ArticleBMJ open2020
Evaluation of a national complex oral health improvement programme: a population data linkage cohort study in Scotland.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of School Fluoride Delivery Programs: A Community Guide Systematic Review.American journal of preventive medicine · 2025Pooled it
- Exploring brushing and questionnaire data from a feasibility randomised control trial of a school-based smart, connected toothbrushing program.BMC oral health · 2025Trial
- Clinical effectiveness/child-patient and parent satisfaction of two topical fluoride treatments for caries: a randomised clinical trial.Scientific reports · 2024Trial
- Economic Evaluation of the Protecting Teeth @ 3 Randomized Controlled Trial.JDR clinical and translational research · 2023Trial
- Early twice-daily toothbrushing and adolescent dental caries: a causal inference analysis using the Longitudinal Study of Australian Children.BMC oral health · 2026Article
- Structural Embedding of Oral Health Within Pooled Universal Coverage Mechanisms: Where Are We in 2026?Healthcare (Basel, Switzerland) · 2026Review
- Outcome of a National Education Program on Supervised Daily Toothbrushing and Biannual Fluoride Varnish Application on Dental Caries in Chilean Preschool Children: An Ecological Cohort Study.Caries research · 2026Article
- Successful Oral Health Interventions for Children Living in Vulnerable Circumstances - A Scoping Review.International dental journal · 2025Article
- Developing a Prototype Home-Based Toothbrushing Support Tool for Families in Scotland: A Mixed-Methods Study With Modified Delphi Survey and Semi-Structured Interviews.Community dentistry and oral epidemiology · 2025Article
- Caregivers' views on childcare staff's role in promoting children's oral health.BMC oral health · 2025Article
- A Cohort Study on the Impact of Oral Health on the Quality of Life of Adolescents and Young Adults.Clinics and practice · 2025Article
- Knowledge, attitude and practice of caries prevention in children among Bhutanese oral health professionals.International journal of paediatric dentistry · 2025Article
- A Communication Toolkit to Assist Families Access Dental Care Services in Scotland: A Qualitative Evaluation.Dentistry journal · 2025Article
- Association between lesion depth and placement technique with failures requiring extraction of preformed metal crowns in primary molars. A retrospective study.European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry · 2025Article
- Improving children's oral health in Wales through partnership.BMJ paediatrics open · 2024Article
- Inequalities in children's tooth decay requiring dental extraction under general anaesthetic: a longitudinal study using linked electronic health records.BMJ public health · 2024Article
- Estimated impact of the UK soft drinks industry levy on childhood hospital admissions for carious tooth extractions: interrupted time series analysis.BMJ nutrition, prevention & health · 2023Article
- Caries Preventive Interventions and Oral Health Inequalities: A Scoping Review.JDR clinical and translational research · 2023Article
- Inequalities in access to NHS primary care dental services in Scotland during the COVID-19 pandemic.British dental journal · 2023Article
- The impact of dental care programs on healthcare system and societal outcomes: a scoping review.BMC health services research · 2022Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesChild dental caries is a global public health challenge with high prevalence and wide inequalities. A complex public health programme (Childsmile) was established. We aimed to evaluate the reach of the programme and its impact on child oral health.
settingEducation, health and community settings, Scotland-wide.
interventionsChildsmile (national oral health improvement programme) interventions: nursery-based fluoride varnish applications (FVAs) and supervised daily toothbrushing, community-based Dental Health Support Worker (DHSW) contacts and primary care dental practice visits-delivered to the population via a proportionate universal approach.
participants50 379 children (mean age=5.5 years, SD=0.3) attending local authority schools (2014/2015).
designPopulation-based individual child-level data on four Childsmile interventions linked to dental inspection survey data to form a longitudinal cohort. Logistic regression assessed intervention reach and the independent impact of each intervention on caries experience, adjusting for age, sex and area-based Scottish Index of Multiple Deprivation (SIMD). OUTCOME MEASURES: Reach of the programme is defined as the percentage of children receiving each intervention at least once by SIMD fifth. Obvious dental caries experience (presence/absence) is defined as the presence of decay (into dentine), missing (extracted) due to decay or filled deciduous teeth.
results15 032 (29.8%) children had caries experience. The universal interventions had high population reach: nursery toothbrushing (89.1%), dental practice visits (70.5%). The targeted interventions strongly favoured children from the most deprived areas: DHSW contacts (SIMD 1: 29.5% vs SIMD 5: 7.7%), nursery FVAs (SIMD 1: 75.2% vs SIMD 5: 23.2%). Odds of caries experience were markedly lower among children participating in nursery toothbrushing (>3 years, adjusted OR (aOR)=0.60; 95% CI 0.55 to 0.66) and attending dental practice (≥6 visits, aOR=0.55; 95% CI 0.50 to 0.61). The findings were less clear for DHSW contacts. Nursery FVAs were not independently associated with caries experience.
conclusionsThe universal interventions, nursery toothbrushing and regular dental practice visits were independently and most strongly associated with reduced odds of caries experience in the cohort, with nursery toothbrushing having the greatest impact among children in areas of high deprivation.
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