The Caries Management System: are preventive effects sustained postclinical trial?

Area of Science:

• Dental Public Health
• Caries Research
• Clinical Dentistry

Background:

• The Caries Management System (CMS) was developed to decrease caries risk and the need for restorative dental care.
• A 3-year randomized controlled clinical trial (RCT) evaluated the CMS in private general dental practices.

Purpose of the Study:

• To assess the long-term legacy of the CMS by reporting outcomes at 2 and 4 years post-trial.
• To determine if the benefits of the CMS in reducing caries risk and restorative needs persist after the initial trial period.

Main Methods:

• The study involved 19 dental practices across diverse locations.
• Patient outcomes were measured by the cumulative increment in the DMFT index (Decayed, Missing, Filled Teeth).
• Statistical analyses included multilevel modeling and general linear modeling to assess patient and practice-level outcomes.

Main Results:

• Over a 4-year post-trial period (years 4-7), CMS patients had a 28% lower DMFT increment (2.44 vs. 3.39, P < 0.01).
• From baseline to year 7, CMS patients showed a 29% reduction in DMFT increment (6.13 vs. 8.66, P < 0.0001).
• Patients in CMS practices had significantly lower odds of being classified as high caries risk (OR = 0.23).

Conclusions:

• Adherence to CMS protocols in general dental practices leads to sustained patient benefits.
• Patients continue to experience reduced caries risk and lower needs for restorative treatment long after the initial trial.
• The CMS demonstrates a lasting positive impact on caries management in private dental settings.