IADR Abstract Archives
Effectiveness of 1.1%Sodium Fluoride in a High Caries Risk Population
Objectives: Evaluate the effectiveness of prescription 1.1% sodium fluoride (NaF) paste/gel in preventing new caries-related restorations/extractions in patients at high risk for caries.
Methods: The study was a retrospective analysis of longitudinal data from 10/01/2008-06/30/2018, using the Department of Veterans Affairs electronic dental, medical, and pharmacy records. Patients receiving 2+ single-unit restorations associated with a caries diagnosis within a 12-month period (index year) were included in the study. The intervention was number of 1.1%NaF paste/gel prescriptions received during the index year. The outcome was new caries-related restorations/extractions in the 12 months following the index year. Covariates included demographic data, medical complexity, medication burden, use of preventive dental services, number of caries-related restorations, time between first and last restoration, and use of other fluoride treatments (in-office rinse/gel or varnish). Bivariate analyses included a cross-tabulation of fluoride receipt with all predictor variables and the outcome. Logistic regression modelled the outcome with the intervention and all covariates.
Results: Within the overall study sample, 27.3% (18,491/67,806) received 1.1% NaF paste/gel. Of those who did receive 1.1%NaF paste/gel, 46.4% received one prescription/yr, 22.1% received 2, and 31.5% received 3+. Receiving prescription fluoride alone vs. no fluoride did not significantly affect the number of new caries-related restorations/extractions during the outcome year (OR=1.03, 95%CI=0.96,1.10). When combined with in-office fluoride rinse/gel or varnish, it reduced their effectiveness in preventing future caries related restorations/extractions.
Conclusions: In this clinical setting with a large population of high caries-risk patients, 1.1% NaF paste/gel showed poor effectiveness. Three to four tubes of 1.1% NaF are required for continuous one-year use. Therefore, prescription receipt/refill was low in our study sample. To address the inconsistency between efficacy and effectiveness, increased education of both providers and patients and greater patient compliance is required.
Methods: The study was a retrospective analysis of longitudinal data from 10/01/2008-06/30/2018, using the Department of Veterans Affairs electronic dental, medical, and pharmacy records. Patients receiving 2+ single-unit restorations associated with a caries diagnosis within a 12-month period (index year) were included in the study. The intervention was number of 1.1%NaF paste/gel prescriptions received during the index year. The outcome was new caries-related restorations/extractions in the 12 months following the index year. Covariates included demographic data, medical complexity, medication burden, use of preventive dental services, number of caries-related restorations, time between first and last restoration, and use of other fluoride treatments (in-office rinse/gel or varnish). Bivariate analyses included a cross-tabulation of fluoride receipt with all predictor variables and the outcome. Logistic regression modelled the outcome with the intervention and all covariates.
Results: Within the overall study sample, 27.3% (18,491/67,806) received 1.1% NaF paste/gel. Of those who did receive 1.1%NaF paste/gel, 46.4% received one prescription/yr, 22.1% received 2, and 31.5% received 3+. Receiving prescription fluoride alone vs. no fluoride did not significantly affect the number of new caries-related restorations/extractions during the outcome year (OR=1.03, 95%CI=0.96,1.10). When combined with in-office fluoride rinse/gel or varnish, it reduced their effectiveness in preventing future caries related restorations/extractions.
Conclusions: In this clinical setting with a large population of high caries-risk patients, 1.1% NaF paste/gel showed poor effectiveness. Three to four tubes of 1.1% NaF are required for continuous one-year use. Therefore, prescription receipt/refill was low in our study sample. To address the inconsistency between efficacy and effectiveness, increased education of both providers and patients and greater patient compliance is required.