A study led by Queen Mary’s Professor of Dental Public Health, Professor Cynthia Pine, has identified a low-cost and low-intensity intervention technique that could prevent tooth decay for thousands of children across the UK.
Nearly a quarter of five-year-olds in the UK experience tooth decay. During 2017-18, 33,779 children aged nine or under were admitted to hospital to have teeth extracted because of tooth decay. It is the single highest reason for children to be admitted to hospital and each extraction costs the NHS around £1,000.
While surgery deals with the immediate problem, it cannot stop future decay. In a study led by Professor Pine, researchers found that a single therapeutic conversation by trained dental nurses with families of children having teeth extracted has led to a 29 per cent reduction in risk of those children having new tooth decay.
Using behaviour change techniques to combat tooth decay
Professor Pine and her team developed a ‘talking’ intervention and trained dental nurses to have a therapeutic conversation with parents of children coming to have their children’s teeth taken out. The Dental Recur Brief Negotiated Interview (DR-BNI) is based on two methods – motivational interviewing and behaviour change techniques.
The trial ran in 12 centres in the UK with over 200 families of five to seven-year-old children having baby teeth extracted. Families had an equal chance of having the DR-BNI or a control conversation about new adult teeth.
DR-BNI focuses on how families can prevent tooth decay in the future. Rather than telling families what to do, they choose goals they feel they can do, like swapping sweet drinks for unsweetened ones or brushing their child’s teeth at bedtime. For the control conversation families, they were advised to visit the dentist as usual.
Change how we talk to parents about prevention
Professor Pine said: “This trial is important because we found that if we change how we talk to parents about prevention, their children go on to develop many fewer cavities.
“The key is helping parents to choose one or two behaviours they feel they can change for their child, rather than us telling parents what to do, that makes the difference.”
Children from the most deprived areas have more than twice the level of decay (34 per cent) than those from the least deprived (14 per cent). The main causes of tooth decay in children are too many sugary snacks and drinks, and not brushing teeth with fluoride toothpaste daily.
Significantly reducing the risk of new decay experience
In a wide range of high risk children across the UK, this single, low cost, low intensity intervention was successful in significantly reducing the risk of new decay experience. DR-BNI provides opportunities for dental nurses to go beyond clinical prevention to facilitate behaviour change, and to support oral health improvements for children at high risk of developing tooth decay.
The research team have now been invited by Health Education North West to develop the DR-BNI into a training module for dental nurses in the NHS. They plan to have the DR-BNI available by early Spring 2020.