Preferences for caries prevention agents in adult patients: findings from the dental practice–based research network

Abstract

Objectives To identify factors that are significantly associated with dentists’ use of specific caries preventive agents in adult patients, and whether dentists who use one preventive agent are also more likely to use certain others. Methods Data were collected from 564 practitioners in The Dental Practice-Based Research Network, a multi-region consortium of participating practices and dental organizations. Results In-office topical fluoride was the method most frequently used. Regarding at-home preventive agents, there was little difference in preference between non-prescription fluoride, prescription fluoride, or chlorhexidine rinse. Dentists who most frequently used caries prevention were also those who regularly perform caries risk assessment and individualize caries prevention at the patient level. Higher percentages of patients with dental insurance were significantly associated with more use of in-office prevention modalities. Female dentists and dentists with more-recent training were more likely to recommend preventive agents that are applied by the patient. Dentists who reported more-conservative decisions in clinical treatment scenarios were also more likely to use caries preventive agents. Groups of dentist who shared a common preference for certain preventive agents were identified. One group used preventive agents selectively, whereas the other groups predominately used either in-office or at-home fluorides. Conclusions Caries prevention is commonly used with adult patients. However, these results suggest that only a subset of dentists base preventive treatments on caries risk at the individual patient level.

Risk Factors of Caries Progression in a Hispanic School-aged Population

“…In fact, the dentist's overall subjective impression of the patient might have good caries-predictive power (Disney et al, 1992), but it is unclear how this information is incorporated into everyday practice. A recent survey of US practices suggests that a significant proportion of dentists had yet to adopt treatments based on assessment of caries risk (Riley et al, 2010), even when multiple expert-opinion tools are available for children [e.g., Caries Assessment Tool-CAT of the American Academy of Pediatric Dentistry, developed for use in multiple settings (2007); the American Dental Association's Caries Risk Tool (2008); the Caries Management by Risk Assessment tool (Ramos-Gomez et al, 2007)]. Therefore, a more objective, easy-to-implement, and validated risk tool is highly desirable, particularly for use in non-dental settings (e.g., schools, medical offices), to help target limited human/economic resources toward disease prevention.…”

Evidence–practice gap for dental sealant application: results from a dental practice-based research network in Japan

“…The same questionnaire survey by the US DPBRN found that 69% of patients of 6-18 years of age received sealant application 13 , compared to 34% in the JDPBRN. Further, 77% of US DPBRN dentists provided sealants to more than 50% of their patients, compared to 32% in the JDPBRN 13 .…”

“…Further, 77% of US DPBRN dentists provided sealants to more than 50% of their patients, compared to 32% in the JDPBRN 13 . According to a previous Japanese survey of dental diseases and conditions in 2005, 27 the prevalence of dental sealant use on permanent teeth in Japanese aged 10 to 14 years was 26%.…”

“…13 Dentists in Scandinavia use sealants less frequently than dentists in US, but by contrast, Scandinavian dentists practice caries risk assessment relatively more often. 13 Riley et al, discussed that Scandinavian dentists' relatively higher use of caries risk information may allow the lower overall use of caries prevention treatment through more-customized or more-targeted application to high-risk patients. 13 …”

“…13 Riley et al, discussed that Scandinavian dentists' relatively higher use of caries risk information may allow the lower overall use of caries prevention treatment through more-customized or more-targeted application to high-risk patients. 13 …”