"Strong Teeth": the acceptability of an early-phase feasibility trial of an oral health intervention delivered by dental teams to parents of young children

Genetic Association between the Risk of Dental Caries and MTR Gene Polymorphism in Chinese Children

Early childhood caries (ECC) is common in children. Little is known about the genetic association of the methionine synthesis reductase (MTRR) gene rs1801394 and methionine synthetase (MTR) gene rs1805087 polymorphisms with ECC, which was examined in the Chinese Han population. Genotyping was performed using the buccal mucosa from 150 normal and 150 ECC children. For genotype and allele distribution comparison, Chi-square test and multiple logistic regression analysis were performed. The odd ratio (OR) and 95% confidence interval (CI) were calculated. MTR gene rs1805087 AG genotype distribution in the ECC group was clearly different from the control group (P = 0.029), and the ECC risk in cases with AG genotype was 0.525 times lower than those carrying AA genotype (95% CI = 0.292-0.942). Logistic regression analysis after adjustment for other clinical indicators determined that the MTR gene rs1805087 AG genotype was still strongly associated with susceptibility to ECC (OR = 0.499, 95% CI = 0.273-0.913, P = 0.024). Significant association was also seen for sugary food intakes (OR = 1.965, 95% CI = 1.162-3.321, P = 0.012), tooth brushing (OR = 0.569, 95% CI = 0.356-0.924, P = 0.023) and sex (OR = 0.562, 95% CI = 0.349-0.907, P = 0.018) with ECC risk. No notable genetic association was found between MTRR gene rs1801394 polymorphism and ECC risk. MTR gene rs1805087 polymorphism may aggrandize the susceptibility to ECC, and AA genotype appeared to be a dangerous element for the development of ECC.

"Strong Teeth": an early-phase study to assess the feasibility of an oral health intervention delivered by dental teams to parents of young children

BACKGROUND

Tooth decay (caries) is a significant health burden in young children. There is strong evidence for the benefits of establishing appropriate home-based oral health behaviours in early childhood. Dental teams are well placed to provide this information and there is clear advice on what oral health information should be given to parents. However, research has shown that there is limited guidance, training and resources on how dental teams should deliver this advice. "Strong Teeth" is a complex oral health intervention, using evidence-based resources and training underpinned by behaviour change psychology, to support behaviour change conversations in dental practice. This early phase evaluation aims to assess the feasibility of this intervention, prior to a full-scale trial.

METHODS

The study recruited 15 parents of children aged 0-2-years-old and 21 parents of children aged 3-5 years old, from five NHS dental practices across West Yorkshire. Participant demographics, self-reported brushing behaviours, dietary habits, a dental examination and three objective measures of toothbrushing were collected in a home-setting at baseline, then at 2-weeks and 2-months post-intervention. Recruitment, retention and intervention delivery were analysed as key process outcomes. Brushing habits were compared to national toothbrushing guidelines - the Delivering Better Oral Health toolkit (Public Health England).

RESULTS

Strong Teeth was feasible to deliver in a General Dental Practice setting in 94% of cases. Feasibility of recruitment (37%) exceeded progression criterion, however retention of participants (75%) was below the progression criterion for the 0-2 age group. More than half of children recruited aged 3-5-years had caries experience (52%). Total compliance to toothbrushing guidance at baseline was low (28%) and increased after the intervention (52%), an improvement that was statistically significant. Dietary habits remained largely unchanged. Plaque scores significantly decreased in the 3-5-year-olds and toothbrushing duration increased in all age groups.

CONCLUSION

"Strong Teeth" intervention delivery and data collection in the home setting was feasible. There was a positive indication of impact on reported toothbrushing behaviours. Some amendments to study design, particularly relating to the inclusion of the 0-2-year-old group, should be considered before progression to a full trial. Trial registration ISRCTN Register: ISRCTN10709150. Registered retrospectively 24/7/2019.