Caries Risk-Based Hierarchical Management

Caries management measures of different intensities would be implemented according to caries risk level (17 (link)). Through the WeChat public platform of “Guangdong Caries Prevention and Control,” the doctor side sent the clinical examination data of the study participants to the patient side, and the patient side fed back the questionnaire data to the doctor side. After data integration, caries risk was graded for the study participants, and then hierarchical management was conducted. The experimental group performed pit and fissure sealing (3M company, the United States) at school. Caries restoration treatment was carried out at their own expense according to the actual situation of the children and their parents. Topical fluoridation (Colgate, the United States, 5% sodium fluoride) at school every 3 months for high-risk children, every 6 months for intermediate-risk children, and every 12 months for low-risk children. Participants in the experimental group were required to regularly access the WeChat public platform to receive self-management internet intervention at least every 3 months for high-risk children, at least every 6 months for intermediate-risk children, and at least every 12 months for low-risk children. The self-management internet intervention mainly included the following contents: Researchers assisted the study participants to develop specific and personalized self-management goals. The study participants completed caries online health education, diet guidance, online brushing, fluoride use (fluoridated toothpaste ingredient list) uploading, and online doctor-patient interaction. Participants who did not actively use the platform were given reminders. The purpose of caries management was achieved by using the online caries management platform, as shown in Figure 2. Figure 3 shows functions of the patients' mobile terminal.
After collecting clinical examination data and questionnaire data of control group. Caries risk was also graded for participants in the control group, and then hierarchical management was conducted. In addition to offline preventive clinical operations (topical fluoridation, pit and fissure sealing) with the same frequency as the experimental group, the researchers also conducted regular interventions for children in the control group in classroom, including oral health education, diet instruction, teaching children how to choose and use fluoridated toothpaste, education on brushing methods, and encouraging children with caries to seek medical treatment in time. The interval of interventions was every 3 months for those at high risk, every 6 months for those at intermediate risk, and every 12 months for those at low risk.