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Professional Issues Supporting Your Practice

Measuring fluoride performance: A longitudinal study

This summary is based on the article published in the Journal of the American Dental Association:  Longitudinal outcomes of using a fluoride performance measure for adults at high risk of experiencing caries (May 2014)

For the next 3 months, you can access the full-text article here, courtesy of the American Dental Association. 

Gretchen Gibson, DDS, MPH; M. Marianne Jurasic, DMD, MPH; Carolyn J. Wehler, RDH, MPH; Michelle B. Orner, MPH; Martha E. Nunn, DDS, PhD; Elizabeth Nuñez, DMD, MST; Terry G. O’Toole, DDS; Patricia E. Arola, DDS, MHA, FAGD, FACHE; Susan C. Bestgen, DDS;; Judith A. Jones, DDS, MPH, DScD

Background

Dental caries remains a primary dental problem for adults in the United States—particularly older adults, those of racial and ethnic minorities and those who are living in poverty or have low levels of education. (1) The dental population treated by the VA includes a large proportion of veterans at high risk of experiencing caries. (2, 3) In 2008, the VA Office of Dentistry committed to addressing the issue of dental caries by using a medically based preventive approach.

Staff of the Veterans Affairs Office of Dentistry, the dental care arm of the U.S. Department of Veterans Affairs’ Veterans Health Administration, developed a performance measure (PM) regarding appropriate fluoride use.

Purpose of the Study

The study examines the effectiveness of the PM in reducing the overall rate of restorations in dental patients eligible for continuous and comprehensive care, and specifically in veterans at high risk of experiencing caries.

The authors hypothesized that restoration rates would decrease in these veterans after the introduction of the PM on Oct. 1, 2008 and that fewer new restorations would be placed one year after patients were identified as being at high risk of experiencing caries.

Results of the Study

  • Findings from this study demonstrate the decrease in the percentage of new restorations among all eligible veterans and veterans at high caries-development risk, as well as a reduction in number of restorations and surfaces in both populations.
  • Fluoride use for patients at high risk of experiencing caries rose from 51.8 percent in 2008 to 93.6 percent in 2012. Restoration rates fell consistently after the implementation of the PM.
  • Fluoride use reduces the need for future restorations in adults at high risk of experiencing caries.

References

  1. Dye BA, Tan S, Smith V, et al. Trends in oral health status: United States, 1988–1994 and 1999–2004. Vital Health Stat 2007 11(248):1–92.
  2. Boehmer U, Kressin NR, Spiro A 3rd., et al. Oral health of ambulatory care patients. Mil Med 2001;166(2):171–178.
  3. Jones JA, Kressin NR, Spiro A 3rd., et al. Self-reported and clinical oral health in users of VA health care. J Gerontol A Biol Sci Med Sci 2001;56(1):M55–M62.

 

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