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Major Children’s Dental Study

2012-04-27

Health Minister Edwin Poots marked the completion of the first phase of a pioneering research study aimed at making a significant improvement to the oral health of young children in Northern Ireland.

Northern Ireland has the highest level of childhood dental decay in the UK and in order to tackle this issue, a pioneering research trial involving a partnership between academia and healthcare professionals, has been commissioned and is now taking place across Northern Ireland.

This major trial aimed at improving children’s dental health – Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) – is the largest ever practice-based randomized control trial to investigate the prevention of tooth decay in young children. Around 1,200 children aged 2- 3 years together with 88 dental practitioners working in community and high street dentistry are taking part. The trial will evaluate the use of fluoride varnish and fluoride toothpaste in preventing dental decay. The trial will follow and monitor the oral health of participants over a three year period.

The findings from this pioneering study will be used to inform the development of future children’s dental health policy in Northern Ireland and across the UK and wider afield.

Speaking at an event to mark the successful recruitment of children onto the NIC-PIP Trial, the Health Minister Edwin Poots, said: “This is the first time that such a trial has been undertaken in Western Europe and is a major coup for Northern Ireland. Although we know that fluoride varnish works in clinically controlled environments, it has never been tested as to whether these topical fluorides are effective in ‘real life’ settings such as dental practices.

“If this trial is able to prove effectiveness and cost effectiveness of topical fluorides in dental practice, it will revolutionise how we care for young dental patients and will dramatically reduce dental caries in our population. It will also shift the focus of the dental service towards preventive care.”

Mr Michael Donaldson, Head of Dental Services, HSCB, highlighted the importance and unique partnership working of the trial. He said: “The HSCB sees the NIC-PIP Trial as world class research that will help commissioners and policy makers across the UK decide how best to prevent dental decay in young children’s teeth.

“It has a taken considerable time and effort from everyone involved to put this trial together. We have created a research infrastructure of dental practices, Trust dentists, clinical researchers and leading academics who are working incredibly well together. We have moved up a league with this trial and are now in a position to compete for funding for other large scale projects.”

Speaking at the event, Prof Martin Tickle, University of Manchester, outlined how the trial aimed to examine the effectiveness of applying fluoride varnish and the use of fluoride toothpaste, alongside dental education in preventing dental decay. He said: “Setting up and running this ground-breaking trial has been a very significant challenge, but I have been hugely impressed how the Health and Social Care Board and Trusts have supported the trial and how the dental community in Northern Ireland has come together to overcome all of the obstacles to make the trail work. The results of the trial will be very important to tell us how best to manage the dental care of young children in dental practice.”

Solveig Noble, Clinical Director of Community Dental Services, Northern Health and Social Services Trust, also outlined the significance of the trial in improving children’s dental health and reducing unnecessary suffering from tooth decay. She said: “As community dentists, we see young children in pain from advanced tooth decay on a daily basis. At this stage the only option is dental extractions under general anaesthetic in hospital. This is extremely traumatic for the child and their parents and often leads to increased anxiety for future dental treatment. In 2010, 5,595 children attended the Community Dental Service for dental extractions under general anaesthetic. We are therefore delighted to be involved in this groundbreaking research as our service actively supports preventative measures that will lead to the reduction of tooth decay in young children..”

Supporting this health prevention initiative, Carolyn Slee, who is providing a parent’s view to this study, said: “As a parent, I want to ensure the best possible dental health for my child and for my children to have healthy teeth.”

Local dentist, Marie Johnston, Knock Dental Surgery, Belfast, said: “I see at firsthand some of the 25% of children in Northern Ireland that present with tooth decay at their first dental visit. Tooth decay causes discomfort and pain for the child and feelings of distress for their parents. At Knock Dental Surgery we are very pleased to be involved in this research which will provide evidence of an effective method of reducing tooth decay in children and shape future best practice.”

Dr Peter Davidson, Director, NETSCC, HTA, National Institute for Health Research, said: “This funding demonstrates the commitment that the NIHR HTA programme has in supporting research which could lead to nationally important improvements in health related outcomes.”

Seamus Killough, BDA and member of the Trial Team said: ‘Dentists in Northern Ireland have a crucial role to play in the patient education and the promotion of good oral health. BDA is long on record as being keen that preventive measures, including those incorporating fluoride, must be enabled in the primary dental care setting. This clinical trial is a first for Northern Ireland and BDA is pleased that our members are involved throughout.’

The following local dentists together with community dental departments of each of the five Health and Social Care Trusts are participating in this clinical trial:

Colin Gardiner, Ballymena

Laura Jones, Ballymena

Stephen Bailie, Belfast

Adrian Farquharson, Belfast

Mark Haycock, Belfast

Marie Johnston, Belfast

Ben Goode, Coleraine

Matthew Preston, Coleraine

Liam Diamond, Cookstown

Philip McLorinan, Dunmurry

Derek Maguire, Portadown

Raymond Haugh, Kilkeel

Dermot Morgan, Kilkeel

Lesley McKee, Limavady

Paul Thompson, Lisburn

Gerry Cleary, Londonderry

Lynne Henderson, Maghera

Anne Gormley, Maghera

Jonne Knox, Newtownstewart

Douggie Thom, Portglenone

Michael McManus, Warrenpoint

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