***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES It has been suggested that changes in the distribution of dental caries mean that targeting high-risk groups can maximize the cost effectiveness of dental health programs . This study aim ed to assess the effectiveness of a targeted school-based dental screening program in terms of the proportion of children with dental care needs it identified . METHODS The target population was all children in junior and senior kindergarten and grade s 2 , 4 , 6 , and 8 who attended schools in four Ontario communities . The study was conducted in a r and om sample of 38 schools stratified according to caries risk .  Universal screening was implemented in these schools . The parents of all children identified as having dental care needs were sent a short question naire to document the sociodemographic and family characteristics of these children . Children with needs were divided into two groups : those who would and who would not have been identified had the targeted program been implemented . The characteristics of the two groups were compared . RESULTS Overall , 21.0 percent of the target population were identified as needing dental care , with 7.4 percent needing urgent care . The targeted program would have identified 43.5 percent of those with dental care needs and 58.0 percent of those with urgent needs . There were substantial differences across the four communities in the proportions identified by the targeted program . Identification rates were lowest when the difference in prevalence of need between the high- and low-risk groups was small and where the low-risk group was large in relation to the high-risk group . The targeted program was more effective at identifying children from disadvantaged background s. Of those with needs who lived in households receiving government income support , 59.0 percent of those with needs and 80.1 percent of those with urgent needs would be identified . CONCLUSIONS The targeted program was most effective at identifying children with dental care needs from disadvantaged background s. However , any improvements in cost effectiveness achieved by targeting must be balanced against inequities in access to public health care re sources Objective To obtain consensus amongst a sample of primary care dentists in the North West of Engl and on a set of clinical criteria that should trigger referral following school dental screening . Design Delphi process . Setting Primary dental care , Engl and 2002 Method Primary care dentists in the North West of Engl and were r and omly selected to complete a two round ' Delphi exercise ' that included 10 potential referral criteria . The dentists were invited to express their level of support for the inclusion of each referral criterion . Main outcome measures Level of agreement for each referral criterion . Acceptance of any criterion was that the interquartile range should be no more than 3 scale points with the lower value being no less than 7 . Results Eighty-eight dentists , ( 72.7 % ) , completed the Delphi exercise . Six referral criteria met with the groups ' approval : Child with caries in permanent dentitionChild with darkened/discoloured permanent incisorsChild aged 9 - 10 years with overjet greater than 10 mmChild over six years with either gross plaque , calculus or swollen gumsChild with evidence of sepsisChild registered with a GDP with caries in permanent dentition . Conclusion It is possible for a representative sample of primary care dentists in the North West to agree referral criteria following school dental screening Background Recent studies have cast doubt on the effectiveness and efficiency of school based dental screening programmes in improving dental attendance or improving dental health . In 2002 the National Dental Inspection Programme was introduced in Scotl and which categorises children by their dental health and informs parents of the findings via a personalised letter home and encourages dental registration . In addition , epidemiological data for local and national planning purpose s is collected . This replaced an earlier school screening system in Lothian where a generic letter urging registration was sent to children who were identified as not being registered with a dentist . The objective of this study is to compare dental registration s rates among unregistered children in these two school inspection systems with a system where letters were sent home but no dental inspection was carried out . Methods The study was design ed as a single blinded , cluster r and omised , controlled trial involving 12,765 12–13-year-old children attending all 65 state Secondary schools in Lothian and Fife during the academic year 2003/4.After stratifying for school size and range of social deprivation , schools were r and omly allocated to one of four groups:1 . ' Traditional ' inspection , letter to unregistered children only,2 . Letter sent home to unregistered children only , no inspection,3 . National Dental Inspection Programme , letter to all children,4 . Control group in which the children were neither inspected nor sent a letter .  Dental Registration status was compared at baseline and 3 months post inspection . Results The registration levels in both the ' Traditional ' screening and the NDIP inspection groups rose 3 months post inspection ( 14 % and 15.8 % respectively ) but were not significantly different from one another or the control group which rose by 15.8 % ( p > 0.05 ) . The group who were sent a letter home but were not inspected also has a rise in registration levels of 18.1 % which was not significantly different from either of the groups who were inspected or the control group ( p > 0.05 ) . The only significant predictors of registration were previous registration ( p < 0.05 ) and within those who previously registered , the length of time since last registration ( P < 0.001 ) . Conclusion Neither of the two dental inspection methods nor a letter home to unregistered children result ed in a significant rise in registration rates in 12–13-year-olds compared to a control group of children who received no intervention The aim of this study was to assess the prevalence of condition-specific impacts on daily performances attributed to malocclusion in British adolescents . Two hundred 16- to 17-year-old adolescents were r and omly selected from 957 children attending a public college in London , UK . During interviews , participants provided information about demographic variables and socio-dental impacts on quality of life attributed to malocclusions , using the Condition-Specific form of the Oral Impacts on Daily Performances ( CS-OIDP ) index . Adolescents were also clinical ly examined using the Index of Orthodontic Treatment Need . Statistical comparison by covariates was performed using chi-squared test and chi-squared test for trends . The prevalence of oral impacts on daily performances attributed to any oral condition was 26.5 % whereas the prevalence of CS-OIDP attributed to malocclusion was 21.5 % . There was no statistically significant difference by sex , age , ethnicity or orthodontic treatment status of schoolchildren in the prevalence of CS-OIDP attributed to malocclusion ( P > /= 0.243 for all cases ) . However , there was a linear trend for the prevalence of CS-OIDP attributed to malocclusion , by level of normative orthodontic treatment need ( P = 0.042 ) . The prevalence of such impacts increased from 16.8 % for adolescents with no/slight need for orthodontic treatment , to 31.7 % for those with definite need for orthodontic treatment . Although findings support the idea that malocclusion has physical , psychological and social effects on quality of life of these adolescents , the inconsistencies in findings between the self-reports of impacts of malocclusion and the assessment of normative needs highlight the shortcomings of using only clinical indexes to estimate orthodontic treatment needs Objective To determine dental attendance and treatment outcomes following two models of dental screening . Design An observational prospect i ve cohort study . Setting Infant , primary and junior schools in the North West of Engl and .Subjects Children aged six to nine years at the start of the study . Interventions Subjects received a screening examination according to either a ' Traditional model ' or ' New model ' of school dental screeningMain outcome measures Attendance at a dentist within four months of the intervention and treatment received by children referred via the ' New model  ' with caries in their permanent teeth . Results In the ' New model ' of school dental screening 46 % of screened positive and 41 % of screened negative children attended a dentist during the study period . Some 44 % of children referred with caries in permanent teeth attended a dentist and 53 % of those attending received treatment for the referred condition . Larger proportions of children from disadvantaged background s were screened positive but higher proportions of children from more affluent background s attended the dentist and subsequently received treatment . Conclusion School dental screening has a minimal impact on dental attendance and only a small proportion of screened positive children receive appropriate treatment . The programme fails to reduce inequalities in utilisation of dental services The aim of this study was to determine the effectiveness of a school dental screening in encouraging school children aged 4 to 6 years to visit a dentist . One thous and five hundred and sixty-two children attending the 13 primary schools in Wallasey . Merseyside , were examined by a single trained examiner ; those with urgent treatment needs or evidence of recent treatment were excluded . The remaining 528 children with signs of dental caries were entered into the study . Children within each school were stratified by age , sex and number of carious teeth and then allocated at r and om to test and control groups . Parents of children in the test group were advised by letter that their child would benefit from a more detailed clinical examination . A reply slip was attached to the letter and non-responders were carefully followed up . The control group received no such interventions . After 4 months , data on dental visits by both test and control group children were extracted from clinical records . Attendance data were obtained for 262 children ( 97 per cent ) in the test group and 243 children ( 94 per cent ) in the control group . Seventy-three per cent of the test group and 42 per cent of the control group visited the dentist over the review period ; the difference of 31 per cent favour of the test group was statistically significant . Attendances at both general dental practitioners and community dental clinics were increased . The effect of the screening procedure was seen particularly in areas of lower socio-economic status . ( ABSTRACT TRUNCATED AT 250 WORDS Dental  screening of children in schools is undertaken in many countries . There is no evidence that this activity is effective . The objective of our study was to determine if school dental screening of children reduces untreated disease or improves attendance at the population level . A four-arm cluster-r and omized controlled trial was undertaken in the northwest of Engl and . In total , 16,864 children aged 6–9 years in 168 schools were r and omly allocated to 3 test groups , which received screening according to different models , and a control , which received no intervention . There were no significant differences in caries increment in the primary and secondary dentitions or in the proportions of children attending a dentist after screening between the control group and the 3 intervention arms . School dental screening delivered according to 3 different models was not effective at reducing levels of active caries and increasing attendance in the population under study The purpose of this study was to evaluate the effectiveness of a screening program and referral system in stimulating dental attendance of children in need of treatment at Bapuji Dental College and Hospital of Davangere , India . A total of fourteen schools in the Davangere area were selected r and omly and divided into two groups : seven schools that had a dental screening program ( study group , n=2100 children ) , and seven schools that did not have one ( control group , n=2400 children ) . The attendance rate by members of the study group was determined during the three-month period from the date of initiating the school screening program . During this same period the students who visited the college from the control group underwent a dental examination . Chi-square tests were used to test the difference between different variables . The response rate for seeking treatment was 31 percent for the study group ( 34.2 percent for males ; 26.2 percent for females ) and 10 percent for the control group ( 9.6 percent for males ; 10.5 percent for females ) . In both the groups , the treatment need was highest for dental caries ( study group=36.3 percent , control group=11.1 percent ) and least for fluorosis ( study group=21.2 percent , control group=1.2 percent ) . The study demonstrated that  screening  and motivation significantly improved the percentage of school children who sought dental care UNLABELLED The school dental screening programme has been in existence from the beginning of the 20th century yet its value in encouraging attendance among children with a dental health need is not fully established . OBJECTIVE To evaluate the effectiveness of school dental screening in promoting dental attendance among children with a treatment need and to examine the relative importance of screening , social class and other factors in dental attendance . METHODS Sixty-four participating schools were assigned to study and control groups using a stratified , blocked r and omisation technique . The study group children received the st and ard school dental screening and the dental attendance of those with a positive screening result was assessed after 2 months by means of a question naire issued to the children 's parents . The control group children were not , at this stage , screened , yet their parents received the same question naire assessing dental attendance  over the 2-month period . However , only question naires from control group children who had a positive result at a subsequent screening were retained for analysis . RESULTS A total of 2,321 children were screened , with 980 having a positive result . The mean dmft of those screening positive was 4.85 . In all , 664 completed question naires were returned , giving a response rate of 67.8 % . Dental attendance was reported among 45.5 % of the study group ( n=352 ) in the 2 months following screening . In the same period , 27.6 % of the control group ( n=312 ) cl aim ed attendance . The effect was found to be significant among the high employed group ( P<0.01 ) and the unemployed group ( P<0.05 ) . CONCLUSION School dental screening was capable of stimulating dental attendance . The strong effect among the lowest socio-economic group shows that school dental screening may be used to decrease dental health inequalities 
    Output:
    
There is currently no evidence to support or refute the clinical benefits or harms of dental screening .
CLINICAL SIGNIFICANCE Evidence from the review ed trials suggests no clinical benefit from school-based screening in improving  children 's oral health .