儿童可能是有效的。
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来源期刊
Community dentistry and oral epidemiology
Community dentistry and oral epidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.40
自引率
8.70%
发文量
82
审稿时长
6 months
期刊介绍: The aim of Community Dentistry and Oral Epidemiology is to serve as a forum for scientifically based information in community dentistry, with the intention of continually expanding the knowledge base in the field. The scope is therefore broad, ranging from original studies in epidemiology, behavioral sciences related to dentistry, and health services research through to methodological reports in program planning, implementation and evaluation. Reports dealing with people of all age groups are welcome. The journal encourages manuscripts which present methodologically detailed scientific research findings from original data collection or analysis of existing databases. Preference is given to new findings. Confirmations of previous findings can be of value, but the journal seeks to avoid needless repetition. It also encourages thoughtful, provocative commentaries on subjects ranging from research methods to public policies. Purely descriptive reports are not encouraged, nor are behavioral science reports with only marginal application to dentistry. The journal is published bimonthly.
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