Outcomes associated with dentists' risk assessment.
OBJECTIVE
To examine retrospectively the caries-related restorative experience of at-risk individuals who received fluoride-based preventive interventions to determine if the intervention resulted in fewer caries-related procedures.


METHODS
Administrative data from two dental health plans were used to determine the relationship between caries risk assessment (CRA) scores, preventive treatment and caries-related treatment procedures. We identified 45 693 adults who were consecutively enrolled for at least 1 year before and 2.5 years after the CRA. Variables representing the number of teeth with any caries-related treatment procedure and receipt of preventive treatment were created.


RESULTS
The outcome variable of interest was having at least one tooth with a caries-related procedure in the 2-year follow-up period. In plan A, the recommendation for home-use fluoride was not significantly related to caries-related treatment procedures in the follow-up period for individuals at low, moderate or high risk (P > 0.300). In plan B, application of in-office fluoride was associated with having at least one tooth with a caries-related treatment procedure in the follow-up period (P < 0.001).


CONCLUSIONS
We found incomplete compliance with guidelines for recommendation or administration of preventive treatment for patients at elevated risk for caries. We were also unable to identify any significant reductions in caries-related procedures for individuals receiving a fluoride intervention, compared with those who did not, when stratified by risk level.
Rindal
D Brad
DB
HealthPartners Research Foundation, Minneapolis, MN 55440-1524, USA. d.brad.rindal@healthpartners.com
Rush
William A
WA
Perrin
Nancy A
NA
Maupomé
Gerardo
G
Bader
James D
JD
D000328:Adult; D002327:Cariostatic Agents / Q000627:therapeutic use*; D003731:Dental Caries / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data*; D004812:Epidemiologic Methods; D005260:Female; D005457:Fluoridation; D005459:Fluorides / Q000627:therapeutic use*; D006124:Group Practice, Dental; D006801:Humans; D008297:Male; D008875:Middle Aged
D002327:Cariostatic Agents; D005459:Fluorides