Title: 0089 - Annual “Big-Bang” Prevention is Effective on Occlusal and Smooth Surfaces


Santosh Tadakamadla (Presenter)
Griffith University

Ratilal Lalloo, The University of Queensland
Jeroen Kroon, Griffith University, Queensland
Ohnmar Tut, Griffith University
Sanjeewa Kularatna, Queensland University of Technology
Newell Johnson, Griffith University


Objectives: Provision of professional dental care is costly and unsustainable in remote Australia. We hypothesised that an annual “Big Bang” using known preventive interventions would be effective and potentially cost-effective. The objective here is to present the efficacy of the intervention differentiated by type of tooth surface.

Methods: In 2015 and 2016 Fissure Sealants, Povidone Iodine and Fluoride Varnish were applied to consenting children in a remote Indigenous community in Far North Queensland. Those without consent constituted a natural control group. Clinical examination for dental caries at baseline (2015), one and two year follow-up, was conducted using ICDAS II which involves scoring each surface of all teeth for dental caries and restorations based on established criteria. Outcome was the cumulative number of surfaces with new caries (caries incidence) at one and two years follow-up in deciduous and permanent dentitions

Results: 408 children participated at baseline while 141 (35%) and an additional 59, totalling 200 (49%) failed to attend at one and 2 years respectively. Caries incidence on occlusal surfaces was less in children receiving the intervention (1.12±1.41) than those without (2.05±2.09, p<0.0001) after one year. The intervention was also effective on smooth/proximal surfaces with lower caries incidence in the intervention group (3.27±4.23) than the control group. (4.96±5.34, p=0.005). Similarly, the intervention was effective after two annual applications at two years follow-up with lower caries incidence being observed on both occlusal (1.58±1.65 vs 2.35±2.27, p=0.008) and smooth+proximal surfaces (4.22±5.14 Vs 5.88±4.78, p=0.018) in intervention than the control group.

Conclusions: Annual application of Fissure Sealants, where clinically indicated, then Povidone Iodine then Fluoride Varnish was equally effective in reducing caries incidence on occlusal and smooth+proximal surfaces at both one and two years follow-up. Annual preventive intervention is feasible, effective, and likely to be cost-effective for remote communities without resident oral health professionals.

This abstract is based on research that was funded entirely or partially by an outside source:
National Health and Medical Research Council of Australia (NHMRC) Project Grant ID #1081320

Disclosure Statement:
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: NONE