Another update for Canadian dentists regarding chlorhexidine varnish therapy for the prevention of dental caries.
Some of the reasons for my belief that CVT has been marketed prematurely have been described. They include the belief that the only really important outcome from the patients' and dentists' perspectives is proven reductions in dental caries. Associated with this is the need to recognize that, using such a criterion, the numbers of patients who may truly benefit from CVT in Canada are small--much smaller than those who promote the testing for and use of CVT appear to infer. Once proven clinically effective, the cost effectiveness of CVT for different patient groups must be demonstrated. I also think that studies to determine Cariescreen's accuracy in terms of predictive values for the "gold standard" plate counts of mutans streptococci should be undertaken. These results should then be given to dentists to help them in their decisions about using CVT in their practices, and if this decision is affirmative, in their discussions with patients for whom they decide CVT will be beneficial. Similarly, the effectiveness of the single application of CVT must be proven by a properly-designed study, since the current justification is inadequate for so important an issue. Finally, dentists should have been provided with all of this basic information before CVT was marketed in Canada.
Lewis
D W
DW
Department of Community Dentistry, University of Toronto.
D000293:Adolescent; D002170:Canada; D002327:Cariostatic Agents / Q000191:economics; D002648:Child; D002710:Chlorhexidine / Q000008:administration & dosage* / Q000191:economics; D003362:Cost-Benefit Analysis; D003731:Dental Caries / Q000191:economics / Q000517:prevention & control*; D003732:Dental Caries Activity Tests; D006801:Humans; D010936:Plant Extracts / Q000008:administration & dosage; D011237:Predictive Value of Tests; D013295:Streptococcus mutans / Q000187:drug effects; D032362:Styrax
C457659:Benzoin Gum; D002327:Cariostatic Agents; D010936:Plant Extracts; D002710:Chlorhexidine