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Intervention Review

Recall intervals for oral health in primary care patients

  1. Paul V Beirne1,*,
  2. Jan E Clarkson2,
  3. Helen V Worthington3

Editorial Group: Cochrane Oral Health Group

Published Online: 17 OCT 2007

Assessed as up-to-date: 9 AUG 2007

DOI: 10.1002/14651858.CD004346.pub3


How to Cite

Beirne PV, Clarkson JE, Worthington HV. Recall intervals for oral health in primary care patients. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD004346. DOI: 10.1002/14651858.CD004346.pub3.

Author Information

  1. 1

    University College Cork, Brookfield Health Sciences Complex, Department of Epidemiology and Public Health, Wilton, Cork, Ireland

  2. 2

    University of Dundee, Dental Health Services Research Unit, Dundee, UK

  3. 3

    School of Dentistry, The University of Manchester, Cochrane Oral Health Group, MANDEC, Manchester, UK

*Paul V Beirne, Department of Epidemiology and Public Health, University College Cork, Brookfield Health Sciences Complex, College Road, Wilton, Cork, Ireland. p.beirne@ucc.ie.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 17 OCT 2007

SEARCH

This is not the most recent version of the article. View current version (19 DEC 2013)

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

The frequency with which patients should attend for a dental check-up and the potential effects on oral health of altering recall intervals between check-ups have been the subject of ongoing international debate for almost 3 decades. Although recommendations regarding optimal recall intervals vary between countries and dental healthcare systems, 6-monthly dental check-ups have traditionally been advocated by general dental practitioners in many developed countries.

Objectives

To determine the beneficial and harmful effects of different fixed recall intervals (for example 6 months versus 12 months) for the following different types of dental check-up: a) clinical examination only; b) clinical examination plus scale and polish; c) clinical examination plus preventive advice; d) clinical examination plus preventive advice plus scale and polish.
To determine the relative beneficial and harmful effects between any of these different types of dental check-up at the same fixed recall interval.
To compare the beneficial and harmful effects of recall intervals based on clinicians' assessment of patients' disease risk with fixed recall intervals.
To compare the beneficial and harmful effects of no recall interval/patient driven attendance (which may be symptomatic) with fixed recall intervals.

Search methods

We searched the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Reference lists from relevant articles were scanned and the authors of some papers were contacted to identify further trials and obtain additional information.
Date of most recent searches: 5th March 2007.

Selection criteria

Trials were selected if they met the following criteria: design - random allocation of participants; participants - all children and adults receiving dental check-ups in primary care settings, irrespective of their level of risk for oral disease; interventions - recall intervals for the following different types of dental check-ups: a) clinical examination only; b) clinical examination plus scale and polish; c) clinical examination plus preventive advice; d) clinical examination plus scale and polish plus preventive advice; e) no recall interval/patient driven attendance (which may be symptomatic); f) clinician risk-based recall intervals; outcomes - clinical status outcomes for dental caries (including, but not limited to, mean dmft/DMFT, dmfs/DMFS scores, caries increment, filled teeth (including replacement restorations), early carious lesions arrested or reversed); periodontal disease (including, but not limited to, plaque, calculus, gingivitis, periodontitis, change in probing depth, attachment level); oral mucosa (presence or absence of mucosal lesions, potentially malignant lesions, cancerous lesions, size and stage of cancerous lesions at diagnosis). In addition the following outcomes were considered where reported: patient-centred outcomes, economic cost outcomes, other outcomes such as improvements in oral health knowledge and attitudes, harms, changes in dietary habits and any other oral health-related behavioural change.

Data collection and analysis

Information regarding methods, participants, interventions, outcome measures and results were independently extracted, in duplicate, by two review authors. Authors were contacted, where deemed necessary and where possible, for further details regarding study design and for data clarification. A quality assessment of the included trial was carried out. The Cochrane Collaboration's statistical guidelines were followed.

Main results

Only one study (with 188 participants) was included in this review and was assessed as having a high risk of bias. This study provided limited data for dental caries outcomes (dmfs/DMFS increment) and economic cost outcomes (reported time taken to provide examinations and treatment).

Authors' conclusions

There is insufficient evidence from randomised controlled trials (RCTs) to draw any conclusions regarding the potential beneficial and harmful effects of altering the recall interval between dental check-ups. There is insufficient evidence to support or refute the practice of encouraging patients to attend for dental check-ups at 6-monthly intervals. It is important that high quality RCTs are conducted for the outcomes listed in this review in order to address the objectives of this review.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Recall intervals for oral health in primary care patients

The effects on oral health and the economic impact of altering the recall interval between dental check-ups (the time period between one dental check-up and the next) are unclear.
Primary care dental practitioners in many countries have traditionally recommended dental check-ups at 6-monthly intervals for patients.
Only one randomised controlled trial satisfied the eligibility criteria for this review. Due to the limited quantity and quality of the available evidence, no conclusions could be reached regarding the beneficial and harmful effects of varying recall intervals between dental check-ups. There is insufficient evidence to support or refute the practice of encouraging patients to attend for dental check-ups at 6-monthly intervals.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

回診間隔對於基層照護病患的口腔健康

這30年以來,國際上對於病患需作牙齒檢查的頻率以及改變回診間隔對口腔健康的可能影響一直有爭議。雖然對於適當的回診間隔依國家及牙醫健康照護系統的不同而異,大多數已開發國家的牙醫師傳統上會建議6個月的牙齒定期回診。

目標

評估不同的固定回診間隔(例如6個月或 12個月)對以下不同的牙齒檢查的好壞處: a)只有臨床檢查; b)臨床檢查加上洗牙(scale)磨光(polish); c)臨床檢查加上預防建議;d)臨床檢查加上洗牙磨光及預防建議。 評估各不同型式的牙齒檢查但相同固定回診間隔的相對益處及壞處。比較依照臨床醫師評估病人的疾病風險而給予之回診間隔與固定回診間隔的益處與壞處。比較沒有定期回診間隔或由病人自行決定的回診(可能是有症狀的)與有固定回診間隔的益處及壞處。

搜尋策略

我們搜尋了the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE資料庫。 搜尋有關文獻中的參考資料及聯絡部份文獻中的作者取得進一步的資訊。最近一次的搜尋日期是2007年3月5日。

選擇標準

選擇符合以下條件的試驗: 設計  受測試者以隨機分組;受試者  所有的小孩及成人,接受基層照護的牙科檢查,不論他們的口腔疾病的風險程度;處置  以下不同牙齒檢查的回診間隔:a)只有臨床檢查;b)臨床檢查加上洗牙磨光; c)臨床檢查加上預防建議;d)臨床檢查加上洗牙磨光及預防建議;e)沒有定期回診/病人自行回診(可能是有症狀的); f)臨床醫師依照風險程度的回診頻率; 結果  臨床狀況的結果如齲齒(包含,但不限於dmft/DMFT平均值、dmft/DMFT指數、齲齒增加、填補牙齒(包含替換填補物),早期終止或回覆早期齲齒);牙周病(包含但不限於牙菌斑,牙結石,牙齦炎,牙周病,牙周囊袋探測深度增加,牙周附著程度);口腔黏膜(有或無黏膜疾病,潛在惡性疾病,癌病變,診斷癌病變時的大小及分期)。 另外以下的結果若有報告也會被考慮:以病人為中心的結果,經濟成本的結果及其他結果如口腔衛生知識態度的改善,風險因子及飲食改變或其他與口腔衛生有關的行為變化。

資料收集與分析

由兩位回顧作者重複且獨立的收集研究的方法,受試者,處置,評估結果的方式及結果的資訊。 在有需要及可能的情況下,會聯絡作者,已進一步取得研究設計細節並釐清數據。 並評估納入試驗的品質及遵照Cochrane Collaboration 對統計的處理準則。

主要結論

在此回顧中只有1個研究(188個受試者)被收入,並且被評估為有嚴重的偏差。這個研究對於齲齒結果(dmfs/DMFS增加)及經濟成本結果(報告檢查及治療的時間)提供有限的資料。

作者結論

並沒有足夠證據可以對於改變牙齒檢查回診間隔的潛在益處與壞處作結論。也沒有足夠證據支持或反對鼓勵病人參與每6個月回診的醫療行為。因此重要的是針對本文獻回顧提出的結果需進行高品質的隨機對照試驗,以滿足本文獻回顧的目的。

翻譯人

本摘要由臺灣大學附設醫院張玉芳翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

改變牙齒檢查的回診間隔(在2次牙齒檢查間的時間間隔)對於口腔健康及經濟的影響的效果尚不清楚。在許多國家的基層牙醫師傳統上建議病人每6個月作牙齒檢查。只有1個隨機對照試驗符合在此回顧中的納入條件。基於數量及品質均僅有相當有限的證據,尚無法就不同的回診間隔的益處和壞處作結論。也沒有足夠證據支持或反對鼓勵病人參與每6個月定期的牙齒檢查。