General Practitioners' Use of Caries-Preventive Agents in Adult Patients Versus Pediatric Patients

Abstract

Background Evidence suggests that caries prevention reduces caries in adults. This study tested the frequency of recommended caries prevention agents for children compared to adult patients. Methods This study surveyed 467 Dental Practice-Based Research Network general dentists who practice within the United States and treat both pediatric and adult patients. Dentists were asked the percentage of their patients who are administered or recommended dental sealants, in-office and at-home fluoride, chlorhexidine rinse, and xylitol gum. Results Adults were less likely to receive in-office caries preventive agents compared to pediatric patients. However, the rate of recommendation for at-home preventive regimens was very similar. Dentists with a conservative approach to caries treatment were the most likely to use caries prevention at similar rates in adults as in children. In addition, practices with a greater number of patients with dental insurance were significantly less likely to provide in-office fluoride or sealants to adult patients than to their pediatric patients. Conclusion In-office caries prevention agents are more commonly used by general dentists for their pediatric patients compared to their adult patients. Practice Implications Some general dentists should consider providing additional in-office prevention agents for their adult patients who are at increased risk for dental caries.

Edentulism in High Poverty Rural Counties

“…Other commonly used preventive agents include topical fluorides, which could also be used in adults at home, in medical or dental settings. A national dental practice‐based research network recently demonstrated that most general practitioners do not offer topical fluorides to patients in their offices but promote their use at home 41 . In addition to topical applications, water fluoridation can also play a role in edentulism prevention.…”

“…A national dental practice-based research network recently demonstrated that most general practitioners do not offer topical fluorides to patients in their offices but promote their use at home. 41 In addition to topical applications, water fluoridation can also play a role in edentulism prevention. An English study found that water fluoridation reduces tooth decay in adolescents and reduces the dental health disparities between socioeconomic groups.…”

A Markov cost‐effective analysis of biannual fluoride varnish for preventing dental caries in permanent teeth over a 70‐year time horizon

“…Despite established efficacy, professionally applied fluoride varnish has not had widespread practice . In countries with community water fluoridation such as Australia, the Republic of Ireland and the US, fluoride varnish is recommended for elevated caries risk, whereas in countries with limited or no water fluoridation such as England and Scotland, fluoride varnish is recommended for all children and young adults .…”

Concordance between clinical practice and published evidence

“…5,9,13 In another study, only 44% of general dentists reported using a rubber dam for all root canal treatments. 14 Several studies found that dentists do not use sealants for caries prevention and treatment for adults or children 12,15,16 as often recommended by evidence-based guidelines. 1,17 …”