***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: OBJECTIVE This study evaluates the effectiveness of a multi-component oral health intervention in preschool children in a non-r and omized intervention study with a complementary baseline control . METHODS Participants in the main study were 2137 children born between October 2003 and July 2004 in Fl and ers , Belgium . In the intervention group ( 50.5 % of participants ) , an oral health education program was added to a st and ard preventive care program during the first 3 years of life .  Oral health examinations  were performed by trained dentists when the children were 3 ( 2007 ) and 5 ( 2009 ) years old . Data on dietary habits , oral hygiene habits and dental attendance were obtained through structured question naires . Regression analyses were applied to compare the results of the intervention and control group with baseline measurements obtained before the intervention ( 2003 ) in other cohorts of 3- ( N = 1291 ) and 5-year-olds ( N = 1325 ) living in the same regions . RESULTS The prevalence of caries experience was generally lower in the main study compared with the baseline cohorts , with little differences between the intervention and control group . For the oral health-related behaviours , the control group scored mostly better . Nevertheless , compared with baseline , limited differences were observed in dental attendance , tooth brushing , helping with tooth brushing and consuming in-between drinks ( P < 0.05 ) . CONCLUSION The study illustrates that a multi-component , theory-based intervention at community level had only a limited and temporary effect on oral health-related behaviours in the community under study . Further research is needed to determine how oral health in young children can be improved in the long term OBJECTIVE To assess the impact of oral health promotion integrated with a health promoting school ( HPS ) initiative on the oral health outcomes of secondary school students . MATERIAL S AND METHOD Using an urban-rural stratified cluster r and omized approach , the intervention was applied to secondary school students in Arusha , Tanzania . In the urban , three control ( n = 315 ) and two intervention ( n = 214 ) schools performed oral clinical examination and question naires at baseline . In rural the corresponding figures at baseline were two ( n = 188 ) and three ( n = 360 ) schools . After 2 years , 374 and 358 students remained in the intervention and control arms . RESULTS Mean number of decayed teeth ( DT ) increased in the intervention ( mean score 1.0 vs 1.7 , p < 0.001 ) and control schools ( mean score 1.2 vs 1.7 , p < 0.001 ) . Mean number of teeth with plaque decreased significantly in intervention and control schools . No significant difference in caries increment and plaque decline scores was observed between groups . Mean number of teeth with bleeding decreased ( 0.5 vs 0.3 , p < 0.05 ) in intervention schools , whereas no change was observed in the control schools ( 0.4 vs 0.5 , p = 0.051 ) . Increment in mean number of DT between baseline and follow-up was largest and smallest in students who , respectively , deteriorated and improved their plaque and bleeding scores . CONCLUSION The intervention activities did not show any effect with respect to dental caries , calculus and plaque status among the students investigated . Compared with the control group , more favorable changes in the intervention group occurred with respect to bleeding on probing , suggesting a weak but positive effect on students ' oral hygiene status Background School based oral health education through traditional lecturing has been found successful only in improving oral health knowledge , while has low effectiveness in oral hygiene and gingival health . The aim of this study was to evaluate the effectiveness of experiential learning ( EL ) oral health education to traditional lecturing ( TL ) , on enhancing oral health knowledge , attitude and behavior as well as oral hygiene , gingival health and caries of 10-year-old children . Methods Eighty-four children were recruited for the EL and 100 for the TL group from 3 locations in Greece . Data regarding oral health knowledge , attitude and behavior were collected via question naires . Data regarding dental plaque , gingivitis and caries were collected by clinical examination . The evaluation using question naires and clinical examination was assessed at baseline and 6 and 18 months afterwards . Two calibrated pediatric dentists examined the students using a periodontal probe and artificial light .  Modified hygiene index ( HI ) was used for dental plaque recording , the simplified gingival index ( GI-S ) was used for gingivitis and DMFT , based on BASCD criteria , for dental caries . Based on a dedicated manual , the teacher applied in the classroom the oral health educational program using EL . Results EL group had statistically significant better hygiene than the TL at 6 months ( p < 0.05 ) . Within the same group , both groups had enhanced oral health knowledge at 6 and 18 months ( p < 0.05 ) and improved oral health behavior ( p > 0.05 ) and attitude ( p > 0.05 ) at 6 months in comparison to baseline . Conclusion EL program was found more successful than TL in oral hygiene improvement . Both oral health education programs improved the oral health knowledge , attitude and behavior of children . Trial registration Clinical Trials.gov ( NCT02320162 ) Even though there is no “ gold st and ard ” for determining caries lesion activity , it is nonetheless possible to evaluate the validity of such diagnostic measures . The aim of this study was to estimate the construct and predictive validity of caries lesion activity assessment s by means of their ability to reflect known effects of fluoride on caries . A three-year trial of the effect of daily supervised brushing with fluoride toothpaste was carried out among 273 12-year-old children . All children were examined clinical ly according to diagnostic criteria for activity assessment . The relative risk ( fluoride vs. control ) for caries lesion transitions among diagnostic categories was calculated . Fluoride inhibited progression of caries at all stages of lesion formation while at the same time enhancing lesion regression . The effects were most pronounced for active non-cavitated lesions . It is concluded that the clinical diagnostic criteria have construct and predictive validity for the assessment of caries lesion activity The effect of reducing the abrasivity of toothpaste on dental caries was observed in a 3-year clinical trial involving 1106 11 - 13-year-old Berkshire schoolchildren were divided into three groups ; Group 1 were allocated a low abrasivity paste containing 0.8 % sodium monofluorophosphate , Group 2 a paste of conventional abrasivity also containing 0.8 % sodium monofluorophosphate and Group 3 a low abrasivity non-fluoride paste . After 3 years the net DMFS increments ( clinical and radiographic scores combined ) were 4.22 in Group 1 , 4.72 in Group 2 and 6.43 in Group 3 . The differences between Groups 1 and 3 and between Groups 2 and 3 were highly significant ( P less than 0.001 ) . The mean increment in Group 1 was lower than in Group 2 but did not reach statistical significance . Reducing the abrasivity of the toothpaste had no meaningful effect on the st and ard of oral hygiene and prevalence of gingivitis as measured by the Gingival and Plaque Indices BACKGROUND Prophylaxis efforts for the maintenance of tooth health led to a distinctive decrease in caries frequency with children and young persons . Because the toothbrush can still be described as the most important oral hygiene aid , possible differences between the effectivity of electric and manual toothbrushes should be tested in the present study . Elementary school children had been instructed -- within a special prophylaxis program -- over a period of three years to clean their teeth partly with electric partly with manual toothbrushes . MATERIAL AND METHODS In two parallel classes ( 1st class ) of the same elementary school ( Private Martinusschule Mainz-Gonsenheim ) the A-class ( n = 24 children ) was instructed to clean their teeth with a manual toothbrush suitable for children ( Oral-B , Power Tip , Braun AG , Kronberg , Germany ) whereas the B-class ( n = 26 ) received electric toothbrushes ( Oral-B-7 EB 5 K , Braun AG , Kronberg , Germany ) . Every three months the children were instructed in group-preventive methods in school , followed by cleaning instructions , remotivations and the distribution of new electric respectively manual toothbrushes . In order to record the influence of the intensive quarterly oral hygiene instruction , elementary school children ( 1st class ) of the same school type were looked after and examined within the yearly group prophylaxis ( n = 40 ) . The yearly dental examinations included the recording of carious frequency ( DMF-T , dmf-t ) , approximal plaque accumulation ( API ) , and the evaluation of the gingival state ( GI-Index ) as well as the present dental restorative material s. RESULTS After an investigation period of three years no essential differences regarding caries frequency , proportion of dentitions of natural state of health and plaque involvement were found with the children of the respective classes . Children using electric toothbrushes showed after 3 years 27 % of healthy-natured dentitions on average ( 46 % of the children had got API-values of up to 30 % ) and the children who used manual toothbrushes showed 22 % of nature-healthy dentitions ( 52 % of the children had got API-values of up to 30 % ) and in 33 % of the control children who received instructions only once a year healthy-natured dentitions were found after 3 years ( 75 % of the children had got API-values of up to 35 % ) . CONCLUSIONS With regard to caries and gingivitis prevalence modern electric toothbrushes for children can be considered equally efficient like conventional manual toothbrushes for children with children of normal caries risk The clinical effects of different preventive regimens provided for young people in their early and middle teens were studied during a 2-year period . The regimens studied during the 1st year of the trial were professional tooth-cleaning plus fluoride mouth-rinsing every 3rd week versus fluoride varnish treatment every 6 months . During the 2nd year , the preventive measures were given in accordance with the estimated needs of each individual . The results were related to the individuals ' previous experience with dental prevention to determine whether this had a significant influence . The results showed that fairly good or excellent effects on the individuals ' oral hygiene and gingival status were readily achieved and maintained with a professional tooth-cleaning plus fluoride mouth-rinsing regimen . The study failed to demonstrate any superior caries-preventive effect of the fluoride varnish treatments . Subsequent individualized prevention produced similar average end results in all groups . Differences in the results in accordance with the individuals ' previous experience with dental prevention indicate a superior and prolonged influence on dental health of professional  tooth-cleaning plus fluoride mouth-rinsing in comparison with a fluoride-based program alone Abstract The effect of a dental prophylactic program based on systematic plaque control has been tested during a 3-year period on youths aged 16–19 years . During their last year at comprehensive school they received professional tooth cleaning every third week by specially trained dental hygiene nurses . At the end of this first experimental year the subjects were offered continued prophylaxis of the same type against caries and gingivitis during 2 more years . Interested subjects were divided equally at r and om into test groups A and B. In the second year group A received professional tooth cleaning once a month and in the third year once each 6 months . Group B was offered , both in the second and third years , only two prophylactic sessions each year according to this model . Test group C comprised the subjects who expressed no interest in continued professional tooth cleaning . A control group , group D , consisted of pupils of the same ages from a neighboring school area . These received in the first experimental year a prophylactic program based on mouthrinsing each second week with 0.2 % sodium fluoride solution . After this first year neither test group C nor the control group D participated in any organized dental health care program . After the first year there were significant differences among the groups , the plaque and gingival indices in the control group D being significantly higher than in test groups A , B and C. At the end of the third year significant improvements in these indices had taken place in groups A and B. The corresponding values in groups C and D did not differ significantly at the three recordings . Significant correlations existed between the plaque and gingivitis scores at the end of the experimental period within the respective groups . Significantly more dental caries ( new DPS ) developed in the control group D than in test groups A and B during the period of the experiment : on average 3.3 versus 1.0 and 1.2 new DFS , respectively . The figure for caries increment in group C was 2.0 . Regardless of grouping , individuals with caries increment during the experimental period had a significantly higher number of risk factors , here defined as the total of upper or lower quartile values for lactobacillus counts , secretion rate and buffering capacity of the saliva , than individuals without caries increment The preset study was performed to assess the effect on caries and gingivitis of plaque control measures such as oral hygiene instruction , toothcleaning practice and professional toothcleaning .  104 children , 13 - 14 years old , participated in the trial . Prior to the start of the preventive treatment all children were examined regarding  oral hygiene , gingivitis and caries .  The caries examintion was limited to the proximal surfaces of molars and premolars . Following this baseline examination the children were r and omly divided into two treatment groups A , and B. Both groups of children were recalled for professional toothcleaning once every 2 weeks during an 18-month period . In each child the professional toothcleaning was restricted to either the right or the left jaws by r and om selection . In addition , the children of Group A at each recall 
    Output:
    
Mechanical plaque control procedures are effective in reducing plaque and gingivitis .
The addition of fluoride to mechanical plaque control is significant for caries management .
Chlorhexidine rinse has a positive effect on gingivitis and inconclusive role in caries