INTERVAL (investigation of NICE technologies for enabling risk-variable-adjusted-length) dental recalls trial: a multicentre randomised controlled trial investigating the best dental recall interval for optimum, cost-effective maintenance of oral health in dentate adults attending dental primary care

Jan E Clarkson; Nigel B Pitts; Debbie Bonetti; Dwayne Boyers; Hazel Braid; Robert Elford; Patrick A Fee; Ruth Floate; Beatriz Goulão; Gerry Humphris; Ian Needleman; John D T Norrie; Fiona Ord; Marjon van der Pol; Craig R Ramsay; David N J Ricketts; Helen V Worthington; Linda Young; INTERVAL Trial Collaboration

doi:10.1186/s12903-018-0587-2

INTERVAL (investigation of NICE technologies for enabling risk-variable-adjusted-length) dental recalls trial: a multicentre randomised controlled trial investigating the best dental recall interval for optimum, cost-effective maintenance of oral health in dentate adults attending dental primary care

Jan E Clarkson, Nigel B Pitts, Debbie Bonetti, Dwayne Boyers, Hazel Braid, Robert Elford, Patrick A Fee, Ruth Floate, Beatriz Goulão, Gerry Humphris, Ian Needleman, John D T Norrie, Fiona Ord, Marjon van der Pol, Craig R Ramsay, David N J Ricketts, Helen V Worthington, Linda Young, INTERVAL Trial Collaboration

Research output: Contribution to journal › Article › peer-review

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Abstract

BACKGROUND: Traditionally, patients at low risk and high risk of developing dental disease have been encouraged to attend dental recall appointments at regular intervals of six months between appointments. The lack of evidence for the effect that different recall intervals between dental check-ups have on patient outcomes, provider workload and healthcare costs is causing considerable uncertainty for the profession and patients, despite the publication of the NICE Guideline on dental recall. The need for primary research has been highlighted in the Health Technology Assessment Group's systematic review of routine dental check-ups, which found little evidence to support or refute the practice of encouraging 6-monthly dental check-ups in adults. The more recent Cochrane review on recall interval concluded there was insufficient evidence to draw any conclusions regarding the potential beneficial or harmful effects of altering the recall interval between dental check-ups. There is therefore an urgent need to assess the relative effectiveness and cost-benefit of different dental recall intervals in a robust, sufficiently powered randomised control trial (RCT) in primary dental care.

METHODS: This is a four year multi-centre, parallel-group, randomised controlled trial with blinded outcome assessment based in dental primary care in the UK. Practitioners will recruit 2372 dentate adult patients. Patient participants will be randomised to one of three groups: fixed-period six month recall, risk-based recall, or fixed-period twenty-four month recall. Outcome data will be assessed through clinical examination, patient questionnaires and NHS databases. The primary outcomes measure gingival inflammation/bleeding on probing and oral health-related quality of life.

DISCUSSION: INTERVAL will provide evidence for the most clinically-effective and cost-beneficial recall interval for maintaining optimum oral health in dentate adults attending general dental practice.

TRIAL REGISTRATION: ISRCTN95933794 (Date assigned 20/08/2008).

Original language	English
Article number	135
Number of pages	10
Journal	BMC Oral Health
Volume	18
DOIs	https://doi.org/10.1186/s12903-018-0587-2
Publication status	Published - 7 Aug 2018

Bibliographical note

The authors thank the tremendous contribution of all members of the INTERVAL Trial Collaboration. This project was funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme (project number 06/35/99) and will be published in full in Health Technology Assessment. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.

Keywords

Journal Article
dental recall
oral health
RCT
primary care

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Clarkson, J. E., Pitts, N. B., Bonetti, D., Boyers, D., Braid, H., Elford, R., Fee, P. A., Floate, R., Goulão, B., Humphris, G., Needleman, I., Norrie, J. D. T., Ord, F., van der Pol, M., Ramsay, C. R., Ricketts, D. N. J., Worthington, H. V., Young, L., & INTERVAL Trial Collaboration (2018). INTERVAL (investigation of NICE technologies for enabling risk-variable-adjusted-length) dental recalls trial: a multicentre randomised controlled trial investigating the best dental recall interval for optimum, cost-effective maintenance of oral health in dentate adults attending dental primary care. BMC Oral Health, 18, Article 135. https://doi.org/10.1186/s12903-018-0587-2

INTERVAL (investigation of NICE technologies for enabling risk-variable-adjusted-length) dental recalls trial: a multicentre randomised controlled trial investigating the best dental recall interval for optimum, cost-effective maintenance of oral health in dentate adults attending dental primary care. / Clarkson, Jan E; Pitts, Nigel B; Bonetti, Debbie et al.
In: BMC Oral Health, Vol. 18, 135, 07.08.2018.

Research output: Contribution to journal › Article › peer-review

Clarkson, JE, Pitts, NB, Bonetti, D, Boyers, D, Braid, H, Elford, R, Fee, PA, Floate, R, Goulão, B, Humphris, G, Needleman, I, Norrie, JDT, Ord, F, van der Pol, M , Ramsay, CR, Ricketts, DNJ, Worthington, HV, Young, L & INTERVAL Trial Collaboration 2018, 'INTERVAL (investigation of NICE technologies for enabling risk-variable-adjusted-length) dental recalls trial: a multicentre randomised controlled trial investigating the best dental recall interval for optimum, cost-effective maintenance of oral health in dentate adults attending dental primary care', BMC Oral Health, vol. 18, 135. https://doi.org/10.1186/s12903-018-0587-2

Clarkson JE, Pitts NB, Bonetti D, Boyers D, Braid H, Elford R et al. INTERVAL (investigation of NICE technologies for enabling risk-variable-adjusted-length) dental recalls trial: a multicentre randomised controlled trial investigating the best dental recall interval for optimum, cost-effective maintenance of oral health in dentate adults attending dental primary care. BMC Oral Health. 2018 Aug 7;18:135. doi: 10.1186/s12903-018-0587-2

Clarkson, Jan E ; Pitts, Nigel B ; Bonetti, Debbie et al. / INTERVAL (investigation of NICE technologies for enabling risk-variable-adjusted-length) dental recalls trial : a multicentre randomised controlled trial investigating the best dental recall interval for optimum, cost-effective maintenance of oral health in dentate adults attending dental primary care. In: BMC Oral Health. 2018 ; Vol. 18.

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T2 - a multicentre randomised controlled trial investigating the best dental recall interval for optimum, cost-effective maintenance of oral health in dentate adults attending dental primary care

AU - Clarkson, Jan E

AU - Pitts, Nigel B

AU - Bonetti, Debbie

AU - Boyers, Dwayne

AU - Braid, Hazel

AU - Elford, Robert

AU - Fee, Patrick A

AU - Floate, Ruth

AU - Goulão, Beatriz

AU - Humphris, Gerry

AU - Needleman, Ian

AU - Norrie, John D T

AU - Ord, Fiona

AU - van der Pol, Marjon

AU - Ramsay, Craig R

AU - Ricketts, David N J

AU - Worthington, Helen V

AU - Young, Linda

AU - INTERVAL Trial Collaboration

N1 - The authors thank the tremendous contribution of all members of the INTERVAL Trial Collaboration. This project was funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme (project number 06/35/99) and will be published in full in Health Technology Assessment. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.

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N2 - BACKGROUND: Traditionally, patients at low risk and high risk of developing dental disease have been encouraged to attend dental recall appointments at regular intervals of six months between appointments. The lack of evidence for the effect that different recall intervals between dental check-ups have on patient outcomes, provider workload and healthcare costs is causing considerable uncertainty for the profession and patients, despite the publication of the NICE Guideline on dental recall. The need for primary research has been highlighted in the Health Technology Assessment Group's systematic review of routine dental check-ups, which found little evidence to support or refute the practice of encouraging 6-monthly dental check-ups in adults. The more recent Cochrane review on recall interval concluded there was insufficient evidence to draw any conclusions regarding the potential beneficial or harmful effects of altering the recall interval between dental check-ups. There is therefore an urgent need to assess the relative effectiveness and cost-benefit of different dental recall intervals in a robust, sufficiently powered randomised control trial (RCT) in primary dental care.METHODS: This is a four year multi-centre, parallel-group, randomised controlled trial with blinded outcome assessment based in dental primary care in the UK. Practitioners will recruit 2372 dentate adult patients. Patient participants will be randomised to one of three groups: fixed-period six month recall, risk-based recall, or fixed-period twenty-four month recall. Outcome data will be assessed through clinical examination, patient questionnaires and NHS databases. The primary outcomes measure gingival inflammation/bleeding on probing and oral health-related quality of life.DISCUSSION: INTERVAL will provide evidence for the most clinically-effective and cost-beneficial recall interval for maintaining optimum oral health in dentate adults attending general dental practice.TRIAL REGISTRATION: ISRCTN95933794 (Date assigned 20/08/2008).

AB - BACKGROUND: Traditionally, patients at low risk and high risk of developing dental disease have been encouraged to attend dental recall appointments at regular intervals of six months between appointments. The lack of evidence for the effect that different recall intervals between dental check-ups have on patient outcomes, provider workload and healthcare costs is causing considerable uncertainty for the profession and patients, despite the publication of the NICE Guideline on dental recall. The need for primary research has been highlighted in the Health Technology Assessment Group's systematic review of routine dental check-ups, which found little evidence to support or refute the practice of encouraging 6-monthly dental check-ups in adults. The more recent Cochrane review on recall interval concluded there was insufficient evidence to draw any conclusions regarding the potential beneficial or harmful effects of altering the recall interval between dental check-ups. There is therefore an urgent need to assess the relative effectiveness and cost-benefit of different dental recall intervals in a robust, sufficiently powered randomised control trial (RCT) in primary dental care.METHODS: This is a four year multi-centre, parallel-group, randomised controlled trial with blinded outcome assessment based in dental primary care in the UK. Practitioners will recruit 2372 dentate adult patients. Patient participants will be randomised to one of three groups: fixed-period six month recall, risk-based recall, or fixed-period twenty-four month recall. Outcome data will be assessed through clinical examination, patient questionnaires and NHS databases. The primary outcomes measure gingival inflammation/bleeding on probing and oral health-related quality of life.DISCUSSION: INTERVAL will provide evidence for the most clinically-effective and cost-beneficial recall interval for maintaining optimum oral health in dentate adults attending general dental practice.TRIAL REGISTRATION: ISRCTN95933794 (Date assigned 20/08/2008).

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