March 2016

The objective: To examine whether audit and feedback could improve the quality of the application of dental sealant in rural Thai school children. Research design: A single blind, cluster randomized controlled trial was conducted. Clinical setting: Hospital-based and schoolbased school sealant applied by dental nurses in Southern province of Thailand. Participants: Dental nurses and school children who received dental sealant were involved. Intervention: The intervention consisted of confidential feedback of data and tailor-made problemsolving workshops. Main outcome measures: Sealant quality was measured by sealant retention and caries on sealed surfaces at six-month after sealing. The teeth examinations were done among different groups of children prior and after the intervention. Results: After the intervention, the sealant retention rate increased dramatically in the intervention group, whereas in the control group the rate was similar to that found at baseline. The rate of caries after the intervention was stable in the intervention group and increased slightly in the control group. At the beginning of the study, the adjusted odds ratio of complete sealant retention between the intervention and control group was 0.47 which increased to 1.99 at the end of the study. However, no effect on caries on sealed surfaces was observed. Conclusions: The intensive focus on actual problems during the audit and feedback improved the dental nurses’ performance and the quality of the dental service, although it had no statistical impact on the incidence of caries. Key words: audit and feedback, dental sealant, quality of service, dental caries, school children, Thailand