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In spite of the implementation of water fluoridation schemes and the general improvement in oral health, dental decay remains a problem in the North East of England. The consumption of sugared medicines makes a small but significant contribution to this problem. Specifically, there is concern that their long term use increases dental disease in children, especially those with chronic illness. With ample evidence to suggest that non-sugar sweeteners do not produce dental decay, an intervention was implemented to increase the substitution of sugar-free medicine prescribing.

Test and control areas were chosen for the intervention matched for population size and socio-economic characteristics, GP and pharmacist numbers. The three-year initiative (1996 was the intervention year) was evaluated in two ways: by questionnaires distributed before and after, and by quantitative analysis of prescribing; access was obtained to the Prescribing Analysis and Cost (PACT) system whereby all National Health Service prescriptions are monitored for content.
There was an overall increase in the prescribing of sugar-free medicines in both test and control areas 1995 - 1997 (P<0.01) and this increase was significantly greater in the test area (P<0.0001). There was an increased probability that sugar-free medicines would be prescribed in the test area during 1995 - 1997 compared with a relatively static probability in the control area (P<0.0001) and this was principally due to the marked increase in sugar-free prescribing seen in

1997 (one year after the intervention) in the test area. There was a small, non-significant change in the knowledge and awareness of the role of liquid oral medicines containing sugar in dental disease of both pharmacists and general practitioners after the intervention.

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