Effectiveness of School Dental Screening to Reduce Untreated Caries: A Cluster-Randomized Controlled Trial

The aim of the study was to evaluate the effectiveness of dental screening plus referral to a specific treating facility (intervention arm) against screening plus advice letter to see a dentist (traditional screening, and control arm) on changes in untreated caries among primary schoolchildren. A cluster-randomized, assessor-blinded, controlled trial was conducted in 16 public schools in Riyadh city, Saudi Arabia. Children aged 6-11 years without any compromising medical condition were eligible for inclusion. Children were examined for dental caries at baseline and 12 months later. Parents reported their socio-demographic characteristics and their child use of dental services at baseline and follow-up. Differences in the number of decayed primary and permanent teeth between trial arms were assessed using 3-level mixed-effects models to account for the clustering of children within schools and baseline demographic differences between arms. Data from 1,098 children (537 in the intervention and 561 in the control arm) were analysed. In the mixed-effect model, no differences in the increment of decayed primary and permanent teeth were found between the intervention and control arms (rate ratio: 0.88; 95% CI: 0.53-1.06). No differences between arms were found in the proportion of children visiting the dentist either (secondary outcome). The findings of this trial provided no support for the effect of post-screening referral to a specific dental hospital, compared to traditional screening, on changes in untreated dental caries among primary schoolchildren.