Use of Caries Preventive Services in the NWPRECEDENT Dental Network

Objective: This cross-sectional study assessed the use of caries preventive services by NW PRECEDENT dental network practitioners and compared the caries experience of patients who received such services in the past 12 months with those that had not.

Methods:  An oral health survey was conducted on about 18 patients in each of 73 practices in the network.  Eligible patients (total of 1338 aged 3-92) were randomly assessed for having received the following preventive services within the past 12 months:  fluoride varnish or gel, sealant in molar or premolar, prophylaxis, as well as the occurrence of one or more new caries lesions.  Patients were stratified by gender and age (1-17 yo, 18-64 yo, and 65+ yo).  Logistic regression(p<0.05) was used to investigate the association between the preventive measures and the presence of a new caries lesion in the past 12 months.

Results:   The percent of patients receiving prophylaxis/fluoride/sealant varied by age groups as follows: 94%/29%/23% for 1-17 yo, 82%/6%/1% for 18-64 yo, and 77%/9%/0% for 65+ yo.  For the 1-17 yo age group, males had twice the odds of having a new lesion than females in the past 12 months, and patients receiving a sealant had 2.26X higher odds of having a new lesion.  In the 18-64 yo group, receiving a prophylaxis in the past 12 months was significantly associated with lower odds for having a new lesion (0.625X).

Conclusions:  This study reports a relatively modest overall use of preventive services (prophylaxis-83%, fluoride-9%, and sealants-4%) in the NW PRECEDENT network. The lower odds for a new lesion in the middle age group with prophylaxis were expected, but the opposite relation for sealants in the young suggests that sealants may often not be prescribed until a caries lesion appears somewhere in the mouth. Submitted on behalf of Northwest PRECEDENT, NIDCR grants DE016750/DE016752.