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Biomedical subjects

R M Davies

Publications and source records attributed to R M Davies.

At least 19 recordsLinked to original sources
PubMed2006

The prevalence and severity of fluorosis in children who received toothpaste containing either 440 or 1,450 ppm F from the age of 12 months in deprived and less deprived communities.

This study compared fluorosis in the upper central incisors of children from socially diverse backgrounds who had received either 440- or 1,450-ppm F toothpaste from 12 months of age. The children were resident in non-fluoridated districts in the north-west of England. They received either 440- or 1,450-ppm F toothpaste and advice regarding its use until the age of 5-6 years. Dental fluorosis (TF index) was assessed on digital images of dried teeth when the children (n = 1,268) were 8-10 years old. In the less deprived districts the prevalences of fluorosis (TF >or=0) for the 1,450- and 440-ppm F groups were 34.5 and 23.7% (p = 0.006). In the deprived districts the prevalences of fluorosis were 25.2 and 19.5% (p = 0.2). Overall the prevalences of TF >or=2 were 7 and 2.1% for the 1,450- and 440-ppm F groups and 2.2 and 0.2% for TF >or=3. These differences were statistically significant (p < 0.003). There was a strong association between the deprivation status of wards and fluorosis. Only 1 subject with a TF score of 3 was identified in the two most deprived quintiles of the Townsend score. It is concluded that careful targeting of programmes of this type to children living in high caries risk deprived communities carries only a small risk of aesthetically objectionable fluorosis (TF >2) whether low or high fluoride toothpastes are used. High fluoride (1,450 ppm F) toothpastes should not be provided on a community basis to very young children in less deprived communities.

Cariostatic Agents↗
PubMed2006

The effects of illumination and focal distance on light-induced fluorescence images in vitro.

When using quantitative light-induced fluorescence a number of factors can influence illumination level. The purpose of this study was to investigate, using a high-resolution camera and fibre-optic light source, the impact of illumination level and focal distance on common quantitative light-induced fluorescence outcomes. Twenty-four extracted teeth were examined using 6 illumination levels and 4 focal distances. Analysis was conducted using multiple linear regression models fitted to log DeltaQ, log DeltaF and log area with clustering of teeth and robust standard errors. Separate models were used for the different light and focal levels. The regression coefficients were significant for both DeltaQ and DeltaF but not area. Despite the significant regressions the actual effect was very small, and unlikely to confound clinical trial or practice results.

Dental Caries Activity Tests↗
PubMed2005

Effect of whitening gels on the surface roughness of restorative materials in situ.

Peroxide gels are effective in changing tooth colour but their effect on restorative materials has been poorly studied. The purpose of this investigation was to assess the impact of a commercially available whitening gel containing hydrogen peroxide and a sodium percarbonate formulation on the surface of restorative materials. A total of 12 subjects participated in a double-blinded crossover study. Each wore an intra-oral appliance containing five bovine enamel blocks restored with amalgam, posterior composite, microfilled composite, glass ionomer cement and porcelain. Appliances were worn continuously for 14 days and whitening products were applied twice daily. After 14 days the appliances were removed and values for roughness (R(a)) were obtained using atomic force microscopy. Mean values of R(a) were assessed between baseline and 14 days, and although minor variations were seen, there were no statistically significant differences detected for any material or any whitening product.

Analysis of Variance↗
PubMed2005

A staged intervention dental health promotion programme to reduce early childhood caries.

OBJECTIVE: This paper reports the results of a community trial to assess the effects of a multi-stage dental health promotion programme in reducing Early Childhood Caries (ECC). RESEARCH DESIGN: Two health districts (Primary Care Groups) were matched for dental disease levels and socio-demographic factors. One was randomly allocated to be the test Primary Care Group (PCG), the other the control PCG. Children in the test PCG received a series of interventions to support positive dental health behaviour from the age of 8 to 32 months. Interviews were conducted with parents of children aged 21 months and clinical examinations were undertaken on a larger cohort of children aged 3-4 years in test and control PCGs. SETTING: The interventions were gift bags containing a trainer cup, toothpaste containing 1,450 ppm F and toothbrush, and advice given to the children's parents on attendance at designated clinics and medical practices and further paste and brushes posted to the children's homes. Parents were interviewed on the telephone. Examinations took place at Children's Centres and nursery departments attached to primary schools. OUTCOME MEASURES: Severity and prevalence of ECC and general caries and proportion of parents reporting adopting dentally healthy behaviours. RESULTS: In the test PCG the prevalence of ECC in children who had received the interventions was 16.6% compared with 23.5% of children in the control area, a reduction of 29% (p=0.003). The mean dmft (1.17) and prevalence of general caries experience (28.7%) in the test children were also significantly lower than for children in the control PCG (1.72: 39.2%) (p=0.001). Analysis from a community perspective, which included data from all children examined in both areas, showed the prevalence of ECC in the test and control PCGs was 21.3% and 22.8% respectively and the mean dmft 1.47 and 1.72. The proportion with general caries experience remained statistically significant in favour of the test area 33.8% vs 39.9% (p=0.01). Parents in the test PCG were more likely to report cessation of bottle use (33% vs 18%), use of sugar-free drinks (49% vs 24%), commencement of brushing before first birthday (45% vs 27%) and twice daily brushing (52% vs 34%). CONCLUSION: The parents who received this multi-stage intervention were more likely to report adoption of three positive oral health behaviours; using a trainer cup from one year of age, using safe drinks and brushing twice daily with a fluoride toothpaste. The programme failed to reduce the prevalence of ECC in the community but the prevalence of ECC and general caries experience among the children who participated was less than among children in the control PCG.

Beverages↗
PubMed2004

Thermal effects of the Er:YAG laser on a simulated dental pulp: a quantitative evaluation of the effects of a water spray.

OBJECTIVES: To quantify the temperature increments in a simulated dental pulp following irradiation with an Er:YAG laser, and to compare those increments when the laser is applied with and without water spray. METHODS: Two cavities were prepared on either the buccal or lingual aspect of sound extracted teeth using the laser. One cavity was prepared with water spray, the other without and the order of preparation randomised. Identical preparation parameters were used for both cavities. Temperature increments were measured in the pulp chamber using a calibrated thermocouple and a novel pulp simulant. RESULTS: Maximum increments were 4.0 degrees C (water) and 24.7 degrees C (no water). Water was shown to be highly significant in reducing the overall temperature increments in all cases (p<0.001; paired t-test). None of the samples prepared up to a maximum of 135 J cumulative energy prepared with water spray exceeded that threshold at which pulpal damage can be considered to occur. Only 25% of those prepared without water spray remained below this threshold. DISCUSSION: Extrapolation of the figures suggests probably tolerable limits of continuous laser irradiation with water in excess to 160 J. With the incorporation of small breaks in the continuity of laser irradiation that occur in the in vivo situation, the cumulative energy dose tolerated by the pulp should far exceed these figures. CONCLUSIONS: The Er:YAG laser must be used in conjunction with water during cavity preparation. As such it should be considered as an effective tool for clinical use based on predicted pulpal responses to thermal stimuli.

Body Temperature↗
PubMed2004

The effectiveness of a toothpaste containing triclosan and polyvinyl-methyl ether maleic acid copolymer in improving plaque control and gingival health: a systematic review.

OBJECTIVE: To compare the effectiveness of triclosan/copolymer and fluoride dentifrices in improving plaque control and gingival health. SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register, MEDLINE (1986 to March 2003) and EMBASE (1986 to March 2003). Personal files and the reference lists of all articles were checked for further studies. SELECTION CRITERIA: Trials were selected if they met the following criteria: random allocation of participants; participants were adults with plaque and gingivitis; unsupervised use of dentifrices for at least 6 months; and primary outcomes - plaque and gingivitis after 6 months. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted information. For each plaque and gingivitis index, the mean differences for each study were pooled as weighted mean differences (WMDs) with the appropriate 95% confidence intervals (CIs) using the random effect models. MAIN RESULTS: Sixteen trials provided data for the meta-analysis. The triclosan/copolymer dentifrice significantly improved plaque control compared with a fluoride dentifrice, with a WMD of -0.48 (95% CI: -0.64 to -0.32) for the Quigley-Hein index and WMD of -0.15 (95% CI: -0.20 to -0.09) for the plaque severity index. When compared with a fluoride dentifrice, the triclosan/copolymer dentifrice significantly reduced gingivitis with WMDs -0.26 (95% CI: -0.34 to -0.18) and -0.12 (95% CI: -0.17 to -0.08) for the Loe and Silness index and gingivitis severity index, respectively.

Complex Mixtures↗
PubMed2004

Relationship between area deprivation and the anticaries benefit of an oral health programme providing free fluoride toothpaste to young children.

OBJECTIVE: To determine the effectiveness of providing free toothpaste containing either 1450 or 440 ppm F on caries experience in 5-year-old children living in areas with different levels of material deprivation. DESIGN: Five-year, examiner-blind, randomized, controlled, parallel-group, clinical trial. Children were randomly assigned to three groups. SETTING: Health Districts in the north-west of England with high levels of dental caries. Clinical examinations were performed in schools during the period October 1999 to April 2000 when the children were 5-6 years old. PARTICIPANTS: Children from 3-month birth cohorts resident in nine, nonfluoridated health districts. INTERVENTIONS: Toothpaste containing either 440 or 1450 ppm F and dental health literature posted at 3-month intervals and toothbrush provided annually from the age of 1-5 years. Comparison group received no intervention. MAIN OUTCOME MEASURES: Mean dmft and proportion of participants with dmft > 0, dmft > or = 4, upper primary incisor caries and extraction of one or more primary teeth. Outcomes tabulated for quartiles of participants based on the distribution of the Townsend index of material deprivation. RESULTS: A total of 3467 children were included in the final data analysis. The Townsend index was found to be useful in identifying groups of children with increased caries risk. Overall, participants in the programme using the high-fluoride toothpaste had significantly (P < 0.002) less caries than the comparison group with similar absolute reductions in mean dmft for the most- and least-deprived groups. Relative to the comparison group the association between deprivation and dental caries was changed so that in the most-deprived quartile those using the low-fluoride toothpaste tended to have less dental caries than the comparison group whereas in the least deprived they tended to have more. This difference in the association (slope) was statistically significant (P < 0.05). Provision of both low- and high-fluoride toothpaste appeared to reduce the risk of extractions for participants in the most-deprived quartile (P < 0.05). CONCLUSION: The relative benefits of the programmes supplying the two toothpastes considered in this study are different depending on the deprivation status of the participants. For the most-deprived groups postal provision of either a low- or high-fluoride toothpaste provides similar levels of benefit. In the less deprived groups only provision of the high-fluoride toothpaste provided a benefit. The absolute caries reduction seen for provision of the high-fluoride toothpaste was not related to the deprivation status and hence the programme did not reduce deprivation-related health inequalities. Targeting the programme using the methods employed in this study is unlikely to improve the effectiveness of the programme.

Cariostatic Agents↗
PubMed2004

Predictors of outcome for orofacial pain in the general population: a four-year follow-up study.

Orofacial pain is often persistent, but it is not clear why it lasts in some patients but not in others. We aimed to describe the natural course of orofacial pain in a general population sample over a four-year period and to identify factors that would predict the persistence of pain. A cross-sectional population-based survey was conducted in the United Kingdom, involving 2504 participants (participation rate 74%), of whom 646 (26%) reported orofacial pain. Overall, 424 (79% adjusted participation rate) of these individuals participated at the four-year follow-up, of whom 229 (54%) reported orofacial pain and 195 (46%) did not report such pain. Persistent orofacial pain was associated with females, older age, psychological distress, widespread body pain, and taking medication for orofacial pain at baseline. These findings may have implications for the identification and treatment of patients with orofacial pain.

Adolescent↗
PubMed2004

The prevalence and severity of fluorosis and other developmental defects of enamel in children who received free fluoride toothpaste containing either 440 or 1450 ppm F from the age of 12 months.

OBJECTIVE: To assess the impact of a programme regularly supplying free fluoride toothpaste to children on the prevalence and severity of fluorosis and other developmental defects of enamel. DESIGN: Randomised, controlled, parallel three-group clinical trial. Two groups received toothpaste containing either 440 or 1450 ppm F; the third group received no intervention. Children were supplied with toothpaste and advice on its use from the age of 12 months until they were 5-6 years old. The participants were a sub sample of those involved in a study that considered the caries benefits of providing free fluoride toothpaste. They were eligible if they completed the main study, lived in four of the nine districts involved and attended schools with 6 or more eligible participants. SETTING: Children from the north west of England consuming drinking water containing less than 0.1 ppm F were examined in primary schools. PARTICIPANTS: 3731 children completed the main study. Of the 1833 children in the four selected districts, 927 were from schools with six or more participants. METHOD: Digital images encompassing the upper and lower anterior sextants were taken of each child when they were 8-9 years old. MAIN OUTCOME MEASURES: Developmental defects of enamel and dental fluorosis (TF index) were recorded on upper central incisors from wet and dry images. RESULTS: A total of 703 children were included in the data analysis. In the 1450 ppm F (n=218), 440 ppm F (n = 226) and control (n = 259) groups the prevalence of dental fluorosis (TF > 0) was 17%, 15% and 12% for the wet (p > 0.05) and 26%, 24% and 25% for the dry (p > 0.05) photographs respectively. The prevalence of TF scores 2 or 3 (highest score) was 5%, 4% and 2% and for the wet (p > 0.05) and 7%, 4% and 5% for the dry (p > 0.05) photographs respectively. All subjects identified with TF score 3 were found in the group using the 1450 ppm F toothpaste (3 wet and 4 dry) and there were statistically significant differences between the three groups for both wet (p = 0.03) and dry photographs (p < 0.01). However, the pairwise comparisons between the groups failed to attain statistical significance. The highest prevalence and severity of demarcated opacities was seen in the control group and for the wet photographs the difference between the three groups attained statistical significance (p = 0.04). For both the wet and dry photographs the prevalence of any enamel defects (including fluorosis) and large demarcated or TF score 3 was similar for the three groups (p > 0.05). CONCLUSION: Previously it has been reported that only the provision of 1450 ppm F toothpaste provides anticaries benefits in a programme of this type. This benefit is accompanied by a slight increase in prevalence of TF score 3 but not the overall prevalence of developmental defects of enamel. Careful targeting and implementation of a programme of this type is required to maximise benefits and minimise risks of fluoride exposure.

Cariostatic Agents↗
PubMed2003

The rational use of oral care products in the elderly.

This review examines the evidence of the effectiveness of oral care products in preventing and controlling dental caries and periodontal disease in the ageing population. The strength of evidence is indicated using the following hierarchy: Type 1 (systematic reviews), Type 2 (randomised controlled trials), Type 3 (observational studies) and Type 4 (traditional reviews). Most of the evidence to support the effectiveness of fluoride products is extrapolated from studies involving children and adolescents. The few studies that have been performed in older adults suggest that fluoride toothpaste and, in the case of high caries risk individuals, the adjunctive use of other fluoride delivery systems, may be effective in preventing coronal and root caries. Some dentifrices containing triclosan have been shown to improve plaque control and gingival health and one, which contains triclosan/copolymer, reduces the progression of periodontitis in adults and high-risk individuals. Powered toothbrushes with an oscillation-rotation action are more effective in reducing plaque and improving gingival health than manual toothbrushes.

Aged↗
PubMed2003

Association between local mechanical factors and orofacial pain: survey in the community.

OBJECTIVES: The aetiology of orofacial pain (OFP) is not well understood. We aimed to determine the relationship between OFP and local mechanical factors in an unselected general population sample. METHODS: A cross-sectional population-based survey was conducted in the United Kingdom, involving 2504 participants (adjusted participation rate 74%). Postal questionnaire was used to collect information on OFP and local mechanical factors. RESULTS: A significant association was found between OFP and a history of tooth grinding, facial trauma, the jaw getting stuck or locked, a clicking or grating sound in the jaw joint when opening or closing the mouth, difficulty in opening the mouth wide, and chewing of pens or biting finger nails. The jaw getting stuck or locked had the highest relative risk of 2.7 (95% CI: 2.3-3.2). A history of orthodontic treatment, having any type of dentures and using chewing gum were not associated with OFP. There was some evidence of heterogeneity between types of OFP and local mechanical factors. CONCLUSIONS: Local factors play an important role in the aetiology of OFP.

Adolescent↗
PubMed2003

The rational use of fluoride toothpaste.

Well-formulated fluoride toothpastes are clinically proven to prevent and control dental caries. They may also be a risk factor in the aetiology of dental fluorosis. This review considers the available evidence to support the appropriate use of fluoride toothpaste to maximise the benefit and minimise the risk. Three factors have an important influence on the anticaries efficacy of fluoride toothpaste, namely concentration, frequency of brushing and post brushing rinsing behaviour. The evidence suggests that low-fluoride (<600 ppm F) toothpastes provide less caries protection than standard (1,000 ppm F) or high (1,500 ppm F) concentration formulations. However, low-fluoride toothpastes are appropriate for very young children (under 7 years) at low caries risk, particularly if living in fluoridated areas. For other young children, higher concentrations of fluoride should be used. Brushing should be recommended twice daily, whilst rinsing with large volumes of water should be discouraged. Small amounts of toothpaste are comparable in efficacy to large amounts. The risk of fluorosis is associated with the ingestion of high doses of fluoride during tooth development and consequently only young children are at risk. The variability in the dose of fluoride ingested is mainly a function of the amount used, less so its concentration. To minimise fluorosis risk, parents should be advised to use only a pea-sized amount of toothpaste and encourage spitting out of excess. It is concluded that by using fluoride toothpastes appropriately, the benefits can be maximised and the risks of fluorosis minimised.

Age Factors↗
PubMed2003

Factors associated with health care seeking behaviour for orofacial pain in the general population.

OBJECTIVE: To describe the health care seeking behaviour associated with orofacial pain (OFP) and determine factors associated with such behaviour. DESIGN: Cross-sectional population-based study using postal questionnaires. PARTICIPANTS: Adults aged 18-64 years from a general medical practice in south-east Cheshire, UK (participation rate 74%). RESULTS: Of the 2,504 respondents to the questionnaire 646 reported OFP, of whom 555 (86%) indicated whether or not they sought professional help. A total of 255 (46%) responded that they had sought advice. The majority had sought advice from their medical practitioner (57%) or dentist (51%), and 64% had taken medication because of OFP. The likelihood of seeking treatment increased linearly with age (p < 0.001) while gender, education and psychological distress did not show a significant association with seeking treatment. Persons who were regular dental attenders had an increased likelihood of seeking treatment for OFP (RR 1.4; 95% CI 1.1,1.8). Perception of illness had moderate association with healthcare seeking (RR 0.8; 95% CI 0.7,0.96). There was a significant trend of increasing RR with increasing total number of pain symptoms (p < 0.001), frequency of pain, duration of pain episodes, pain intensity and disability associated with pain. Participants who reported pain duration of more than three months had almost double the likelihood (RR 1.8; 95% CI 1.4,2.3) of seeking treatment. Decrease in self-reported control over pain and ability to decrease pain were both associated with an increased likelihood of seeking professional care (p < 0.001). CONCLUSIONS: The strongest predictors of health care seeking behaviour were different characteristics of pain.

Adolescent↗
PubMed2003

An assessment of the cost effectiveness of a postal toothpaste programme to prevent caries among five-year-old children in the North West of England.

OBJECTIVE: To assess the cost effectiveness of a postal toothpaste programme to prevent caries in 5-year-old children in the north west of England. PARTICIPANTS: Birth cohorts of children aged 12 months were recruited from high caries risk populations in nine health districts. DESIGN: The results of a randomised controlled trial to measure the effects of a postal toothpaste programme are used and related to the costs of running a similar programme. Children in the trial received free toothpaste on four occasions a year and a toothbrush once a year for four years from age 12 months to 5 years. When aged 5-6 years children were examined by trained, calibrated examiners using BASCD standards. Those who received toothpaste containing 1450 ppm F were found to have a significantly lower mean dmft than those who had not. The costs that would be incurred by a public dental service running such a postal toothpaste programme are identified, measured and related to the likely health improvement that could be achieved. MAIN OUTCOME MEASURES: The cost per tooth saved and the cost per child saved from caries experience and extraction experience. RESULTS: The estimated cost per tooth saved from carious attack was pounds sterling 80.83 and the cost per child of preventing caries experience was pounds sterling 424.38 and avoiding any extractions was pounds sterling 679.01. Analysis resulted in an overestimation of costs and underestimation of benefits. CONCLUSION: The programme achieved a significant caries reduction in children who received the 1450 ppm F toothpaste and the costs are now available to those considering provision of treatment services in areas where children are at high caries risk.

Cariostatic Agents↗
PubMed2002

Association between female hormonal factors and oro-facial pain: study in the community.

The aim of this study was to determine the relationship between the prevalence of oro-facial pain (OFP) in the population and female hormonal factors. The cross-sectional population study was conducted in a general medical practice in the north-west of England. A random sample of 4000 adults aged 18-65 years were mailed questionnaires, of whom 2504 responded (adjusted participation rate 74%). Of these 1245 women provided information on both OFP and hormonal factors. For pre- or peri-menopausal women, there was no relationship between oral contraceptive use and OFP (age-adjusted relative risk (RR) 1.10; 95% confidence interval (CI) 0.81, 1.45), whilst a high score on a pre-menstrual symptom questionnaire was associated with an age-adjusted RR of 1.87 (95% CI 1.36, 2.57). Those who reported menstruating for 6 days or longer had moderate increase in risk of OFP (age-adjusted RR 1.39; 95% CI 1.01, 1.91). In post-menopausal women, there was a moderate relationship between hormone replacement therapy use and OFP (age-adjusted RR 1.46; 95% CI 1.02, 2.08). For women overall, there was an increased risk of OFP in those who reported ever having had painful periods (age-adjusted RR 1.47; 95% CI 1.20, 1.80), but no association was found with the number of children. This cross-sectional community-based study adds important information on the relationship between female hormonal factors and OFP. Women who report OFP are more likely to report symptoms associated with menstruation. This may indicate either the importance of hormones per se or identify a group of women who are more likely to report symptoms in general.

Adolescent↗
PubMed2002

Sex hormonal factors and chronic widespread pain: a population study among women.

OBJECTIVE: The observation of higher rates of chronic widespread pain, the cardinal feature of fibromyalgia, in women has led to hypotheses about the role of sex hormonal factors in the aetiology of symptoms. There is little available evidence from epidemiological studies on their importance or role. METHODS: A population postal survey was carried out involving 1178 female participants living in south-east Cheshire in the north-west of England. RESULTS: Amongst pre- and peri-menopausal women, the risk of chronic widespread pain was unrelated either to the length of the menstrual cycle or the usual length of period reported by participants. Risk was similar in current users and non-users of the oral contraceptive pill, and amongst users there was no relationship with duration of use. However, the reporting of chronic widespread pain showed a relationship with total score on a premenstrual symptom questionnaire. However, this relationship was explained by pain symptoms. Amongst post-menopausal women, reporting chronic widespread pain was not related to age at menopause. An increased (but non-significant) risk of chronic widespread pain was associated with current hormone replacement therapy (HRT), which may be a consequence of HRT being prescribed for menopausal symptoms. CONCLUSION: This study, conducted on a large unselected population, has not demonstrated an association between sex hormonal factors and chronic widespread pain.

Adolescent↗
PubMed2002

A randomised controlled trial of the effectiveness of providing free fluoride toothpaste from the age of 12 months on reducing caries in 5-6 year old children.

OBJECTIVE: To assess the impact of regularly supplying free fluoride toothpaste regularly to children, initially aged 12 months, and living in deprived areas of the north west of England on the level of caries in the deciduous dentition at 5-6 years of age. A further aim was to compare the effectiveness of a programme using a toothpaste containing 440 ppmF (Colgate 0-6 Gel) with one containing 1,450 ppmF (Colgate Great Regular Flavour) in reducing caries. DESIGN: Randomised controlled parallel group clinical trial. Clinical data were collected from test and control groups when the children were 5-6 years old. SETTING: A programme of posting toothpaste with dental health messages to the homes of children initially aged 12 months. Clinical examinations took place in primary schools. PARTICIPANTS: 7,422 children born in 3-month birth cohorts living in high caries areas in nine health districts in north west England. Within each district children were randomly assigned to test or control groups. INTERVENTIONS: Toothpaste, containing either 440 ppmF or 1450 ppmF, and dental health literature posted at three monthly intervals to children in test groups until they were aged 5-6 years. MAIN OUTCOME MEASURES: The dmft index, missing teeth and the prevalence of caries experience. RESULTS: An analysis of 3,731 children who were examined and remained in the programme showed the mean dmft to be 2.15 for the group who had received 1,450 ppmF toothpaste and 2.49 for the 440 ppmF group. The mean dmft for the control group was 2.57. This 16% reduction between the 1,450 ppmF and control group was statistically significant (P<0.05). The difference between the 440 ppmF group and control was not significant. Further analyses to estimate the population effect of the programme also confirmed this relationship. CONCLUSION: This study demonstrates that a programme distributing free toothpaste containing 1,450 ppmF provides a significant clinical benefit for high caries risk children living in deprived, non-fluoridated districts.

Analysis of Variance↗