IQuaD dental trial; improving the quality of dentistry: a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of periodontal disease in dentate adults attending dental primary care

Jan E Clarkson; Craig R Ramsay; Paul Averely; Deborah Bonetti; Dwayne Boyers; Louise Campbell; Graham R Chadwick; Anne Duncan; Andrew Elders; Jill Gouick; Andrew F Hall; Lynne Heasman; Peter A Heasman; Penny J Hodge; Clare Jones; Marilyn Laird; Thomas J Lamont; Laura A Lovelock; Isobel Madden; Wendy McCombes; Giles I McCracken; Alison M McDonald; Gladys McPherson; Lorna E Macpherson; Fiona E Mitchell; John David Taylor Norrie; Nigel B Pitts; Marjon van der Pol; David Nj Ricketts; Margaret K Ross; James G Steele; Moira Swan; Martin Tickle; Pauline D Watt; Helen V Worthington; Linda Young

doi:10.1186/1472-6831-13-58

IQuaD dental trial; improving the quality of dentistry: a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of periodontal disease in dentate adults attending dental primary care

Jan E Clarkson, Craig R Ramsay, Paul Averely, Deborah Bonetti, Dwayne Boyers, Louise Campbell, Graham R Chadwick, Anne Duncan, Andrew Elders, Jill Gouick, Andrew F Hall, Lynne Heasman, Peter A Heasman, Penny J Hodge, Clare Jones, Marilyn Laird, Thomas J Lamont, Laura A Lovelock, Isobel Madden, Wendy McCombesGiles I McCracken, Alison M McDonald, Gladys McPherson, Lorna E Macpherson, Fiona E Mitchell, John David Taylor Norrie, Nigel B Pitts, Marjon van der Pol, David Nj Ricketts, Margaret K Ross, James G Steele, Moira Swan, Martin Tickle, Pauline D Watt, Helen V Worthington, Linda Young

Research output: Contribution to journal › Article › peer-review

17 Citations (Scopus)

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Abstract

Periodontal disease is the most common oral disease affecting adults, and although it is largely preventable it remains the major cause of poor oral health worldwide. Accumulation of microbial dental plaque is the primary aetiological factor for both periodontal disease and caries. Effective self-care (tooth brushing and interdental aids) for plaque control and removal of risk factors such as calculus, which can only be removed by periodontal instrumentation (PI), are considered necessary to prevent and treat periodontal disease thereby maintaining periodontal health. Despite evidence of an association between sustained, good oral hygiene and a low incidence of periodontal disease and caries in adults there is a lack of strong and reliable evidence to inform clinicians of the relative effectiveness (if any) of different types of Oral Hygiene Advice (OHA). The evidence to inform clinicians of the effectiveness and optimal frequency of PI is also mixed. There is therefore an urgent need to assess the relative effectiveness of OHA and PI in a robust, sufficiently powered randomised controlled trial (RCT) in primary dental care.Methods/designThis is a 5 year multi-centre, randomised, open trial with blinded outcome evaluation based in dental primary care in Scotland and the North East of England. Practitioners will recruit 1860 adult patients, with periodontal health, gingivitis or moderate periodontitis (Basic Periodontal Examination Score 0--3). Dental practices will be cluster randomised to provide routine OHA or Personalised OHA. To test the effects of PI each individual patient participant will be randomised to one of three groups: no PI, 6 monthly PI (current practice), or 12 monthly PI.Baseline measures and outcome data (during a three year follow-up) will be assessed through clinical examination, patient questionnaires and NHS databases.The primary outcome measures at 3 year follow up are gingival inflammation/bleeding on probing at the gingival margin; oral hygiene self-efficacy and net benefits.

Original language	English
Article number	58
Journal	BMC Oral Health
Volume	13
DOIs	https://doi.org/10.1186/1472-6831-13-58
Publication status	Published - 26 Oct 2013

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Clarkson, J. E., Ramsay, C. R., Averely, P., Bonetti, D., Boyers, D., Campbell, L., Chadwick, G. R., Duncan, A., Elders, A., Gouick, J., Hall, A. F., Heasman, L., Heasman, P. A., Hodge, P. J., Jones, C., Laird, M., Lamont, T. J., Lovelock, L. A., Madden, I., ... Young, L. (2013). IQuaD dental trial; improving the quality of dentistry: a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of periodontal disease in dentate adults attending dental primary care. BMC Oral Health, 13, Article 58. https://doi.org/10.1186/1472-6831-13-58

IQuaD dental trial; improving the quality of dentistry: a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of periodontal disease in dentate adults attending dental primary care. / Clarkson, Jan E; Ramsay, Craig R; Averely, Paul et al.
In: BMC Oral Health, Vol. 13, 58, 26.10.2013.

Research output: Contribution to journal › Article › peer-review

Clarkson, JE, Ramsay, CR, Averely, P, Bonetti, D, Boyers, D, Campbell, L, Chadwick, GR, Duncan, A, Elders, A, Gouick, J, Hall, AF, Heasman, L, Heasman, PA, Hodge, PJ, Jones, C, Laird, M, Lamont, TJ, Lovelock, LA, Madden, I, McCombes, W, McCracken, GI, McDonald, AM, McPherson, G, Macpherson, LE, Mitchell, FE, Norrie, JDT, Pitts, NB, van der Pol, M, Ricketts, DN, Ross, MK, Steele, JG, Swan, M, Tickle, M, Watt, PD, Worthington, HV & Young, L 2013, 'IQuaD dental trial; improving the quality of dentistry: a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of periodontal disease in dentate adults attending dental primary care', BMC Oral Health, vol. 13, 58. https://doi.org/10.1186/1472-6831-13-58

Clarkson JE, Ramsay CR, Averely P, Bonetti D, Boyers D, Campbell L et al. IQuaD dental trial; improving the quality of dentistry: a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of periodontal disease in dentate adults attending dental primary care. BMC Oral Health. 2013 Oct 26;13:58. doi: 10.1186/1472-6831-13-58

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abstract = "Periodontal disease is the most common oral disease affecting adults, and although it is largely preventable it remains the major cause of poor oral health worldwide. Accumulation of microbial dental plaque is the primary aetiological factor for both periodontal disease and caries. Effective self-care (tooth brushing and interdental aids) for plaque control and removal of risk factors such as calculus, which can only be removed by periodontal instrumentation (PI), are considered necessary to prevent and treat periodontal disease thereby maintaining periodontal health. Despite evidence of an association between sustained, good oral hygiene and a low incidence of periodontal disease and caries in adults there is a lack of strong and reliable evidence to inform clinicians of the relative effectiveness (if any) of different types of Oral Hygiene Advice (OHA). The evidence to inform clinicians of the effectiveness and optimal frequency of PI is also mixed. There is therefore an urgent need to assess the relative effectiveness of OHA and PI in a robust, sufficiently powered randomised controlled trial (RCT) in primary dental care.Methods/designThis is a 5 year multi-centre, randomised, open trial with blinded outcome evaluation based in dental primary care in Scotland and the North East of England. Practitioners will recruit 1860 adult patients, with periodontal health, gingivitis or moderate periodontitis (Basic Periodontal Examination Score 0--3). Dental practices will be cluster randomised to provide routine OHA or Personalised OHA. To test the effects of PI each individual patient participant will be randomised to one of three groups: no PI, 6 monthly PI (current practice), or 12 monthly PI.Baseline measures and outcome data (during a three year follow-up) will be assessed through clinical examination, patient questionnaires and NHS databases.The primary outcome measures at 3 year follow up are gingival inflammation/bleeding on probing at the gingival margin; oral hygiene self-efficacy and net benefits.",

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T2 - a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of periodontal disease in dentate adults attending dental primary care

AU - Clarkson, Jan E

AU - Ramsay, Craig R

AU - Averely, Paul

AU - Bonetti, Deborah

AU - Boyers, Dwayne

AU - Campbell, Louise

AU - Chadwick, Graham R

AU - Duncan, Anne

AU - Elders, Andrew

AU - Gouick, Jill

AU - Hall, Andrew F

AU - Heasman, Lynne

AU - Heasman, Peter A

AU - Hodge, Penny J

AU - Jones, Clare

AU - Laird, Marilyn

AU - Lamont, Thomas J

AU - Lovelock, Laura A

AU - Madden, Isobel

AU - McCombes, Wendy

AU - McCracken, Giles I

AU - McDonald, Alison M

AU - McPherson, Gladys

AU - Macpherson, Lorna E

AU - Mitchell, Fiona E

AU - Norrie, John David Taylor

AU - Pitts, Nigel B

AU - van der Pol, Marjon

AU - Ricketts, David Nj

AU - Ross, Margaret K

AU - Steele, James G

AU - Swan, Moira

AU - Tickle, Martin

AU - Watt, Pauline D

AU - Worthington, Helen V

AU - Young, Linda

PY - 2013/10/26

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N2 - Periodontal disease is the most common oral disease affecting adults, and although it is largely preventable it remains the major cause of poor oral health worldwide. Accumulation of microbial dental plaque is the primary aetiological factor for both periodontal disease and caries. Effective self-care (tooth brushing and interdental aids) for plaque control and removal of risk factors such as calculus, which can only be removed by periodontal instrumentation (PI), are considered necessary to prevent and treat periodontal disease thereby maintaining periodontal health. Despite evidence of an association between sustained, good oral hygiene and a low incidence of periodontal disease and caries in adults there is a lack of strong and reliable evidence to inform clinicians of the relative effectiveness (if any) of different types of Oral Hygiene Advice (OHA). The evidence to inform clinicians of the effectiveness and optimal frequency of PI is also mixed. There is therefore an urgent need to assess the relative effectiveness of OHA and PI in a robust, sufficiently powered randomised controlled trial (RCT) in primary dental care.Methods/designThis is a 5 year multi-centre, randomised, open trial with blinded outcome evaluation based in dental primary care in Scotland and the North East of England. Practitioners will recruit 1860 adult patients, with periodontal health, gingivitis or moderate periodontitis (Basic Periodontal Examination Score 0--3). Dental practices will be cluster randomised to provide routine OHA or Personalised OHA. To test the effects of PI each individual patient participant will be randomised to one of three groups: no PI, 6 monthly PI (current practice), or 12 monthly PI.Baseline measures and outcome data (during a three year follow-up) will be assessed through clinical examination, patient questionnaires and NHS databases.The primary outcome measures at 3 year follow up are gingival inflammation/bleeding on probing at the gingival margin; oral hygiene self-efficacy and net benefits.

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