***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 We tested a dental health program in remote Aboriginal communities of Australia 's Northern Territory , hypothesizing that it would reduce dental caries in preschool children . Methods In this 2-year , prospect i ve , cluster-r and omized , concurrent controlled , open trial of the dental health program compared to no such program , 30 communities were allocated at r and om to intervention and control groups . All residents aged 18–47 months were invited to participate . Twice per year for 2 years in the 15 intervention communities , fluoride varnish was applied to children 's teeth , water consumption and daily tooth cleaning with toothpaste were advocated , dental health was promoted in community setting s , and primary health care workers were trained in preventive dental care . Data from dental examinations at baseline and after 2 years were used to compute net dental caries increment per child ( d3mfs ) . A multi-level statistical model compared d3mfs between intervention and control groups with adjustment for the clustered r and omization design ; four other models used additional variables for adjustment . Results At baseline , 666 children were examined ; 543 of them ( 82 % ) were re-examined 2 years later . The adjusted d3mfs increment was significantly lower in the intervention group compared to the control group by an average of 3.0 surfaces per child ( 95 % CI = 1.2 , 4.9 ) , a prevented fraction of 31 % . Adjustment for additional variables yielded caries reductions ranging from 2.3 to 3.5 surfaces per child and prevented fractions of 24–36 % . Conclusions These results corroborate findings from other studies where fluoride varnish was efficacious in preventing dental caries in young children Objective : We aim ed to evaluate the efficacy of oral hygiene instruction , fluoride varnish and casein phosphopeptide-amorphous calcium phosphate ( CPP-ACP ) for remineralizing white spot lesions ( WSL ) , and the effect of these on the dmft index in primary teeth . Subjects and Methods : In this 1-year , r and omized clinical trial , 140 children aged 12 - 36 months with WSL in the anterior maxillary teeth were selected and r and omly divided into 4 groups of 35 children each . Group 1 ( control ) received no preventive intervention . In group 2 , there was oral hygiene and dietary counseling . In group 3 , there was oral hygiene and the application of fluoride varnish at 4 , 8 and 12 months after baseline . In group 4 , there was oral hygiene and tooth mousse was applied by the parents twice a day over a 12-month period . At baseline and 4 , 8 and 12 months after the intervention , the size of WSL in millimeters and the dmft index were recorded . One hundred and twenty-two children completed the study . Data were analyzed using the repeated- measures ANOVA test . Results : In group 1 , the mean percent WSL area and dmft index values had increased significantly at 12 months after baseline ( p < 0.001 ) . The interventions led to significant decreases in the size of the WSL ; the greatest reduction was in group 4 ( 63 % ) followed by group 3 ( 51 % ) and group 2 ( 10 % ) after 12 months . The smallest increase in the dmft index was in group 4 ( 0.17 ) , followed by groups 3 ( 0.3 ) and 2 ( 0.42 ) . However , there were no significant differences between the groups ( p < 0.001 ) . Conclusions : Oral hygiene along with four fluoride varnish applications or constant CPP-ACP during the 12- month period reduced the size of WSL in the anterior primary teeth and caused a small increase in dmft index values OBJECTIVES To determine the efficacy of 5 % sodium fluoride ( NaF ) varnish application in reducing caries increments in the permanent dentition of rural Brazilian school children over the course of 12 months . METHODS A double-blind , r and omized , placebo-controlled trial was conducted with 379 children aged 7 - 14 years who attended three schools in Brazil between January 2006 and December 2007 . During this period , each school was visited four times at 6-month interval for recruitment , dental examinations , and fluoride varnish applications . Recruited children were r and omly assigned to either a treatment ( 5 % NaF varnish , n = 198 ) or a control group ( placebo , n = 181 ) . Trained interviewers collected data on oral health habits and sociodemographic characteristics from the children . Information on the child 's diet was collected through a 7-day food frequency diary . Caries examinations were conducted using the International Caries Detection and Assessment System ( ICDAS ) . The efficacy of fluoride varnish application on caries prevention was reported as a preventive fraction ( PF ) . Crude caries increments of decayed and filled surfaces ( DFS ) were compared between fluoride varnish and placebo groups . A generalized linear model ( GLM ) was constructed to test the differences in DFS increments between the groups after accounting for confounding factors . RESULTS Of the total sample ( N = 379 ) , 210 ( 55.4 % ) children had completed 12 months of follow-up including one or two applications of fluoride varnish or placebo . At the baseline examination , the children in the treatment and control groups presented on average 6.2 and 5.6 DFS , respectively ( P < 0.001 ) . After 12 months of follow-up , the children in the varnish group showed significantly lower DFS increments than did children in the control group ( 10.8 versus 13.3 ; P < 0.007 ) , with PF of 40 % ( 95 % CI : 34.3 - 45.7 % ; P < 0.0001 ) . CONCLUSIONS The results of this study suggest that applications of 5 % NaF varnish can be recommended as a public health measure for reducing caries incidence in this high-caries-risk population 1 The AAPD encourages oral health care providers and caregivers to implement 17 simple preventive practice s that can decrease a childs risks of developing this devastating disease . 18 19 20 21 Methods This policy revision is based on a review of the current pediatric dental , medical , and public health literature related to ECC , including 22 the proceedings of the 2005 Symposium on the Prevention of Oral Disease in Children and Adolescents , Chicago , Illinois1997 Conference on Early Childhood Caries , Bethesda , Md.1 A MEDLINE search was conducted using the terms  early childhood caries , nursing caries  , and baby bottle caries. 25 The literature includes studies that used sound scientific methodology , were reported in refereed journals , and are accepted by the dental profession as state of the art in caries causes and prevention . The literature on the consequences of ECC is based on both prospect i ve and retrospective clinical studies that followed accepted clinical protocol s. Preventive recommendations were based primarily upon review of published studies and proceedings . In cases where the data did not appear sufficient or were inconclusive , recommendations were based upon expert and consensus opinion . 23 OBJECTIVE To measure the effectiveness of fluoride varnish ( FV ) ( Duraflor ) , 5 % sodium fluoride , Pharmascience Inc. , Montréal , QC , Canada ) and caregiver counseling in preventing early childhood caries ( ECC ) in Aboriginal children in a 2-year community-r and omized controlled trial . METHODS Twenty First Nations communities in the Sioux Lookout Zone ( SLZ ) , Northwest Ontario , Canada were r and omized to two study groups . All caregivers received oral health counseling , while children in one group received FV twice per year and the controls received no varnish . A total of 1275 , 6 months to 5-year-old children from the SLZ communities were enrolled . In addition , a convenience sample of 150 primarily non-Aboriginal children of the same age were recruited from the neighboring community of Thunder Bay and used as comparisons . Longitudinal examinations for the dmft/s indices were conducted by calibrated hygienists in 2003 , 2004 and 2005 . RESULTS Aboriginal children living in the SLZ or in Thunder Bay had significantly higher caries prevalence and severity than non-Aboriginal children in Thunder Bay .  FV treatment conferred an 18 % reduction in the 2-year mean ' net ' dmfs increment for Aboriginal children and a 25 % reduction for all children , using cluster analysis to adjust for the intra-cluster correlation among children in the same community . Adjusted odds ratio for caries incidence was 1.96 times higher in the controls than in the FV group ( 95 % CI = 1.08 - 3.56 ; P = 0.027 ) . For those caries-free at baseline , the number ( of children ) needed to treat ( NNT ) equaled 7.4 . CONCLUSIONS Findings support the use of FV at least twice per year , in conjunction with caregiver counseling , to prevent ECC , reduce caries increment and oral health inequalities between young Aboriginal and non-Aboriginal children For children in the primary dentition with high caries prevalence the st and ard semiannual application of fluoride varnish may not be successful in preventing tooth decay . Oftentimes this population is mobile and does not receive consistent preventive care . This trial tested whether an intensive fluoride 5 % sodium varnish regimen ( three applications/2 weeks ) applied annually has an equivalent effect on caries progression in the primary dentition compared to single applications applied semiannually . This study was a r and omized clinical trial with two treatment groups . All participants ( n = 600 ; mean age ± SD = 55.3 ± 4.6 months ) received three varnish applications ( active varnish or placebo ) at semiannual visits over 3 years . Once per year the intensive-treatment group received one set of three active treatments and three placebo treatments 6 months later , each time within 2 weeks . The st and ard group received one active and two placebo treatments every 6 months . Children were assessed clinical ly at baseline and 12 , 24 and 36 months after the initiation of the study . The mean ( SD ) numbers of newly decayed primary tooth surfaces observed over 3 years were 9.8 ( 8.6 ) and 7.4 ( 7.7 ) in the intensive and st and ard groups , respectively . The adjusted rate ratio was 1.13 ( 95 % CI = 0.94–1.37 , p = 0.20 ) . In conclusion , the trial failed to demonstrate clear evidence of a difference in efficacy . However , differences of up to 36 % greater rates of caries in the intensive group could not be ruled out , thus equivalence of the treatments can not be concluded The aim was to study the effect of substitution of invert sugar for sucrose , in combination with fluoride varnish ( Duraphat ) treatment twice a year , on caries development in preschool children . One hundred and eighty-seven 4-years-olds were divided r and omly into four sugar groups : ( 1 ) sucrose ( S ) , ( 2 ) sucrose-Duraphat ( SD ) , ( 3 ) invert sugar ( I ) , and ( 4 ) invert sugar-Duraphat ( ID ) . All families were asked to buy beverages , biscuits , breakfast cereals , marmalade , ice cream , jam , ketchup , sweets and table sugar , totally 32 different food items , sweetened with invert sugar or sucrose . The substitution was , thus , restricted to a number of sugar-rich between-meal products . The study was carried out double-blind for 2 years . The children of those parents who did not want to participate in the sugar groups were divided r and omly into one of the following two groups : ( 5 ) Duraphat ( D ) , and control ( C ) . Because of lack of cooperation , only 114 of the 187 children ( 61 % ) were considered to have completed the study . The mean caries increment , including initial lesions , was 3.86 dmfs in the combined groups S and SD ( n = 63 ) and 3.10 dmfs in the combined groups I and ID ( n = 51 ) during the 2 years ( p = 0.34 ) . The corresponding values for the 2nd year only were 1.84 and 0.67 dmfs , respectively ( p = 0.09 ) . The mean caries increment was 2.86 dmfs in group D ( n = 113 ) and 4.10 dmfs ( p = 0.08 ) in group C ( n = 93 ) . If initial caries lesions were excluded from the index , the difference between groups D and C was significant ( p = 0.008 ) . ( ABSTRACT TRUNCATED AT 250 WORDS Untreated dental caries in Chinese pre-school children is common . This prospect i ve controlled clinical trial investigated the effectiveness of topical fluoride applications in arresting dentin caries .  Three hundred seventy-five children , aged 3 - 5 years , with carious upper anterior teeth were divided into five groups . Children in the first and second groups received annual applications of silver diamine fluoride solution ( 44,800 ppm F ) . Sodium fluoride varnish ( 22,600 ppm F ) was applied every three months to the lesions of children in the third and fourth groups . For children in the first and third groups , soft carious tissues were removed prior to fluoride application . The fifth group was the control .  Three hundred eight children were followed for 30 months . The respective mean numbers of arrested carious tooth surfaces in the five groups were 2.5 
    Output:
    
The results showed that fluoride varnishes have been used at concentrations of 1 % and 5 % in the prevention of ECC .
The preventive fraction was influenced by the frequency of application , the duration of study and sample size .