Fluoride effectiveness in high caries risk and medically complex Veterans

Authors

  • M. Marianne Jurasic,

    Corresponding author
    1. Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
    2. Edith Nourse Rogers Memorial Veterans Hospital, VA Center for Healthcare Organization and Implementation Research, Bedford, MA, USA
    • M. Marianne Jurasic, Boston University School of Dental Medicine, 100 E. Newton St., Room 619, Boston, MA 02118, USA

      Tel.: +1 617 638 5209

      Fax: +1 617 414 1061

      e-mail: mjurasic@bu.edu

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  • Gretchen Gibson,

    1. Veterans Health Care System of the Ozarks, Fayetteville, AR, USA
    2. Department of Veterans Affairs, VHACO Office of Dentistry, Washington, DC, USA
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  • Carolyn J. Wehler,

    1. Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
    2. Edith Nourse Rogers Memorial Veterans Hospital, VA Center for Healthcare Organization and Implementation Research, Bedford, MA, USA
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  • Martha Nunn,

    1. Creighton University School of Dentistry, Omaha, NE, USA
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  • Michelle B. Orner,

    1. Edith Nourse Rogers Memorial Veterans Hospital, VA Center for Healthcare Organization and Implementation Research, Bedford, MA, USA
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  • Elizabeth Nunez,

    1. Department of Veterans Affairs, VHACO Office of Dentistry, Washington, DC, USA
    2. James A. Haley VA Medical Center, Tampa, FL, USA
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  • Terry G. O'Toole,

    1. Department of Veterans Affairs, VHACO Office of Dentistry, Washington, DC, USA
    2. VA San Diego Health Care System, San Diego, CA, USA
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  • Judith A. Jones

    1. Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
    2. Edith Nourse Rogers Memorial Veterans Hospital, VA Center for Healthcare Organization and Implementation Research, Bedford, MA, USA
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Abstract

Background

The Global Burden of Disease Study showed there was a 34.5% increase in years lived with disability due to dental caries from 1990 to 2010. With the aging of 76 million baby boomers, dental caries will continue to pose a significant challenge for older adults.

Objective

Test the effectiveness of prescription or professionally applied fluoride in the prevention of new dental restorations in a clinical setting where patients are medically compromised and more dentally impaired than the general population.

Methods

A retrospective cohort study, using multiple electronic databases within the Department of Veterans Affairs. Propensity scores were used to adjust for confounding by indication and logistic regression modeled the outcome and included all expected covariates.

Results

The study sample included 140 114 high caries risk Veterans with a mean of 3.4 physical comorbidities, 1.2 mental comorbidities, and 11 medication groups per patient. Patients who received clinical fluoride treatments had 17–20% decreased odds of requiring a restoration during the follow-up period.

Conclusions

Prescription self-applied or professionally applied fluoride provided either before or during an episode of care significantly reduced the likelihood of new restorations in high caries risk and medically compromised Veterans.

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