Fluoride effectiveness in high caries risk and medically complex Veterans
Identifieur interne : 005032 ( Istex/Corpus ); précédent : 005031; suivant : 005033Fluoride effectiveness in high caries risk and medically complex Veterans
Auteurs : M. Marianne Jurasic ; Gretchen Gibson ; Carolyn J. Wehler ; Martha Nunn ; Michelle B. Orner ; Elizabeth Nunez ; Terry G. O'Toole ; Judith A. JonesSource :
- Community Dentistry and Oral Epidemiology [ 0301-5661 ] ; 2014-12.
Abstract
The Global Burden of Disease Study showed there was a 34.5% increase in years lived with disability due to dental caries from 1990 to 2010. With the aging of 76 million baby boomers, dental caries will continue to pose a significant challenge for older adults.
Url:
DOI: 10.1111/cdoe.12121
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ISTEX:A069FAE640EB664CF7BB9E3CB230F907DD700A3FLe document en format XML
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Newton St., Room 619, Boston, MA 02118, USATel.: +1 617 638 5209Fax: +1 617 414 1061e‐mail:</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: mjurasic@bu.edu</mods:affiliation></affiliation></author><author><name sortKey="Gibson, Gretchen" sort="Gibson, Gretchen" uniqKey="Gibson G" first="Gretchen" last="Gibson">Gretchen Gibson</name><affiliation><mods:affiliation>Veterans Health Care System of the Ozarks, Fayetteville, AR, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Veterans Affairs, VHACO Office of Dentistry, DC, Washington, USA</mods:affiliation></affiliation></author><author><name sortKey="Wehler, Carolyn J" sort="Wehler, Carolyn J" uniqKey="Wehler C" first="Carolyn J." last="Wehler">Carolyn J. Wehler</name><affiliation><mods:affiliation>Boston University Henry M. 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Marianne" last="Jurasic">M. Marianne Jurasic</name><affiliation><mods:affiliation>Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Edith Nourse Rogers Memorial Veterans Hospital, VA Center for Healthcare Organization and Implementation Research, MA, Bedford, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>M. Marianne Jurasic, Boston University School of Dental Medicine, 100 E. Newton St., Room 619, Boston, MA 02118, USATel.: +1 617 638 5209Fax: +1 617 414 1061e‐mail:</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: mjurasic@bu.edu</mods:affiliation></affiliation></author><author><name sortKey="Gibson, Gretchen" sort="Gibson, Gretchen" uniqKey="Gibson G" first="Gretchen" last="Gibson">Gretchen Gibson</name><affiliation><mods:affiliation>Veterans Health Care System of the Ozarks, Fayetteville, AR, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Veterans Affairs, VHACO Office of Dentistry, DC, Washington, USA</mods:affiliation></affiliation></author><author><name sortKey="Wehler, Carolyn J" sort="Wehler, Carolyn J" uniqKey="Wehler C" first="Carolyn J." last="Wehler">Carolyn J. Wehler</name><affiliation><mods:affiliation>Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Edith Nourse Rogers Memorial Veterans Hospital, VA Center for Healthcare Organization and Implementation Research, MA, Bedford, USA</mods:affiliation></affiliation></author><author><name sortKey="Nunn, Martha" sort="Nunn, Martha" uniqKey="Nunn M" first="Martha" last="Nunn">Martha Nunn</name><affiliation><mods:affiliation>Creighton University School of Dentistry, NE, Omaha, USA</mods:affiliation></affiliation></author><author><name sortKey="Orner, Michelle B" sort="Orner, Michelle B" uniqKey="Orner M" first="Michelle B." last="Orner">Michelle B. 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O'Toole</name><affiliation><mods:affiliation>Department of Veterans Affairs, VHACO Office of Dentistry, Washington, DC, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>VA San Diego Health Care System, CA, San Diego, USA</mods:affiliation></affiliation></author><author><name sortKey="Jones, Judith A" sort="Jones, Judith A" uniqKey="Jones J" first="Judith A." last="Jones">Judith A. Jones</name><affiliation><mods:affiliation>Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Edith Nourse Rogers Memorial Veterans Hospital, VA Center for Healthcare Organization and Implementation Research, MA, Bedford, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Community Dentistry and Oral Epidemiology</title><title level="j" type="alt">COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY</title><idno type="ISSN">0301-5661</idno><idno type="eISSN">1600-0528</idno><imprint><biblScope unit="vol">42</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="543">543</biblScope><biblScope unit="page" to="552">552</biblScope><biblScope unit="page-count">10</biblScope><date type="published" when="2014-12">2014-12</date></imprint><idno type="ISSN">0301-5661</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0301-5661</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">The Global Burden of Disease Study showed there was a 34.5% increase in years lived with disability due to dental caries from 1990 to 2010. With the aging of 76 million baby boomers, dental caries will continue to pose a significant challenge for older adults.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>M. Marianne Jurasic</name><affiliations><json:string>Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA</json:string><json:string>Edith Nourse Rogers Memorial Veterans Hospital, VA Center for Healthcare Organization and Implementation Research, MA, Bedford, USA</json:string><json:string>M. Marianne Jurasic, Boston University School of Dental Medicine, 100 E. 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Goldman School of Dental Medicine</orgName><address><settlement type="city">Boston</settlement><region>MA</region><country key="US">USA</country></address></affiliation><affiliation><orgName>Edith Nourse Rogers Memorial Veterans Hospital</orgName><orgName>VA Center for Healthcare Organization and Implementation Research</orgName><address><settlement type="city">Bedford</settlement><region>MA</region><country key="US">USA</country></address></affiliation><affiliation>M. Marianne Jurasic, Boston University School of Dental Medicine, 100 E. Newton St., Room 619, Boston, MA 02118, USA Tel.: +1 617 638 5209 Fax: +1 617 414 1061 e‐mail: mjurasic@bu.edu</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Gretchen</forename><surname>Gibson</surname></persName><affiliation><orgName>Veterans Health Care System of the Ozarks</orgName><address><settlement type="city">Fayetteville</settlement><region>AR</region><country key="US">USA</country></address></affiliation><affiliation><orgName>Department of Veterans Affairs</orgName><orgName>VHACO Office of Dentistry</orgName><address><settlement type="city">Washington</settlement><region>DC</region><country key="US">USA</country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">Carolyn J.</forename><surname>Wehler</surname></persName><affiliation><orgName>Boston University Henry M. Goldman School of Dental Medicine</orgName><address><settlement type="city">Boston</settlement><region>MA</region><country key="US">USA</country></address></affiliation><affiliation><orgName>Edith Nourse Rogers Memorial Veterans Hospital</orgName><orgName>VA Center for Healthcare Organization and Implementation Research</orgName><address><settlement type="city">Bedford</settlement><region>MA</region><country key="US">USA</country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">Martha</forename><surname>Nunn</surname></persName><affiliation><orgName>Creighton University School of Dentistry</orgName><address><settlement type="city">Omaha</settlement><region>NE</region><country key="US">USA</country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">Michelle B.</forename><surname>Orner</surname></persName><affiliation><orgName>Edith Nourse Rogers Memorial Veterans Hospital</orgName><orgName>VA Center for Healthcare Organization and Implementation Research</orgName><address><settlement type="city">Bedford</settlement><region>MA</region><country key="US">USA</country></address></affiliation></author><author xml:id="author-0005"><persName><forename type="first">Elizabeth</forename><surname>Nunez</surname></persName><affiliation><orgName>Department of Veterans Affairs</orgName><orgName>VHACO Office of Dentistry</orgName><address><settlement type="city">Washington</settlement><region>DC</region><country key="US">USA</country></address></affiliation><affiliation><orgName>James A. Haley VA Medical Center</orgName><address><settlement type="city">Tampa</settlement><region>FL</region><country key="US">USA</country></address></affiliation></author><author xml:id="author-0006"><persName><forename type="first">Terry G.</forename><surname>O'Toole</surname></persName><affiliation><orgName>Department of Veterans Affairs</orgName><orgName>VHACO Office of Dentistry</orgName><address><settlement type="city">Washington</settlement><region>DC</region><country key="US">USA</country></address></affiliation><affiliation><orgName>VA San Diego Health Care System</orgName><address><settlement type="city">San Diego</settlement><region>CA</region><country key="US">USA</country></address></affiliation></author><author xml:id="author-0007"><persName><forename type="first">Judith A.</forename><surname>Jones</surname></persName><affiliation><orgName>Boston University Henry M. Goldman School of Dental Medicine</orgName><address><settlement type="city">Boston</settlement><region>MA</region><country key="US">USA</country></address></affiliation><affiliation><orgName>Edith Nourse Rogers Memorial Veterans Hospital</orgName><orgName>VA Center for Healthcare Organization and Implementation Research</orgName><address><settlement type="city">Bedford</settlement><region>MA</region><country key="US">USA</country></address></affiliation></author><idno type="istex">A069FAE640EB664CF7BB9E3CB230F907DD700A3F</idno><idno type="ark">ark:/67375/WNG-QB31L8GK-K</idno><idno type="DOI">10.1111/cdoe.12121</idno><idno type="unit">CDOE12121</idno><idno type="toTypesetVersion">file:CDOE.CDOE12121.pdf</idno></analytic><monogr><title level="j" type="main">Community Dentistry and Oral Epidemiology</title><title level="j" type="alt">COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY</title><idno type="pISSN">0301-5661</idno><idno type="eISSN">1600-0528</idno><idno type="book-DOI">10.1111/(ISSN)1600-0528</idno><idno type="book-part-DOI">10.1111/cdoe.2014.42.issue-6</idno><idno type="product">CDOE</idno><imprint><biblScope unit="vol">42</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="543">543</biblScope><biblScope unit="page" to="552">552</biblScope><biblScope unit="page-count">10</biblScope><date type="published" when="2014-12"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract style="main" xml:id="cdoe12121-abs-0001"><head>Abstract</head>
Background
<p>The Global Burden of Disease Study showed there was a 34.5% increase in years lived with disability due to dental caries from 1990 to 2010. With the aging of 76 million baby boomers, dental caries will continue to pose a significant challenge for older adults.</p>
Objective
<p>Test the effectiveness of prescription or professionally applied fluoride in the prevention of new dental restorations in a clinical setting where patients are medically compromised and more dentally impaired than the general population.</p>
Methods
<p>A retrospective cohort study, using multiple electronic databases within the Department of Veterans Affairs. Propensity scores were used to adjust for confounding by indication and logistic regression modeled the outcome and included all expected covariates.</p>
Results
<p>The study sample included 140 114 high caries risk Veterans with a mean of 3.4 physical comorbidities, 1.2 mental comorbidities, and 11 medication groups per patient. Patients who received clinical fluoride treatments had 17–20% decreased odds of requiring a restoration during the follow‐up period.</p>
Conclusions
<p>Prescription self‐applied or professionally applied fluoride provided either before or during an episode of care significantly reduced the likelihood of new restorations in high caries risk and medically compromised Veterans.</p></abstract><textClass><keywords><term xml:id="cdoe12121-kwd-0001">adults</term><term xml:id="cdoe12121-kwd-0002">caries</term><term xml:id="cdoe12121-kwd-0003">fluoride</term><term xml:id="cdoe12121-kwd-0004">health services research</term><term xml:id="cdoe12121-kwd-0005">prevention</term></keywords><keywords rend="articleCategory"><term>Original Article</term></keywords><keywords rend="tocHeading1"><term>Original articles</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component type="serialArticle" version="2.0" xml:id="cdoe12121" xml:lang="en"><header><publicationMeta level="product"><doi origin="wiley" registered="yes">10.1111/(ISSN)1600-0528</doi><issn type="print">0301-5661</issn><issn type="electronic">1600-0528</issn><idGroup><id type="product" value="CDOE"></id></idGroup><titleGroup><title sort="COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY" type="main">Community Dentistry and Oral Epidemiology</title><title type="short">Community Dent Oral Epidemiol</title></titleGroup></publicationMeta><publicationMeta level="part" position="60"><doi origin="wiley">10.1111/cdoe.2014.42.issue-6</doi><copyright ownership="publisher">Copyright © 2014 John Wiley & Sons A/S</copyright><numberingGroup><numbering type="journalVolume" number="42">42</numbering><numbering type="journalIssue">6</numbering></numberingGroup><coverDate startDate="2014-12">December 2014</coverDate></publicationMeta><publicationMeta level="unit" position="70" status="forIssue" type="article"><doi>10.1111/cdoe.12121</doi><idGroup><id type="unit" value="CDOE12121"></id></idGroup><countGroup><count number="10" type="pageTotal"></count></countGroup><titleGroup><title type="articleCategory">Original Article</title><title type="tocHeading1">Original articles</title></titleGroup><copyright ownership="thirdParty">Published 2014. This article is a U.S. Government work and is in the public domain in the USA.</copyright><eventGroup><event date="2013-09-23" type="manuscriptReceived"></event><event date="2014-06-20" type="manuscriptAccepted"></event><event agent="SPS" date="2014-06-25" type="xmlCreated"></event><event agent="SPS" date="2014-11-21" type="xmlCorrected"></event><event type="publishedOnlineEarlyUnpaginated" date="2014-07-19"></event><event type="firstOnline" date="2014-07-19"></event><event type="publishedOnlineFinalForm" date="2014-11-25"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.6.4 mode:FullText" date="2015-10-07"></event></eventGroup><numberingGroup><numbering type="pageFirst">543</numbering><numbering type="pageLast">552</numbering></numberingGroup><correspondenceTo><lineatedText><line>M. Marianne Jurasic, Boston University School of Dental Medicine, 100 E. Newton St., Room 619, Boston, MA 02118, USA</line><line>Tel.: +1 617 638 5209</line><line>Fax: +1 617 414 1061</line><line>e‐mail: <email>mjurasic@bu.edu</email></line></lineatedText></correspondenceTo><selfCitationGroup><citation type="self" xml:id="cdoe12121-cit-1001"><author><familyName>Jurasic</familyName> <givenNames>MM</givenNames></author>, <author><familyName>Gibson</familyName> <givenNames>G</givenNames></author>, <author><familyName>Wehler</familyName> <givenNames>CJ</givenNames></author>, <author><familyName>Nunn</familyName> <givenNames>M</givenNames></author>, <author><familyName>Orner</familyName> <givenNames>MB</givenNames></author>, <author><familyName>Nunez</familyName> <givenNames>E</givenNames></author>, <author><familyName>O'Toole</familyName> <givenNames>TG</givenNames></author>, <author><familyName>Jones</familyName> <givenNames>JA</givenNames></author>. <articleTitle>Fluoride effectiveness in high caries risk and medically complex Veterans</articleTitle>. <journalTitle>Community Dent Oral Epidemiol</journalTitle> <pubYear year="2014">2014</pubYear>; <vol>42</vol>: <pageFirst>543</pageFirst>–<pageLast>552</pageLast>. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.</citation></selfCitationGroup><objectNameGroup><objectName elementName="appendix">Appendix</objectName></objectNameGroup><linkGroup><link type="toTypesetVersion" href="file:CDOE.CDOE12121.pdf"></link></linkGroup></publicationMeta><contentMeta><titleGroup><title type="main">Fluoride effectiveness in high caries risk and medically complex Veterans</title><title type="shortAuthors">Jurasic et al.</title></titleGroup><creators><creator affiliationRef="#cdoe12121-aff-0001 #cdoe12121-aff-0002" corresponding="yes" creatorRole="author" xml:id="cdoe12121-cr-0001"><personName><givenNames>M. Marianne</givenNames> <familyName>Jurasic</familyName></personName></creator><creator affiliationRef="#cdoe12121-aff-0003 #cdoe12121-aff-0004" creatorRole="author" xml:id="cdoe12121-cr-0002"><personName><givenNames>Gretchen</givenNames> <familyName>Gibson</familyName></personName></creator><creator affiliationRef="#cdoe12121-aff-0001 #cdoe12121-aff-0002" creatorRole="author" xml:id="cdoe12121-cr-0003"><personName><givenNames>Carolyn J.</givenNames> <familyName>Wehler</familyName></personName></creator><creator affiliationRef="#cdoe12121-aff-0005" creatorRole="author" xml:id="cdoe12121-cr-0004"><personName><givenNames>Martha</givenNames> <familyName>Nunn</familyName></personName></creator><creator affiliationRef="#cdoe12121-aff-0002" creatorRole="author" xml:id="cdoe12121-cr-0005"><personName><givenNames>Michelle B.</givenNames> <familyName>Orner</familyName></personName></creator><creator affiliationRef="#cdoe12121-aff-0004 #cdoe12121-aff-0006" creatorRole="author" xml:id="cdoe12121-cr-0006"><personName><givenNames>Elizabeth</givenNames> <familyName>Nunez</familyName></personName></creator><creator affiliationRef="#cdoe12121-aff-0004 #cdoe12121-aff-0007" creatorRole="author" xml:id="cdoe12121-cr-0007"><personName><givenNames>Terry G.</givenNames> <familyName>O'Toole</familyName></personName></creator><creator affiliationRef="#cdoe12121-aff-0001 #cdoe12121-aff-0002" creatorRole="author" xml:id="cdoe12121-cr-0008"><personName><givenNames>Judith A.</givenNames> <familyName>Jones</familyName></personName></creator></creators><affiliationGroup><affiliation countryCode="US" type="organization" xml:id="cdoe12121-aff-0001"><orgName>Boston University Henry M. Goldman School of Dental Medicine</orgName> <address><city>Boston</city> <countryPart>MA</countryPart> <country>USA</country></address></affiliation><affiliation countryCode="US" type="organization" xml:id="cdoe12121-aff-0002"><orgDiv>Edith Nourse Rogers Memorial Veterans Hospital</orgDiv> <orgName>VA Center for Healthcare Organization and Implementation Research</orgName> <address><city>Bedford</city> <countryPart>MA</countryPart> <country>USA</country></address></affiliation><affiliation countryCode="US" type="organization" xml:id="cdoe12121-aff-0003"><orgName>Veterans Health Care System of the Ozarks</orgName> <address><city>Fayetteville</city> <countryPart>AR</countryPart> <country>USA</country></address></affiliation><affiliation countryCode="US" type="organization" xml:id="cdoe12121-aff-0004"><orgDiv>Department of Veterans Affairs</orgDiv> <orgName>VHACO Office of Dentistry</orgName> <address><city>Washington</city> <countryPart>DC</countryPart> <country>USA</country></address></affiliation><affiliation countryCode="US" type="organization" xml:id="cdoe12121-aff-0005"><orgName>Creighton University School of Dentistry</orgName> <address><city>Omaha</city> <countryPart>NE</countryPart> <country>USA</country></address></affiliation><affiliation countryCode="US" type="organization" xml:id="cdoe12121-aff-0006"><orgName>James A. Haley VA Medical Center</orgName> <address><city>Tampa</city> <countryPart>FL</countryPart> <country>USA</country></address></affiliation><affiliation countryCode="US" type="organization" xml:id="cdoe12121-aff-0007"><orgName>VA San Diego Health Care System</orgName> <address><city>San Diego</city> <countryPart>CA</countryPart> <country>USA</country></address></affiliation></affiliationGroup><keywordGroup type="author"><keyword xml:id="cdoe12121-kwd-0001">adults</keyword><keyword xml:id="cdoe12121-kwd-0002">caries</keyword><keyword xml:id="cdoe12121-kwd-0003">fluoride</keyword><keyword xml:id="cdoe12121-kwd-0004">health services research</keyword><keyword xml:id="cdoe12121-kwd-0005">prevention</keyword></keywordGroup><fundingInfo><fundingAgency>Department of Veterans Affairs</fundingAgency><fundingNumber>AHRQ R21HS019527</fundingNumber><fundingNumber>K24DE18211</fundingNumber></fundingInfo><fundingInfo><fundingAgency>Boston University</fundingAgency></fundingInfo><abstractGroup><abstract type="main" xml:id="cdoe12121-abs-0001"><title type="main">Abstract</title><section xml:id="cdoe12121-sec-0001"><title type="main">Background</title><p>The Global Burden of Disease Study showed there was a 34.5% increase in years lived with disability due to dental caries from 1990 to 2010. With the aging of 76 million baby boomers, dental caries will continue to pose a significant challenge for older adults.</p></section><section xml:id="cdoe12121-sec-0002"><title type="main">Objective</title><p>Test the effectiveness of prescription or professionally applied fluoride in the prevention of new dental restorations in a clinical setting where patients are medically compromised and more dentally impaired than the general population.</p></section><section xml:id="cdoe12121-sec-0003"><title type="main">Methods</title><p>A retrospective cohort study, using multiple electronic databases within the Department of Veterans Affairs. Propensity scores were used to adjust for confounding by indication and logistic regression modeled the outcome and included all expected covariates.</p></section><section xml:id="cdoe12121-sec-0004"><title type="main">Results</title><p>The study sample included 140 114 high caries risk Veterans with a mean of 3.4 physical comorbidities, 1.2 mental comorbidities, and 11 medication groups per patient. Patients who received clinical fluoride treatments had 17–20% decreased odds of requiring a restoration during the follow‐up period.</p></section><section xml:id="cdoe12121-sec-0005"><title type="main">Conclusions</title><p>Prescription self‐applied or professionally applied fluoride provided either before or during an episode of care significantly reduced the likelihood of new restorations in high caries risk and medically compromised Veterans.</p></section></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Fluoride effectiveness in high caries risk and medically complex Veterans</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Fluoride effectiveness in high caries risk and medically complex Veterans</title></titleInfo><name type="personal"><namePart type="given">M. Marianne</namePart><namePart type="family">Jurasic</namePart><affiliation>Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA</affiliation><affiliation>Edith Nourse Rogers Memorial Veterans Hospital, VA Center for Healthcare Organization and Implementation Research, MA, Bedford, USA</affiliation><affiliation>M. Marianne Jurasic, Boston University School of Dental Medicine, 100 E. Newton St., Room 619, Boston, MA 02118, USATel.: +1 617 638 5209Fax: +1 617 414 1061e‐mail:</affiliation><affiliation>E-mail: mjurasic@bu.edu</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Gretchen</namePart><namePart type="family">Gibson</namePart><affiliation>Veterans Health Care System of the Ozarks, Fayetteville, AR, USA</affiliation><affiliation>Department of Veterans Affairs, VHACO Office of Dentistry, DC, Washington, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Carolyn J.</namePart><namePart type="family">Wehler</namePart><affiliation>Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA</affiliation><affiliation>Edith Nourse Rogers Memorial Veterans Hospital, VA Center for Healthcare Organization and Implementation Research, MA, Bedford, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Martha</namePart><namePart type="family">Nunn</namePart><affiliation>Creighton University School of Dentistry, NE, Omaha, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michelle B.</namePart><namePart type="family">Orner</namePart><affiliation>Edith Nourse Rogers Memorial Veterans Hospital, VA Center for Healthcare Organization and Implementation Research, MA, Bedford, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Elizabeth</namePart><namePart type="family">Nunez</namePart><affiliation>Department of Veterans Affairs, VHACO Office of Dentistry, Washington, DC, USA</affiliation><affiliation>James A. Haley VA Medical Center, FL, Tampa, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Terry G.</namePart><namePart type="family">O'Toole</namePart><affiliation>Department of Veterans Affairs, VHACO Office of Dentistry, Washington, DC, USA</affiliation><affiliation>VA San Diego Health Care System, CA, San Diego, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Judith A.</namePart><namePart type="family">Jones</namePart><affiliation>Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA</affiliation><affiliation>Edith Nourse Rogers Memorial Veterans Hospital, VA Center for Healthcare Organization and Implementation Research, MA, Bedford, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><dateIssued encoding="w3cdtf">2014-12</dateIssued><dateCreated encoding="w3cdtf">2014-06-25</dateCreated><dateCaptured encoding="w3cdtf">2013-09-23</dateCaptured><dateValid encoding="w3cdtf">2014-06-20</dateValid><edition>Jurasic MM, Gibson G, Wehler CJ, Nunn M, Orner MB, Nunez E, O'Toole TG, Jones JA. Fluoride effectiveness in high caries risk and medically complex Veterans. Community Dent Oral Epidemiol 2014; 42: 543–552. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.</edition><copyrightDate encoding="w3cdtf">2014</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract>The Global Burden of Disease Study showed there was a 34.5% increase in years lived with disability due to dental caries from 1990 to 2010. With the aging of 76 million baby boomers, dental caries will continue to pose a significant challenge for older adults.</abstract><abstract>Test the effectiveness of prescription or professionally applied fluoride in the prevention of new dental restorations in a clinical setting where patients are medically compromised and more dentally impaired than the general population.</abstract><abstract>A retrospective cohort study, using multiple electronic databases within the Department of Veterans Affairs. Propensity scores were used to adjust for confounding by indication and logistic regression modeled the outcome and included all expected covariates.</abstract><abstract>The study sample included 140 114 high caries risk Veterans with a mean of 3.4 physical comorbidities, 1.2 mental comorbidities, and 11 medication groups per patient. Patients who received clinical fluoride treatments had 17–20% decreased odds of requiring a restoration during the follow‐up period.</abstract><abstract>Prescription self‐applied or professionally applied fluoride provided either before or during an episode of care significantly reduced the likelihood of new restorations in high caries risk and medically compromised Veterans.</abstract><note type="funding">Department of Veterans Affairs - No. AHRQ R21HS019527; No. K24DE18211; </note><note type="funding">Boston University</note><subject><genre>keywords</genre><topic>adults</topic><topic>caries</topic><topic>fluoride</topic><topic>health services research</topic><topic>prevention</topic></subject><relatedItem type="host"><titleInfo><title>Community Dentistry and Oral Epidemiology</title></titleInfo><titleInfo type="abbreviated"><title>Community Dent Oral Epidemiol</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><subject><genre>article-category</genre><topic>Original Article</topic></subject><identifier type="ISSN">0301-5661</identifier><identifier type="eISSN">1600-0528</identifier><identifier type="DOI">10.1111/(ISSN)1600-0528</identifier><identifier type="PublisherID">CDOE</identifier><part><date>2014</date><detail type="volume"><caption>vol.</caption><number>42</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>543</start><end>552</end><total>10</total></extent></part></relatedItem><identifier type="istex">A069FAE640EB664CF7BB9E3CB230F907DD700A3F</identifier><identifier type="ark">ark:/67375/WNG-QB31L8GK-K</identifier><identifier type="DOI">10.1111/cdoe.12121</identifier><identifier type="ArticleID">CDOE12121</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2014 John Wiley & Sons A/SPublished 2014. 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