Non-operative anti-caries agents and dental caries increment among adults at high caries risk: a retrospective cohort study
Identifieur interne : 000B95 ( Pmc/Curation ); précédent : 000B94; suivant : 000B96Non-operative anti-caries agents and dental caries increment among adults at high caries risk: a retrospective cohort study
Auteurs : Benjamin W. Chaffee [États-Unis] ; Jing Cheng [États-Unis] ; John Db Featherstone [États-Unis]Source :
- BMC Oral Health [ 1472-6831 ] ; 2015.
Abstract
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 (
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.
The online version of this article (doi:10.1186/s12903-015-0097-4) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s12903-015-0097-4
PubMed: 26403525
PubMed Central: 4581405
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Non-operative anti-caries agents and dental caries increment among adults at high caries risk: a retrospective cohort study</title>
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<series><title level="j">BMC Oral Health</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>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.</p>
</sec>
<sec><title>Methods</title>
<p>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 (<italic>N</italic>
= 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.</p>
</sec>
<sec><title>Results</title>
<p>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).</p>
</sec>
<sec><title>Conclusions</title>
<p>These results lend evidence that repeatedly receiving anti-caries agents can reduce tooth decay among high-risk patients engaged in regular dental care.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s12903-015-0097-4) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Oral Health</journal-id>
<journal-id journal-id-type="iso-abbrev">BMC Oral Health</journal-id>
<journal-title-group><journal-title>BMC Oral Health</journal-title>
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<issn pub-type="epub">1472-6831</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
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<article-meta><article-id pub-id-type="pmid">26403525</article-id>
<article-id pub-id-type="pmc">4581405</article-id>
<article-id pub-id-type="publisher-id">97</article-id>
<article-id pub-id-type="doi">10.1186/s12903-015-0097-4</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
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<title-group><article-title>Non-operative anti-caries agents and dental caries increment among adults at high caries risk: a retrospective cohort study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Chaffee</surname>
<given-names>Benjamin W.</given-names>
</name>
<address><email>benjamin.chaffee@ucsf.edu</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cheng</surname>
<given-names>Jing</given-names>
</name>
<address><email>jing.cheng@ucsf.edu</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Featherstone</surname>
<given-names>John DB</given-names>
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<address><email>john.featherstone@ucsf.edu</email>
</address>
<xref ref-type="aff" rid="Aff2"></xref>
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<aff id="Aff1"><label></label>
Center to Address Disparities in Children’s Oral Health, UCSF School of Dentistry, 3333 California Street, Suite 495, San Francisco, CA 94143-1361 USA</aff>
<aff id="Aff2"><label></label>
UCSF School of Dentistry, 513 Parnassus Ave, Room S630, San Francisco, CA 94143-0430 USA</aff>
</contrib-group>
<pub-date pub-type="epub"><day>24</day>
<month>9</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>24</day>
<month>9</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection"><year>2015</year>
</pub-date>
<volume>15</volume>
<elocation-id>111</elocation-id>
<history><date date-type="received"><day>4</day>
<month>2</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>16</day>
<month>9</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>© Chaffee et al. 2015</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<abstract id="Abs1"><sec><title>Background</title>
<p>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.</p>
</sec>
<sec><title>Methods</title>
<p>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 (<italic>N</italic>
= 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.</p>
</sec>
<sec><title>Results</title>
<p>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).</p>
</sec>
<sec><title>Conclusions</title>
<p>These results lend evidence that repeatedly receiving anti-caries agents can reduce tooth decay among high-risk patients engaged in regular dental care.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s12903-015-0097-4) contains supplementary material, which is available to authorized users.</p>
</sec>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Dental caries</kwd>
<kwd>Epidemiology</kwd>
<kwd>Caries management</kwd>
<kwd>Longitudinal studies</kwd>
<kwd>Health outcomes research</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2015</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
</record>
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