Topical fluoride for caries prevention Weyant, Robert J., DMD, DrPH; Tracy, Sharon L., PhD; Anselmo, Theresa (Tracy), MPH, BSDH, RDH ...
The Journal of American Dental Association (1922),
November 2013, Letnik:
144, Številka:
11
Journal Article
Recenzirano
Odprti dostop
ABSTRACT Background A panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs presents evidence-based clinical recommendations regarding professionally ...applied and prescription-strength, home-use topical fluoride agents for caries prevention. These recommendations are an update of the 2006 ADA recommendations regarding professionally applied topical fluoride and were developed by using a new process that includes conducting a systematic review of primary studies. Types of Studies Reviewed The authors conducted a search of MEDLINE and the Cochrane Library for clinical trials of professionally applied and prescription-strength topical fluoride agents—including mouthrinses, varnishes, gels, foams and pastes—with caries increment outcomes published in English through October 2012. Results The panel included 71 trials from 82 articles in its review and assessed the efficacy of various topical fluoride caries-preventive agents. The panel makes recommendations for further research. Practical Implications The panel recommends the following for people at risk of developing dental caries: 2.26 percent fluoride varnish or 1.23 percent fluoride (acidulated phosphate fluoride) gel, or a prescription-strength, home-use 0.05 percent fluoride gel or paste or 0.09 percent fluoride mouthrinse for patients 6 years or older. Only 2.26 percent fluoride varnish is recommended for children younger than 6 years. The strengths of the recommendations for the recommended products varied from ”in favor“ to ”expert opinion for.“ As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences.
Amaç: Bu anket çalışmasının amacı; stajlarda çocuk hasta bakan diş hekimliği fakültesi öğrencilerinin, koruyucu diş hekimliği de içerisine alan çocuk diş hekimliğine yaklaşımını değerlendirmektir.
...Gereç ve Yöntemler: Amaca yönelik olarak 20 sorudan oluşan bir anket formu hazırlandı ve anket, öğrencilere sınav ortamından uzak stressiz bir ortamda online olarak uygulandı. Veriler bilgisayar ortamında kodlandı ve analiz edildi.
Bulgular: Katılımcıların %55,9’u çocuk hasta bakmayı sevdiklerini belirtmişlerdir. %72,8’i çocuk hasta bakarken tedirgin olduğunu belirtirken, %16,9’u çocuk, %83,1’i yetişkin hastayı tedavi etmeyi tercih etmektedir. . Mezuniyet sonrasında meslek hayatlarında rutin olarak çocuk hasta tedavi etmeyi, %67,6’sı çok sık olmamakla birlikte düşünebilirim yanıtını verirken, %25’i evet, %7,4’ü ise mecbur kalmadıkça kesinlikle düşünmüyorum yanıtını vermiştir. Çocuk hasta bakarken kadınların daha tedirgin olmasına rağmen, çocuk hasta bakmayı erkelere göre daha çok tercih etmektedir (p0,05). Katılımcıların sınıflarına ve cinsiyete göre çocuk diş hekimliği hizmetinin en iyi verildiğini düşündükleri kurumlara ilişkin değerlendirmelerinde istatistiksel olarak anlamlı bir farklılık bulunmamaktadır (p>0,05). Her iki sınıf ve cinsiyet için en sık verilen yanıt diş hekimliği fakülteleri olmuştur.
Sonuç: Ülkemizde çocuk ve genç nüfusunun fazla olmasına rağmen, geleceğin diş hekimi adayları, bu tedavilerde yeteri kadar istekli olmadıkları görülmüştür. Öğrenimleri süresince çocuk hastaları tedavi etmeye yönelik bilgi ve tecrübelerinin arttırılması, ileride daha çok sayıda çocuk hastayı tedavi edilebilmelerine yardımcı olacaktır.
To investigate the effectiveness of a novel agent containing Nano Silver Fluoride 1500 (NSF 1500) and chitosan to inactivate carious lesions in children.
The study included eighty children. While ...both groups had fluoride dentifrice applied to their teeth, only the experimental group received treatment with the NSF 1500-ppm solution. The first and sixth-month interval examinations were conducted by two calibrated dentists (k = 0.85).
The NSF 1500 group had 69.2% of their teeth with arrested decay, while the control group had 24.1%. The difference was statistically significant (
0.001), with a preventive fraction of 59.4%. The number needed to treat (NNT) was approximately two. The NSF 1500 formulation was more effective than toothbrushing alone with fluoridated dentifrice in preventing dental caries.
The effectiveness of NSF 1500 is determined by the size and depth of the dental cavity. Its ability to arrest caries lesions was comparable to previously tested products, NSF 400 and NSF 600.
Preventive dentistry, dental caries, nanoparticles.
Toothbrushing is considered fundamental self-care behavior for maintenance of oral health, and brushing twice a day has become a social norm, but the evidence base for this frequency is weak. This ...systematic review and meta-analysis aims to assess the effect of toothbrushing frequency on the incidence and increment of carious lesions. Medline, Embase, Cinahl, and Cochrane databases were searched. Screening and quality assessment were performed by 2 independent reviewers. Three different meta-analyses were conducted: 2 based on the caries outcome reported in the studies (incidence and increment) with subgroup analyses of categories of toothbrushing frequency; another included all studies irrespective of the caries outcome reported with the type of dentition as subgroups. Meta-regression was conducted to assess the influence of sample size, follow-up period, diagnosis level for carious lesions, and methodological quality of the articles on the effect estimate. Searches retrieved 5,494 titles: after removing duplicates, 4,305 remained. Of these, 74 were reviewed in full, but only 33 were eligible for inclusion. Self-reported infrequent brushers demonstrated higher incidence (odds ratio OR, 1.50; 95% confidence interval CI, 1.34 to 1.69) and increment (standardized mean difference SMD, 0.28; 95% CI: 0.13 to 0.44) of carious lesions than frequent brushers. The odds of having carious lesions differed little when subgroup analysis was conducted to compare the incidence between ≥2 times/d vs <2 times/d (OR: 1.45; 95% CI: 1.21 to 1.74) and ≥1 time/d vs <1 time/d brushers (OR: 1.56; 95% CI: 1.37 to 1.78). When meta-analysis was conducted with the type of dentition as subgroups, the effect of infrequent brushing on incidence and increment of carious lesions was higher in deciduous (OR: 1.75; 95% CI: 1.49 to 2.06) than permanent dentition (OR: 1.39; 95% CI: 1.29 to 1.49). Findings from meta-regression indicated that none of the included variables influenced the effect estimate.
Oral diseases are a major global public health problem affecting over 3·5 billion people. However, dentistry has so far been unable to tackle this problem. A fundamentally different approach is now ...needed. In this second of two papers in a Series on oral health, we present a critique of dentistry, highlighting its key limitations and the urgent need for system reform. In high-income countries, the current treatment-dominated, increasingly high-technology, interventionist, and specialised approach is not tackling the underlying causes of disease and is not addressing inequalities in oral health. In low-income and middle-income countries (LMICs), the limitations of so-called westernised dentistry are at their most acute; dentistry is often unavailable, unaffordable, and inappropriate for the majority of these populations, but particularly the rural poor. Rather than being isolated and separated from the mainstream health-care system, dentistry needs to be more integrated, in particular with primary care services. The global drive for universal health coverage provides an ideal opportunity for this integration. Dental care systems should focus more on promoting and maintaining oral health and achieving greater oral health equity. Sugar, alcohol, and tobacco consumption, and their underlying social and commercial determinants, are common risk factors shared with a range of other non-communicable diseases (NCDs). Coherent and comprehensive regulation and legislation are needed to tackle these shared risk factors. In this Series paper, we focus on the need to reduce sugar consumption and describe how this can be achieved through the adoption of a range of upstream policies designed to combat the corporate strategies used by the global sugar industry to promote sugar consumption and profits. At present, the sugar industry is influencing dental research, oral health policy, and professional organisations through its well developed corporate strategies. The development of clearer and more transparent conflict of interest policies and procedures to limit and clarify the influence of the sugar industry on research, policy, and practice is needed. Combating the commercial determinants of oral diseases and other NCDs should be a major policy priority.
Although preventive dental visits are considered important for maintaining pediatric oral health, there is relatively little research showing that they reduce subsequent nonpreventive dental visits ...or costs. At least 1 study seemed to find that early preventive dental care is associated with more restorative and emergency visits. Previous studies are limited by their inability to account for unmeasurable factors that may lead children to "select" into using both more preventive and nonpreventive dental care. We used econometric techniques that minimize selection bias to assess the effectiveness of preventive dental care in reducing subsequent nonpreventive dental service utilization among children.
Using data from Alabama's Children's Health Insurance Program (CHIP), 1998-2010., a cohort study of children's dental service utilization was conducted. Outcomes were 1-year lagged nonpreventive dental care and expenditures, and overall dental and medical expenditures. Children who were continuously enrolled for at least 3 years were included. Separate models were estimated for children aged <8 years (n = 14 972) and those aged ≥8 years (n = 21 833).
More preventive visits were associated with fewer subsequent nonpreventive dental visits and lower nonpreventive dental expenditures for both groups. However, more preventive visits did not reduce overall dental or medical (inclusive of dental) expenditures.
Preventive dental visits can reduce subsequent nonpreventive visits and expenditures for children continuously enrolled in CHIP. However, they may not reduce overall program costs. Effective empirical research in this area must continue to address unobserved confounders and selection issues.
This letter is a response to commentary by Dr. Smith on 'Examining the association between cancer history in early life and dental care utilization'. We provided additional information and ...clarification regarding our analysis and results in response to Dr. Smith's questions and comments. Despite the limitations and weaknesses of our study, we still believe that it provides important information and further research questions.
Objective: To assess the prevalence of tooth decay and it’s associated factors among the age group of 15-20 years old visiting Ayder Comprehensive Specialized Hospital. Material and Methods: An ...epidemiological cross-sectional descriptive study was conducted among 384 subjects aged 15-20 years. A closed-ended questionnaire, according to the World Health Organization methodology was used to collect the data. The subjects were examined for the presence of tooth decay using the DMFT Index. One examiner was trained and standardized using a Kappa test (K=0.90). To test the differences in the DMF-T index related to socioeconomic variables, the Chi-square and the Mann-Whitney tests were employed. For all tests, the level of significance was set at p≤0.05 with 95% Confidence level. Results: The magnitude of tooth decay among study participants was 57.8%. The mean decayed, missed and filled was 1.26 and prevalence was higher in males (34.1%). Poor oral hygiene practice was strongly associated factor with tooth decay. 56.2% of visitors from the urban area were mainly affected by tooth decay. Conclusion: Tooth decay is highly prevalent among visitors between15-20 years of age. Tooth brushing habit, residency, and consumption of sugary food and drinks were significantly associated with the occurrence of tooth decay. Early diagnosis and prompt treatment can prevent further damage.
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