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Objective: To systematically review evidence for interventions to prevent early childhood caries (ECC) in Indigenous children in high-income countries. Search strategy: In November 2016, we searched Medline (from 1946), Embase (from 1980), the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed (from 1996) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (from 1982) for randomised and quasi-randomised controlled trials including children aged 0-5 years. Outcomes included the decayed, missing and filled teeth (dmft) index or similar index; the number of children with reported pain or emergency dental visits because of pain; the number of children referred for dental care; plaque scores; the amount of oral debris present; change in parent/carer attitude or knowledge towards baby teeth; reported regular dental visits and adverse outcomes. Two authors independently screened for inclusion and assessed the risk of bias. Main results: Four trials reported in five papers with 2,311 participants were included. Interventions were fluoride varnish with counselling/health promotion, chlorhexidine varnish, and motivational interviewing techniques plus oral hygiene materials and a dental examination. Two trials showed fluoride varnish applied biannually over a 2-year period reduced caries prevalence (mean difference [MD]: -3.00; 95% confidence interval [CI]: -4.94 to -1.06; MD: -2.47; 95% CI: -2.57 to -2.37). Motivational interviewing with oral hygiene materials and a dental examination can reduce the number of carious lesions in children aged 30 months (d[subscript 2-4]efs > 0 MD: -5.10; 95% CI: -8.74 to -1.46; d[subscript 3-4]efs > 0; MD: -4.40; 95% CI: -7.55 to -1.25). Conclusion: Fluoride varnish applied biannually over 2 years is effective at reducing ECC in Indigenous children. Motivational interviewing has some benefit in caries prevention. Further research is required to test other preventive programmes.

Objective: The National Health and Hospitals Reform Commission Report suggests introducing an internship period for all newly qualified dental/oral health practitioners in Australia. This study gauged the opinions of undergraduates from three dental schools in Australia. Methods: An online survey collected demographic information on gender and age, the program registered for, year and place of study. The level of support for an internship was gauged using a five-point scale. Open-ended questions on the concerns, advantages and disadvantages of an internship concluded the survey. All students in the participating universities were invited to participate via email. Results: There were 445 responses. Forty per cent of students were supportive of an internship scheme. The level of support differed by gender, age, relationship status, having a previous tertiary qualification and year of study. Males, older participants, those with children and those with previous qualifications were less supportive. The main concerns related to issues around choice, family commitments, location of internship placements and salary levels. Conclusion: Support for an internship scheme for dental graduates elicited a divided opinion amongst dental students. Many issues around financing and logistics have to be addressed before any such scheme could be implemented in Australia: there is a need to consult with dental graduates and promote the benefits to the student body. (Contains 2 tables.)

Objective: The Tooth Smart Programme is a hospital-based parent-counselling programme established to stabilize existing carious lesions and prevent new caries in children. The purpose of this qualitative study was to: explore participating parents' experiences of and views about parent counselling; identify and describe factors that influence the uptake of oral health advice; and uncover any unanticipated outcomes of parent counselling. Methods: A purposively selected group of parents were invited to participate in, face-to-face, semi-structured interviews. Interviews were audio-recorded and transcribed. Transcripts were analyzed by qualitative thematic analysis. Results: Participants liked the programme sessions occurring in a hospital dental clinic. This approach was valued because it allowed a dental assessment to accompany the preventive advice. Most felt that they had been successful in increasing the frequency and quality of their child's tooth-brushing. Some reported that increased brushing reduced their child's dental pain. Conversely, most had found it hard to control their child's snacking on sugary foods and drinks. Conclusion: Future development of programmes should consider participants' expressed need for parent counselling to be provided in patient-centred sessions. (Contains 1 figure.)

Objective: (1) to provide a commentary on a conference held at the University of Manchester entitled Researching Water Fluoridation: Evaluation and Surveillance; (2) to synthesize from the proceedings of the meeting suggestions for future research and public health surveillance. Method: The main points and problematic issues raised by the speakers were documented and, together with information from other sources, used to construct an operational framework for the next stages in developing fluoridation research/ surveillance. Results: Critical areas were identified from the speakers' presentations and plenary discussions for which suggested ways forward were proposed. Important areas needing to be covered in future research/surveillance were then abstracted and tabulated. These included: participants, interventions, outcomes, sampling (sample frame and strategy), stratification, sample size, minimization of bias (blinding, examiner consistency), statistical methods, confounding variables, data requirements for ancillary analyses, and principal measurable adverse events. Conclusions: Covering the full range of criteria for comprehensive evaluation and surveillance would involve a number of complex, logistically demanding and costly procedures, including dietary intake monitoring and medical/dental clinical investigations. These would call for positive consent and compliance of target populations. It is suggested that a piecemeal research strategy, involving pilot studies and a series of separate, though probably linked, projects would be the optimum approach. The extent to which all the identified research/surveillance requirements could be met would depend on the availability of the necessary financial resources. (Contains 2 tables.)

Background and objective: Brushing for Life is intended to promote regular brushing of children's teeth with fluoride toothpaste. The programme is delivered by health visitors who provide toothbrushes, toothpaste and dental health education material at children's 8, 18 and 36 month development checks. The purpose of the present paper was to suggest how all aspects of the programme could be comprehensively assessed; to consider the prospects for its success in the light of evidence from the literature; to review the role of the programme within the wider field of oral health promotion; and to examine appropriate approaches to a quantitative evaluation of its outcome compared with alternatives. Methods: Evaluative reports, and studies of the benefits of toothbrushing in young children published in the literature, were collated. Relevant information was abstracted and assessed and a comprehensive evaluative approach to the programme was constructed and presented. Results: Good practice in dental public health suggested that following implementation, it would be important to ensure that the scheme was fully monitored and evaluated to establish that it was working effectively and giving value for money. Conclusions: Adoption of the programme as a national population-based strategy for the prevention of dental disease in children should depend on its being shown to be effective and economically efficient. (Contains 1 table and 1 figure.)

Background and Objective: The main purpose of this review was to rehearse the available evidence of good practice in dental public health in order to define policies that could improve oral health in the enlarged European Union and associated countries. Secondary objectives were to describe the basic principles of health service organisation and management, to examine available data on current oral health in Europe and some of its likely determinants--together with a brief overview of the organisation of dental services in the constituent countries--and to discuss aspects of policy related to the task of delivering oral health care, including organisational frameworks and resources, strategies and operations, management and the workforce, and monetary and other motivating incentives. Methods: Relevant literature was reviewed selectively and synthesised. Data were abstracted from appropriate papers and reports, and collated and analysed. Results: The information gained was used to suggest a series of strategies to help inform decision makers and those formulating oral health service policy in Europe. Conclusions: The review concludes with a list of suggestions and recommendations that are not intended to be prescriptive but which should point the way toward future progress. (Contains 3 tables and 3 figures.)

Abstract Background Dental caries (decay) is an international public health challenge, especially amongst young children. Early Childhood Caries is a rapidly progressing disease leading to severe pain, anxiety, sepsis and sleep loss, and is a major health problem particularly for disadvantaged populations. There is currently a lack of research exploring the interactions between risk and protective factors in the development of early childhood caries, in particular the effects of infant feeding practises. Methods/Design This is an observational cohort study and involves the recruitment of a birth cohort from disadvantaged communities in South Western Sydney. Mothers will be invited to join the study soon after the birth of their child at the time of the first home visit by Child and Family Health Nurses. Data on feeding practices and dental health behaviours will be gathered utilizing a telephone interview at 4, 8 and 12 months, and thereafter at 6 monthly intervals until the child is aged 5 years. Information collected will include a) initiation and duration of breastfeeding, b) introduction of solid food, c) intake of cariogenic and non-cariogenic foods, d) fluoride exposure, and e) oral hygiene practices. Children will have a dental and anthropometric examination at 2 and 5 years of age and the main outcome measures will be oral health quality of life, caries prevalence and caries incidence. Discussion This study will provide evidence of the association of early childhood feeding practices and the oral health of preschool children. In addition, information will be collected on breastfeeding practices and the oral health concerns of mothers living in disadvantaged areas in South Western Sydney.

This paper provides an overview of the dental management of patients with microstomia. A brief review of its etiology is presented, along with advice on planning preventive and operative care. [ABSTRACT FROM AUTHOR]