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NIHR Signal Cartoons are promising for reducing dental anxiety in children
Cartoons delivered on laptops, projectors or 3D goggles with sound can help distract anxious children who fear dental procedures. Dental anxiety can prevent children from attending the dentist for care, and this type of distraction could offer a useful tool to help them. This review looked at a range of audiovisual approaches tested in trials of healthy children receiving dental treatment under local anaesthetic. The children were assessed for physiological measures related to emotional state (...
NIHR Signal Redesigning oral surgery with enhanced primary dental care, electronic referral and triage may save overall costs
An electronic referral system including consultant-led triage and an advanced oral surgery service in primary care results in fewer people requiring oral surgery in hospital. It comes at a lower overall cost than the previous arrangement. About two-thirds of patients could be treated safely in enhanced primary settings rather than hospital. This NIHR-funded study implemented several changes, an electronic referral system which standardised and improved the level of information provided in refer...
NIHR Signal Pilocarpine improves dry mouth caused by radiotherapy
Out of several treatments tested, the drug pilocarpine gave the most significant improvement in dry mouth following radiotherapy for head and neck cancer. Less dry mouth and increased salivary flow were twice as likely after taking pilocarpine than after a dummy pill. Dry mouth from radiotherapy impairs quality of life. Although people can try simple measures at home, such as sucking ice cubes, they may wish to discuss pilocarpine treatment with their GP. Side effects from this medication are u...
NIHR Signal Fluoride varnish every six months helps protect children’s permanent teeth from decay
Fluoride varnish and fissure sealant are equally good at preventing tooth decay on children’s first permanent back teeth when applied to six or seven year olds in South Wales. Six applications of fluoride varnish were less expensive, by about £68 per child, for the NHS at 36 months compared to applying the more expensive fissure sealant. Children’s permanent back teeth are particularly vulnerable to decay when they first come through. The pitted biting surface can make these t...
NIHR Signal Chlorhexidine mouthwash is useful short-term for people with mild gum disease
In people with mild gum disease chlorhexidine mouthwash, in addition to tooth brushing, reduces plaque build-up in the first weeks or months of use. However, when used for longer than four weeks chlorhexidine mouthwash can lead to tooth staining and a build-up of chalky deposits on the teeth, called tartar. There is insufficient evidence to assess its effectiveness in people with moderate to severe gum disease. Plaque is a sticky bacteria-filled substance that forms on teeth and can cause gum d...
NIHR Signal Fluoride-based treatments alone are not enough to stop tooth decay in young children
Providing a set of additional fluoride-based treatments at dental appointments for children aged two to three years was no better than health education at preventing tooth decay. A range of public health measures to reduce sugar consumption are also needed. The treatment involved providing fluoride toothpaste and applying a fluoride varnish to the teeth at each six-monthly appointment for three years. This large NIHR-funded trial in Northern Ireland found no difference in the number of childre...
NIHR Signal Regular use of fluoride mouthrinse is an option to reduce tooth decay in school children
A reduction intooth decay of about 27% can be expected from the supervised regular use of fluoride mouthrinsing by school children. Tooth decay has a significant impact on health and wellbeing. It is more common in disadvantaged communities and can be prevented by good oral hygiene and diet with reduced sugar intake. Children and young people are encouraged to brush their teeth regularly with fluoride toothpaste and some schools in the UK have supervised programmes to encourage this. This revi...
NIHR Signal “Shallow” treatments of adjacent teeth and their surfaces might be effective in slowing tooth decay
This review found that new surface and shallow dental procedures, called micro-invasive treatments, reduce tooth decay by about three quarters. The treatments for adults were applied to the surfaces of teeth that touch or are next to each other. Four types of treatment were compared with non-invasive strategies such as advice on flossing or the application of fluoride varnish. There were too few trials to determine which micro-invasive technique is best, or for which groups of patients it was mo...
NIHR Signal A supervised toothbrushing programme in nurseries reduced dental treatment costs
This cost analysis showed that a Scotland-wide programme of supervised toothbrushing in nurseries is linked to large savings in dental treatment costs because of the reduced levels of tooth decay in five year-old children. In the eighth year, the programme saved more than two and a half times the programme’s cost of implementation. The greatest reductions in treatment costs were in deprived areas. This study was conducted in Scotland, where the government and health service have prioritis...
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