Association Between Preventive Treatments And Caries Among Mixed Dentition Children, A Retrospective Cohort Analysis.
Abstract: The importance of caries prevention during early childhood has been well documented. The efficacy of prevention treatment modalities is still in discussion. This study aimed to evaluate the effectiveness of the clinical prevention protocols in a University Pediatric Dentistry Clinic by analyzing Electronic Health Record data collected from 2004-2009. The study hypothesized that children ... read morein mixed dentition who received regular preventive treatment (fluoride and sealants) during their semiannual visits were less likely to develop caries on their permanent molars than children who did not. In a five-year retrospective cohort, 3,869 6-12 year old subjects were divided into three prevention groups (semiannual sealants, fluoride, and combined interevention) and one control group (irregular interevention). Evaluations detemined whether they had developed primary or recurrent caries on their first permanent molars between 2004-2009. Other controlled factors included: age, gender, treatment procedure, provider, financial class , zip code, poverty status and water fluoridation. In bivariate analyses, the incidence rate was 59 cases for primary caries 41 cases per 1,000 tooth years for recurrent caries. There was a significant association (p <0.0001) between financial class, age, provider, and prevention groups. Provider, zip, treatment procedures, and gender were associated with primary caries (p <0.0001). Provider, zip, treatment procedures, and poverty groups were associated with recurrent caries (p< 0.0001). In multivariate regression analyses that controlled for financial class, provider, age, zip, and poverty, we found that the control group children had 5.25 times the risk when compared to the children in sealant group (95% CI 4.62, 5.93; p< .0001) for primary caries, and had 6.95 times the risk (95% CI, 4.57, 10.59; p< 0.0001) for recurrent caries. When compared to the fluoride group, the control group children had 6.36 times the risk (95% CI 5.99, 6.75; p< 0 0001) for primary caries; and had 6.29 times the risk (95% CI 5.10, 7.77; p<. 0 0001) for recurrent caries. The fluoride and sealant treatment groups showed fewer cases of caries as compared to the control group. Children in the control group were more likely to experience recurrent caries based on their financial class, zip, age, and poverty group. These findings demonstrate a need for a personalized intervention model that also focuses on individual socio economic factors to fight childhood caries.
Thesis (M.S.)--Tufts University, 2012.
Submitted to the Dept. of Pediatric Dentistry.
Advisor: Paul Stark.
Committee: Cheen Loo, Stanley Alexander, and Alpdogan Kantarci.
Keywords: Dentistry, and Public health.read less
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