IQuaD dental trial; improving the quality of dentistry: a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of…

Jan E Clarkson, Craig R Ramsay, Paul Averley, Debbie Bonetti, Dwayne Boyers, Louise Campbell, Graham R Chadwick, Anne Duncan, Andrew Elders, Jill Gouick, Andrew F Hall, Lynne Heasman, Peter A Heasman, Penny J Hodge, Clare Jones, Marilyn Laird, Thomas J Lamont, Laura A Lovelock, Isobel Madden, Wendy McCombes, Giles I McCracken, Alison M McDonald, Gladys McPherson, Lorna E Macpherson, Fiona E Mitchell, John DT Norrie, Nigel B Pitts, Marjon van der Pol, David NJ Ricketts, Margaret K Ross, James G Steele, Moira Swan, Martin Tickle, Pauline D Watt, Helen V Worthington, Linda Young

Periodontal disease is the most common oral disease affecting adults, and although it is largely preventable it remains the major cause of poor oral health worldwide. Accumulation of microbial dental plaque is the primary aetiological factor for both periodontal disease and caries. Effective self-care (tooth brushing and interdental aids) for plaque control and removal of risk factors such as calculus, which can only be removed by periodontal instrumentation (PI), are considered necessary to prevent and treat periodontal disease thereby maintaining periodontal health. Despite evidence of an association between sustained, good oral hygiene and a low incidence of periodontal disease and caries in adults there is a lack of strong and reliable evidence to inform clinicians of the relative effectiveness (if any) of different types of Oral Hygiene Advice (OHA). The evidence to inform clinicians of the effectiveness and optimal frequency of PI is also mixed. There is therefore an urgent need to assess the relative effectiveness of OHA and PI in a robust, sufficiently powered randomised controlled trial (RCT) in primary dental care.