Background research GigaCool!

Research from 2017 shows that approximately a quarter of 5-year-old children in the Netherlands have or have had cavities (caries) in their teeth. Oral health has a strong socio-economic gradient with the lower socio-economic classes at a disadvantage compared to the higher classes (Schuller et al, 2018). Even though dental care for children up to the age of 18 is reimbursed from the basic package (Healthcare Institute, 2023), only 37% of children aged 0-4 years regularly visit the oral care provider (CBS Health Survey, 2023). The guideline “Oral Care for Young People, prevention and treatment of caries” recommends that children regularly visit an oral care provider for check-ups from the emergence of the first tooth (approximately at the age of 6 months) (KIMO, 2020).

Teeth and dental care is one of the topics described in the Public Health Decree of the Youth Health Care (JGZ) (chapter III, art 6) to which the JGZ should pay attention. Of the 0-4 year old children, 88% visited a childcare center (CB) in 2022 (Dutch Center for Youth Health, 2023). Given the enormous reach of the JGZ, cooperation between the JGZ and oral care practices seems obvious in order to get young children under the supervision of an oral care provider in a timely manner. This collaboration was set up and evaluated in the GigaGaaf! project.

The research project GigaGaaf!

Goal

The goal is really cool! was to improve the oral health of young children by having children referred from the JGZ to the oral care practice as soon as the first tooth breaks through. In the oral care practice, prevention was provided according to the Non Operative Caries Treatment Program (NOCTP) (Ekstrand & Christiansen, 2005) which is known in the Netherlands as the Gewoon Gaaf method (Ivory Cross). This method is based on an individual risk assessment and focuses on prevention by learning healthy (oral health) behavior in which nutritional advice, tooth brushing advice and an individual return interval are the main issues.

Method

The research is GigaCool! was carried out in the period 2014-2023 in regions characterized by a lower socio-economic status and/or by a higher percentage of residents with a non-Dutch background than the average in the Netherlands. Children aged 6 months from the intervention group were referred by the youth doctor or youth nurse to an oral care provider who provided oral care according to the Gewoon Gaaf method (Ivory Cross). Children in the control group received care as usual. The researchers followed the children for more than five years. Parents in both the intervention and control groups completed questionnaires when their child was ½, 2 and 5 years old. A dental check was performed on the children when they were 5 years old.

Results

The results showed that 54% of the children in the intervention group and 7% of the children in the control group had visited the oral care provider before their 13th month of life (Verlinden et al., 2024 - see link). At the age of 5, children from the 21% intervention group had fewer early caries than children from the control group (Verlinden et al., 2023 - see link).

Conclusion

The conclusion was that the GigaGaaf! approach was found to be effective in promoting the referral of very young children to the oral care provider and in improving the oral health of children (Verlinden et al, 2022; Verlinden et al., 2023).

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