Comparative effectiveness of school-based caries prevention: a prospective cohort study

Ruff, Ryan Richard; Niederman, Richard

doi:10.1186/s12903-018-0514-6

Cited by 12 publications

(12 citation statements)

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“…We previously demonstrated that a multi-component school-based caries prevention program was associated with a decreased risk of untreated decay in primary and permanent dentition [11][12][13]. Analyses from this study included generalized estimating equations and mixed-effects regression models, showing consistency in results.…”

Section: Introductionmentioning

confidence: 61%

“…School-based caries prevention can improve oral health by increasing access to care for high-risk populations [17,18]. However, comparative approaches to prevention have shown that impacts on oral health are inconsistent, and the optimal mix of interventions, frequency of care, and program duration is still unknown [12]. In this study, we demonstrated that previous findings on the potential impact of comprehensive caries prevention were robust to alternative correlational structures, such as serial dependence, which may be a more realistic assumption when using longitudinal caries data.…”

Section: Discussionmentioning

confidence: 99%

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School-based caries prevention and longitudinal trends in untreated decay: an updated analysis with Markov chains

2020

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Objective: Dental caries (tooth decay) is the most prevalent childhood disease in the world. A school-based program for the prevention of dental caries providing biannual sealants, interim therapeutic restorations, and fluoride varnish to children aged 5-12 years was previously associated with a significant reduction in the prevalence of untreated tooth decay over time. The objective of this study was to explore potential nonlinear change in the risk of untreated decay in children receiving caries prevention. Results: Across all study participants, there was a significant increase in the odds of untreated tooth decay over time (OR = 1.90, 95% CI 1.51, 2.39), but the rate of this risk rapidly decreased with each observational visit (OR = 0.87, 95% CI 0.93, 0.91). Overall effects substantially depended on the oral health status of participants at baseline: for children with untreated decay at their first observation, the odds of untreated decay over time was 0.39 (95% CI 0.27, 0.55). A quadratic change for this subpopulation showed that the per-visit decrease in decay was attenuated with each subsequent observation (OR = 1.12, 95% CI 1.04, 1.20).

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Section: Introductionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

School-based caries prevention and longitudinal trends in untreated decay: an updated analysis with Markov chains

2020

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“…In-depth studies of non-responders’ biofilm formation mechanisms would likely provide insight into how these organisms evade the antibacterial properties of SDF. Overall, the increased utilization of SDF and other non-surgical interventions for caries in community settings [14, 15] can reduce oral health inequities [38], but a lack of treatment response may leave a susceptible portion of the population vulnerable to disease progression. Additional research is needed to support a deeper understanding of the mechanistic actions underlying the non-responsiveness to SDF.…”

Section: Discussionmentioning

confidence: 99%

Microbial Population Shift and Metabolic Characterization of Silver Diamine Fluoride Treatment Failure on Dental Caries

Paul

Sierra

et al. 2020

Preprint

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Objectives: The objective of this pilot study was to describe the microbial profiles present in the plaque and saliva of children who continued to develop new carious lesions following treatment with silver diamine fluoride (nonresponders) compared to caries active, caries- free and children with arrested caries following SDF treatment in order to identify potential microbial differences that may relate to a re-incidence of caries. Methods: Saliva and plaque samples from infected and contralateral sites were obtained from twenty children who were either caries free, had active carious lesions, were caries active and received SDF treatment immediately before sampling, or had previously received SDF treatment and developed new caries. In total, 8,057,899 Illumina-generated sequence reads from 60 samples were obtained. Reads were processed using the Quantitative Insights Into Microbial Ecology pipeline. Group differences were assessed using Analysis of Variance Models and Tukey Honest Significant Differences. To identify significant taxa between treatment groups, Linear discriminant analysis Effect Size (LefSe) and Analysis of Differential Abundance Taking Sample Variation Into Account were used. Results: Differential abundant analysis indicated that members of the Lachnospiraceae family were significantly enriched in non-responders and the genus Tannerella and species Granulicatella adiances were also highly abundant in this group. LefSe analysis between non- responders and SDF-treated groups revealed that genera Leptotrichia and Granulicatella were enriched in non-responders. We observed the highest abundance of phosphotransferase system and lowest abundance of lipopolysaccharide synthesis in non-responders. Discussion: The microbiome in dental biofilms is responsible for the progression of dental caries. SDF has been shown to be effective in arresting the progression carious lesions, thought to be related to its antimicrobial properties. Findings suggest that a differential abundance of select microbiota and specific pathway functioning may contribute to a potential failure of silver diamine fluoride to arrest dental caries.

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“…Due to the considerable oral health needs of high-risk children resulting from access barriers to traditional office-based care, school-based caries prevention programs have become a popular public health dentistry intervention [ 43 ]. The vast majority of these programs use dental sealants as the primary preventive agent, though others include fluoride varnish and ITR [ 44 , 45 ]. Despite a growing interest in SDF to arrest and prevent caries in clinical trials [ 46 , 47 ], to our knowledge they have never been used in school-based prevention programs in the United States.…”

Section: Discussionmentioning

confidence: 99%

Silver diamine fluoride versus therapeutic sealants for the arrest and prevention of dental caries in low-income minority children: study protocol for a cluster randomized controlled trial

Ruff

Niederman

2018

Trials

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BackgroundDental caries is the most prominent childhood disease in the world. In the United States, more than 50% of children have experienced caries. Untreated caries can have negative impacts on quality of life, academic performance, and school attendance. To reduce oral health disparities, multiple organizations recommend school-based caries prevention.Methods/designA longitudinal, cluster randomized, non-inferiority trial will be conducted in low-income children from primarily Hispanic/Latino backgrounds currently enrolled in public elementary schools in New York City, New York, United States, from 2018 to 2023. The primary objective is to compare the non-inferiority of silver diamine fluoride and fluoride varnish versus glass ionomer therapeutic sealants and fluoride varnish in the arrest and prevention of dental caries. Secondary objectives are to evaluate differences in effectiveness when care is provided by nurses versus dental hygienists and assess the impact of prevention on oral health-related quality of life and educational outcomes. Caries arrest will be evaluated after 2 years, and caries prevention and secondary outcomes will be assessed at the completion of the study. Data analysis will follow intent-to-treat, and statistical analyses will be conducted using a two-sided significance level of 0.05.DiscussionThe comparative effectiveness of alternative caries prevention delivery models is considered to be one of the highest research priorities in the United States. Many treatments are currently available to prevent and arrest dental caries. The simplicity and affordability of silver diamine fluoride may be a viable alternative for the prevention of dental caries in high-risk children.Trial registrationU.S. National Library of Medicine, www.clinicaltrials.gov, ID: NCT03442309. Registered on 22 February 2018.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-2891-1) contains supplementary material, which is available to authorized users.

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Comparative effectiveness of school-based caries prevention: a prospective cohort study

Cited by 12 publications

References 19 publications

School-based caries prevention and longitudinal trends in untreated decay: an updated analysis with Markov chains

School-based caries prevention and longitudinal trends in untreated decay: an updated analysis with Markov chains

Microbial Population Shift and Metabolic Characterization of Silver Diamine Fluoride Treatment Failure on Dental Caries

Silver diamine fluoride versus therapeutic sealants for the arrest and prevention of dental caries in low-income minority children: study protocol for a cluster randomized controlled trial

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