PURPOSE: The purpose of this study was to evaluate a risk-based dental caries prevention program at an urban pediatric primary care clinic serving low-income residents. METHODS: A demonstration caries prevention trial lasting 26 months was conducted with 219 6- to 27-month-old children. A "prevention" group of 6- to 15-month-old children (initial visit) were compared at the end of the trial with a "comparison" group at their initial visit. The latter children were patients of the same clinic who were 12 months older (18-27 months). Preventive services included: caries-risk assessments; mutans streptococci (MS) monitoring; fluoride varnish applications; dental health counseling; referral for dental treatment, if indicated; and periodic recalls. RESULTS: Prevention group children at the last recall experienced fewer mean carious dental surfaces (0.1 vs 1.29, P=.01) and over 8-fold less MS (P=.01) than comparison group subjects at their initial visit. The number of precavitated lesions was not significantly different CONCLUSIONS: Administration of prevention measures was shown to reduce dental caries experience in low socioeconomic status infants and toddlers, and oral MS levels were a reliable indicator of future caries status. Outcomes support establishment of caries prevention programs at urban primary care pediatric clinics.
PURPOSE: The purpose of this study was to evaluate a risk-based dental caries prevention program at an urban pediatric primary care clinic serving low-income residents. METHODS: A demonstration caries prevention trial lasting 26 months was conducted with 219 6- to 27-month-old children. A "prevention" group of 6- to 15-month-old children (initial visit) were compared at the end of the trial with a "comparison" group at their initial visit. The latter children were patients of the same clinic who were 12 months older (18-27 months). Preventive services included: caries-risk assessments; mutans streptococci (MS) monitoring; fluoride varnish applications; dental health counseling; referral for dental treatment, if indicated; and periodic recalls. RESULTS: Prevention group children at the last recall experienced fewer mean carious dental surfaces (0.1 vs 1.29, P=.01) and over 8-fold less MS (P=.01) than comparison group subjects at their initial visit. The number of precavitated lesions was not significantly different CONCLUSIONS: Administration of prevention measures was shown to reduce dental caries experience in low socioeconomic status infants and toddlers, and oral MS levels were a reliable indicator of future caries status. Outcomes support establishment of caries prevention programs at urban primary care pediatric clinics.
Authors: Andrea M de Silva; Shalika Hegde; Bridget Akudo Nwagbara; Hanny Calache; Mark G Gussy; Mona Nasser; Hannah R Morrice; Elisha Riggs; Pamela M Leong; Lisa K Meyenn; Reza Yousefi-Nooraie Journal: Cochrane Database Syst Rev Date: 2016-12-22
Authors: Andrea M de Silva; Shalika Hegde; Bridget Akudo Nwagbara; Hanny Calache; Mark G Gussy; Mona Nasser; Hannah R Morrice; Elisha Riggs; Pamela M Leong; Lisa K Meyenn; Reza Yousefi-Nooraie Journal: Cochrane Database Syst Rev Date: 2016-09-15