Preventing tooth decay in children in a remote community in Australia.

The dental prevention model will essentially reduce the microbial load with the topical disinfectant, povidone iodine; inhibit biofilm adherence to susceptible sites by application of fissure sealants and reduce the susceptibility of the tooth to demineralisation by acids generated in the microbial biofilm by the application of a fluoride varnish. Topical Treatment by PVP-Iodine in conjunction with Fluoride Varnish is simple. The iodine comes in a single application swab. The total treatment time is 3 to 4 minutes and costs less than 20 cents. Clinically the teeth are brushed to remove debris and disrupt the biofilm; then dried with gauze, and painted with 0.2 ml PVP-Iodine. After the iodine application, the teeth are dried again and coated with fluoride varnish at the same visit. Product Name: Povidone Iodine Pads and Swabsticks. Fluoride varnishes are a liquid resin or synthetic base that contain a high concentration of fluoride and set quickly on contact with teeth, even in the presence of saliva. The fluoride varnish takes 3-5 minutes to apply. Fluoride ions in the material are released when the pH drops in response to acid production in the biofilm on the tooth surface and these become available to promote remineralisation of damaged tooth enamel in early carious lesions (white spots). The fluorhydroxyapatite formed over time during the remineralisation process in an initial caries lesion is more resistant to future demineralisation. Product Name: Colgate Durphat -  Varnish Single Dose 5% Sodium Fluoride (22,600 ppm). Dental decay most often occurs on the occlusal pits and fissures of permanent molar teeth. A pit and fissure sealant is defined as a material [both glass-ionomer and resin-based materials are widely used] that is introduced into the occlusal pits and fissures of caries susceptible teeth. Fissues sealant applications take about 15-30 minutes to complete. Product Name: Conseal-Clear, Conseal-Light Grey, Conseal F (White). These interventions will be administered by a dentist or oral/dental health therapist, at baseline, years 1 and 2 of the study. All participants will receive the identical preventive intervention.