Caries prevention in a community-dwelling older population.
A clinical trial was conducted to compare the effect of different caries-preventive strategies on caries progression in lower-income, ethnically diverse persons 60 years of age and older. Two hundred and ninety-seven subjects were randomized into one of five experimental groups. Group 1 received usual care from a public health department or a private practitioner. Group 2 received an educational program of 2 h duration implemented twice a year. Group 3 received the educational program plus a 0.12% chlorhexidine rinse weekly. Group 4 received the education and chlorhexidine interventions and a fluoride varnish application twice a year. Group 5 received all the above interventions as well as scaling and root planing every 6 months throughout the 3-year study. A carious event was defined as the onset of a carious lesion, a filling, or an extraction on a surface which was sound at baseline. Two hundred and one subjects remained in the study for the 3-year period. Groups that received usual intraoral procedures (groups 3, 4, and 5) had a 27% reduction for coronal caries events (p = 0.09) and 23% for root caries events (p = 0.15), when compared to the groups that received no intraoral procedures (groups 1 and 2). Routine preventive treatments may have had only a small-to-moderate effect upon caries development.
Powell
L V
LV
Department of Restorative Dentistry, University of Washington, Seattle, Wash. 98195, USA. lvpowell@u.washington.edu
Persson
R E
RE
Kiyak
H A
HA
Hujoel
P P
PP
D000368:Aged; D000369:Aged, 80 and over; D002327:Cariostatic Agents / Q000008:administration & dosage; D002710:Chlorhexidine / Q000627:therapeutic use; D003149:Community Dentistry; D004245:DMF Index; D016321:Dental Care for Aged; D003731:Dental Caries / Q000453:epidemiology / Q000517:prevention & control*; D012534:Dental Scaling; D004522:Educational Status; D005460:Fluorides, Topical / Q000008:administration & dosage; D006267:Health Education, Dental; D006801:Humans; D015994:Incidence; D016013:Likelihood Functions; D017533:Marital Status; D008875:Middle Aged; D008913:Minority Groups; D011203:Poverty; D012044:Regression Analysis; D017213:Root Caries / Q000453:epidemiology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology
D002327:Cariostatic Agents; D005460:Fluorides, Topical; D002710:Chlorhexidine