The online version of this article (doi:10.1186/s12903-015-0097-4) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests
BC contributed to the design of the study, conducted the statistical analysis, and drafted the manuscript. JC contributed to the design of the study, the analysis plan, and critically reviewed and revised the manuscript. JF conceived the research question, contributed to the design of the study, and critically reviewed and revised the manuscript. All authors read and approved the final manuscript.
Consensus guidelines support non-operative preventives for dental caries management; yet, their use in practice is far from universal. The purpose of this study was to evaluate the effectiveness of non-operative anti-caries agents in caries prevention among high caries risk adults at a university clinic where risk-based caries management is emphasized.
This retrospective observational study drew data from the electronic patient records of non-edentulous adult patients deemed to be at high risk for dental caries during baseline oral evaluations that were completed between July 1, 2007 and December 31, 2012 at a dental university in the United States. We calculated and compared adjusted mean estimates for the number of new decayed or restored teeth (DFT increment) from baseline to the next completed oral evaluation (N = 2,724 patients with follow-up) across three categories of delivery of non-operative anti-caries agents (e.g., high-concentration fluoride toothpaste, chlorhexidine rinse, xylitol products): never, at a single appointment, or at ≥2 appointments ≥4 weeks apart. Estimates were adjusted for patient and provider characteristics, baseline dental status, losses-to-follow-up, and follow-up time.
Approximately half the patients did not receive any form of non-operative anti-caries agent. Most that received anti-caries agents were given more than one type of product in combination. One-time delivery of anti-caries agents was associated with a similar DFT increment as receiving no such therapy (difference in increment: -0.04; 95 % CI: -0.28, 0.21). However, repeated, spaced delivery of anti-caries agents was associated with approximately one decayed or restored tooth prevented over 18 months for every three patients treated (difference in increment: -0.35; 95 % CI: -0.65, -0.08).
These results lend evidence that repeatedly receiving anti-caries agents can reduce tooth decay among high-risk patients engaged in regular dental care.
Additional file 1: STROBE Statement—Checklist of items that should be included in reports of cohort studies. (DOC 82 kb)12903_2015_97_MOESM1_ESM.doc
Diagnosis and Management of Dental Caries Throughout Life. NIH Consensus Statement March 26–28 2001; 18 (1): 1–24. 2001. http://consensus.nih.gov/2001/2001DentalCaries115html.htm. Accessed 13 Jan 2015.
Fellows JL, Gordan VV, Gilbert GH, Rindal DB, Qvist V, Litaker MS, et al. Dentist and practice characteristics associated with restorative treatment of enamel caries in permanent teeth: multiple-regression modeling of observational clinical data from the National Dental PBRN. Am J Dent. 2014;27:91–9. PubMedPubMedCentral
Gomez J, Ellwood RP, Martignon S, Pretty IA. Dentists’ perspectives on caries-related treatment decisions. Community Dent Health. 2014;31:91–8. PubMed
Featherstone JD, Doméjean-Orliaguet S, Jenson L, Wolff M, Young DA. Caries risk assessment in practice for age 6 through adult. J Calif Dent Assoc. 2007;35:703–7. 710–3. PubMed
Wright JT. Current evidence for remineralizing therapeutics in caries management. J Dent Hyg. 2012;86:35–6. PubMed
Jenson L, Budenz AW, Featherstone JD, Ramos-Gomez FJ, Spolsky VW, Young DA. Clinical protocols for caries management by risk assessment. J Calif Dent Assoc. 2007;35:714–23. PubMed
Young DA, Featherstone JD, Roth JR. Curing the silent epidemic: caries management in the 21st century and beyond. J Calif Dent Assoc. 2007;35:681–5. PubMed
Doméjean S, White JM, Featherstone JD. Validation of the CDA CAMBRA caries risk assessment--a six-year retrospective study. J Calif Dent Assoc. 2011;39:709–15. PubMed
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4:e296. CrossRef
Slade GD, Bailie RS, Roberts-Thomson K, Leach AJ, Raye I, Endean C, et al. Effect of health promotion and fluoride varnish on dental caries among Australian Aboriginal children: results from a community-randomized controlled trial. Community Dent Oral Epidemiol. 2011;39:29–43. CrossRefPubMedPubMedCentral
- Non-operative anti-caries agents and dental caries increment among adults at high caries risk: a retrospective cohort study
Benjamin W. Chaffee
John DB Featherstone
- BioMed Central
Neu im Fachgebiet Zahnmedizin
Mail Icon II