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Notes: Abstract –  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〈inlineGraphic alt="inline image" href="urn:x-wiley:03015661:CDOE150:CDOE_150_mu1" location="equation/CDOE_150_mu1.gif"/〉 years. Comparison group received no intervention. Main outcome measures:  Mean dmft and proportion of participants with dmft 〉 0, dmft ≥ 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.

Notes: Abstract. The aim of this study was to assess the effectiveness of a dentifrice containing 0.3% triclosan, 2.0% copolymer and 0.243% sodium fluoride (Colgate Total®) in the prevention of periodontal attachment loss in adolescents. A 3-year, double-blind, randomised, controlled, clinical trial was conducted on 641 adolescents, initially aged 11–13 years. The participants were enrolled from schools in economically deprived areas of Manchester, England, which had a high % of Asian pupils originating from India, Pakistan and Bangladesh. After the baseline examination, which included assessments of pocket depth, attachment loss and subgingival calculus, the adolescents were randomly allocated to use either a triclosan/copolymer or control dentifrice. The control was identical to the test dentifrice with the exception that it did not contain triclosan/copolymer. Participants were re-examined after 18 and 36 months. After 3 years, a total of 239 adolescents remained in the test and 241 in the control group. The prevalence of attachment loss increased from 2% at baseline to 24% after 3 years. The mean increment of attachment loss during the study was 0.025 mm per site in the control group and 0.018 mm per site in the test group. A linear regression model showed a statistically significant difference in attachment loss between the test and control group, in adolescents with high mean pocket depths at baseline. No adverse effects attributable to the test or control dentifrices were observed during the study. This study has demonstrated that unsupervised use of a triclosan/copolymer dentifrice can significantly reduce periodontal attachment loss, particularly in adolescents with high mean pocket depths.

Notes: 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.

Notes: The aim of this in vitro study was to evaluate the ability of a dental subtraction radiography system to quantitatively detect differences in density between radiographic image pairs. Four periapical radiographs were taken of the upper first permanent molars on 5 human skulls using the Digora radiographic imaging system. The 4 images were a “baseline” image and 3 containing test objects consisting of either 0.5, 1 or 2 mm thick aluminium cylinders, 2.5 mm in diameter. Semi-automated image processing software was used to “warp” the 3 images with test objects into the same geometric/density registration as the corresponding baseline image using a process called patch minimization. “Difference” images were then produced and their contrast stretched. For regions of interest, with and without test objects present, the difference in density between the baseline and “test object” images was calculated using a reference aluminium step wedge. The test objects were clearly visible in all the “difference” images. The mean difference between the actual and estimated volume of the test object was 0.31 (95% CI [−0.55, 1.17]) mm3 Al. There was a strong association (r=0.83) between the actual and estimated aluminium volumes. It is concluded that this system provides adequate precision for clinical evaluation.