***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: Sound evidence on the effectiveness of fluoride varnishes ( FV ) to reduce caries incidence  in preschool children is lacking . Objective : To assess whether the application of FV  in preschool children at 6-month intervals decreases the incidence of caries and produces any adverse effects . Methods : A r and omized , examiner- and patient-blind , placebo-controlled , parallel-group design , clinical trial , comprising 1- to 4-year-old children , 100 in each group ( FV or placebo varnish , PV ) , was conducted in Rio de Janeiro , Brazil . Two trained pediatric dentists performed the clinical examinations ( kappa = 0.85 ) . Dental caries was recorded at the d2 ( cavitated enamel ) and d3 ( dentine ) levels using the International Caries Diagnosis and Assessment System . Results : At baseline , the mean age of the participants was 2.4 years ( SD 0.9 ) and the mean d3mfs was 0.8 ( SD 1.9 ) . Most of the children brushed their teeth with fluoride toothpaste and consumed fluori date d tap water . After 24 months , 89 and 92 children of the test and the control groups were analyzed , respectively . A total of 32 ( 35.9 % ) children in the FV group and 43 ( 46.7 % ) in the PV group presented new dentine caries lesions ( χ2 test ; p = 0.14 ) , showing relative and absolute risk reductions of 23 % ( 95 % CI : -9.5 to 45.9 ) and 11 % ( 95 % CI : -3.5 to 25.0 ) . The mean caries increment differences between the test and control groups were -0.8 ( 95 % CI : -2.0 to 0.4 ) at the d2 level and -0.7 ( 95 % CI : -1.9 to 0.4 ) at the d3 level . Only 2 minor complaints regarding the intervention were reported . Conclusion : Although safe and well accepted , twice-yearly professional FV application , during 2 years , did not result in a significant decrease in caries incidence OBJECTIVES A split-mouth r and omized clinical trial was carried out to assess the effectiveness of a school-based dental sealant ( SBDS ) program for French children from low-income background s. The secondary objectives were to determine the effectiveness of the program according to the baseline individual caries risk ( ICR ) and to assess the sealant retention . METHODS The study included 276 pupils from Nice . The sealing was performed in the first or second grade s. The permanent first molars were r and omized into two groups : one received resin-based sealant and the other no treatment .  Active caries on permanent and temporary teeth , visible plaque , Streptococcus mutans ( SM ) and Lactobacillus counts were recorded at baseline to assess ICR . An intent-to-treat analysis was performed based on the occurrence of new caries at 1 year of follow-up ( study outcome ) . Univariate and multivariable conditional tooth-matched logistic regression analyses ( Proc phreg ; SAS ) were used to assess the effectiveness of the SBDS program . RESULTS At 1 year of follow-up , 253 children ( 421 pairs ) remained in the analysis . In the adjusted analysis , first permanent molars that received sealants were less at risk of developing new caries at 1 year of follow-up compared with those from the control group ( OR = 0.26 , 95 % CI : 0.14 - 0.49 ) . Independently of the treatment , SM count , and all other covariates , only the variable ' active caries at baseline ' remained related to new caries on first molars at 1 year ( OR = 3.11 , 95 % CI : 1.27 - 7.62 ) . The effect of the sealants was significant only when the analyses included subjects with active caries ( OR = 0.25 ; 95 % CI : 0.12 - 0.50 ) or with a high SM count ( > 10(5 ) , OR = 0.20 ; 95 % CI : 0.10 - 0.41 ) at baseline . At the 1-year follow-up , total retention was recorded in 52.7 % ( n = 222 ) of the treated teeth . CONCLUSION The 1-year effectiveness of the SBDS program was demonstrated in low socio-economic areas . Selection of schoolchildren according to individual caries risk factors should be considered in a SBDS program OBJECTIVES This pragmatic r and omized trial evaluated the effectiveness of a tailored educational intervention on oral health behaviors and new untreated carious lesions in low-income African-American children in Detroit , Michigan . METHODS Participating families were recruited in a longitudinal study of the determinants of dental caries in 1021 r and omly selected children ( 0 - 5 years ) and their caregivers . The families were examined at baseline in 2002 - 2004 ( Wave I ) , 2004 - 2005 ( Wave II ) and 2007 ( Wave III ) . Prior to Wave II , the families were r and omized into two educational groups . An interviewer trained in applying motivational interviewing principles ( MI ) review ed the dental examination findings with caregivers assigned to the intervention group ( MI + DVD ) and engaged the caregiver in a dialogue on the importance of and potential actions for improving the child 's oral health . The interviewer and caregiver watched a special 15-minute DVD developed specifically for this project based on data collected at Wave I and focused on how the caregivers can ' keep their children free from tooth decay ' . After the MI session , the caregivers developed their own preventive goals . Some families in this group chose not to develop goals and were offered the project-developed goals . The goals , if defined , were printed on glossy paper that included the child 's photograph . Families in the second group ( DVD-only ) were met by an interviewer , shown the DVD , and provided with the project 's recommended goals . Both groups of families received a copy of the DVD . Families in the MI + DVD group received booster calls within 6 months of the intervention . Both caregivers and the children were interviewed and examined after approximately 2 years ( Wave III : 2007 ) . RESULTS After 6-month of follow-up , caregivers receiving MI + DVD were more likely to report checking the child for ' precavities ' and making sure the child brushes at bedtime . Evaluation of the final outcomes approximately 2 years later found that caregivers receiving the MI + DVD were still more likely to report making sure the child brushed at bedtime , yet were no more likely to make sure the child brushed twice per day . Despite differences in one of the reported behaviors , children whose caregivers received the motivational intervention did not have fewer new untreated lesions at the final evaluation . CONCLUSIONS This study found that a single motivational interviewing intervention may change some reported oral health behaviors , it failed to reduce the number of new untreated carious lesions PURPOSE The purpose of this study was to compare twice daily tooth-brushing using 0.304 percent fluoride toothpaste alone with : ( 1 ) twice daily tooth-brushing plus once daily 10 % casein phosphopeptide-amorphous calcium phosphate ( CPP-ACP ) paste ; and ( 2 ) twice daily tooth-brushing plus once daily 0.12 % chlorhexidine gel ( CHX ) for reducing  early childhood caries ( ECC ) and mutans streptococci ( MS ) colonization . METHODS Subjects ( n=622 ) recruited at birth were r and omized to receive either CPP-ACP or CHX or no product ( study control [ SC ] ) . All children were examined at 6 , 12 , and 18 months old in their homes , and at 24 months old in a community dental clinic . RESULTS At 24 months old , the caries incidence was 1 % ( 2/163 ) in CPP-ACP , 2 % ( 4/180 ) in CHX , and 2 % ( 3/188 ) in SC groups . In children who were previously MS colonized at 12 and 18 months old , 0 % ( 0/11 ) and 5 % ( 3/63 ) , respectively , of the CPP-ACP group remained MS-positive versus 22 % ( 2/9 ) and 72 % ( 18/25 ) in CHX and 16 % ( 4/25 ) and 50 % ( 7/14 ) in SC groups ( P<.001 ) . CONCLUSIONS There is insufficient evidence to justify the daily use of casein phosphopeptide-amorphous calcium phosphate or chlorhexidine gel to control early childhood caries A community intervention trial was conducted to assess the feasibility of APF gel as a caries-preventive agent in a high-risk group of school children in Bangalore City . The study was conducted in two schools , r and omly selected from a list of schools catering to underprivileged children . These schools were r and omly allocated into experimental and control groups . Children aged 9 - 16 years having three or more incipient or cavitated primary or secondary carious lesions were enrolled in the study . In the experimental group , APF gel was applied and oral health education was provided to both groups at baseline and 6 months . Follow-up examination was performed at 6 and 12 months and the caries status was recorded by an investigator who was blinded to the allocation of intervention . There was no statistically significant difference in DMFT and DMFS values , but a significant difference was seen in incipient carious lesions between the experimental and control groups at 6 and 12 months . These results suggest that biannual APF gel application is an effective preventive measure in reversing incipient carious lesions The aim of the study was to evaluate the Lothian 1991 dental health campaigns on 5-year-old schoolchildren 's oral hygiene and gingival health in relation to deprivation . A stratified r and om sample of 486 children was selected from 92 primary schools in the city of Edinburgh . Clinical examinations took place immediately before ( T1 ) , a month after ( T2 ) and 4 months after the campaign ( T3 ) . A total of 342 ( 70 per cent ) children received all 3 examinations . Oral hygiene and gingival health were examined using a modified Silness and Löe and the Ainamo and Bay Index . Toothbrushes and take-home material s were distributed to all children . Dental officers provided 20 minute information sessions for each class and encouraged teachers to continue dental health activities within the classes . For the purpose of the evaluation , schools were categorised as deprived and non-deprived according to established social indicators . The results showed a statistically significant improvement in plaque scores at T2 and T3 ( P < 0.05 , P < 0.01 ) . Also gingival health improved at T2 and T3 ( P < 0.01 , P = 0.001 ) . However , the improvements took place only in the non-deprived schools . Thirty-one per cent of children in non-deprived schools and 18 per cent in deprived schools had a total plaque score of 0 at T1 and 41 per cent and 19 per cent respectively at T3 . The differences in gingival health scores between deprived and non-deprived schools were statistically significant at T2 and T3 but not at T1 . The campaign was therefore successful when evaluating the population as a whole . ( ABSTRACT TRUNCATED AT 250 WORDS OBJECTIVES Previous studies have shown that fluoride mouthrinsing programmes are effective in reducing caries among children and adolescents . National surveys of child dental health in the UK confirm that there is variation in oral health . In particular , children of low socioeconomic status in Scotl and have a disproportionately high share of dental disease . This study aim ed to evaluate an existing school-based fluoride mouthrinsing programme on dental caries in population s stratified by socioeconomic status . METHODS A r and om sample of 1333 children surveyed by the National Dental Inspection Programme with average age 11.4 years was included in the study . Caries prevalence data were collected for the 661 rinsers and 672 nonrinsers . Chi-squared tests and t-tests were carried out to test differences in proportion and in mean D(3)MFT , respectively . The data were modelled using multilevel logistic regression , adjusting for age , sex , deprivation and rinse status . RESULTS There is a strong negative association between deprivation and prevalence of D(3)MFT = 0 . There is no significant difference in prevalence of D(3)MFT between rinsers and nonrinsers , however , mean D(3)MFT is greater for nonrinsers within each deprivation category . After adjusting for age , sex and deprivation , the odds of a tooth being decayed missing or filled for a child who rinsed are 0.79 ( 0.64 , 0.98 ) compared with those of a child who did not . CONCLUSIONS Fluoride rinsing can be effectively targeted at children from deprived areas through school-based initiatives . There are some difficulties in recruiting all children from the more deprived background s , but overall reductions in D(3)MFT were observed UNLABELLED OBJECTIVE ; The aim of this international study was to develop a valid and reliable psychometric measure to examine the extent to which parents ' attitudes about engaging in twice-daily tooth brushing and controlling sugar snacking predict these respective behaviours in their children . A supplementary objective was to assess whether ethnic group , culture , level of deprivation or children 's caries experience impact upon the relationships between oral health related behaviours , attitudes to these respective behaviours and to dental caries . CLINICAL SETTING Nurseries , health 
    Output:
    
Supervised toothbrushing for 5-year-old school children was found to be an effective prevention technique for use in underprivileged groups .
Also a child/mother approach , targeting nutrition and broad oral health education of mothers showed effectiveness .
For older children , a slow-release fluoride device and application of acidulated phosphate fluoride ( APF ) gel showed to be effective .
Conclusion On the basis of this review , we maintain that in addition to studies of water fluoridation and fluoride toothpaste , there are other preventive intervention studies providing scientific evidence for caries reduction among children and adolescents with immigrant or low socioeconomic background