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Comparative effectiveness of school-based caries prevention: a prospective cohort study
Ryan Richard Ruff1, Richard Niederman2
1Department of Epidemiology & Health Promotion, New York University College of Dentistry, 433 First Avenue, New York, NY, 10010, USA. ryan.ruff@nyu.edu.
BMC Oral Health
|March 29, 2018
Summary
School-based dental caries prevention programs combining primary and secondary interventions show promise in reducing untreated decay in children. However, overall caries experience reduction was not significantly different compared to primary prevention alone.
Area of Science:
- Pediatric Dentistry
- Public Health
- Preventive Dentistry
Background:
- Dental caries is the most common childhood disease globally.
- School-based prevention increases access to dental care.
- Optimal prevention strategies remain undefined.
Purpose of the Study:
- To compare the effectiveness of combined primary and secondary prevention versus primary prevention alone in school-based dental caries programs.
- To analyze the impact of different treatment intensities on caries development over time.
Main Methods:
- Two prospective cohorts of US children in distinct prevention programs were analyzed.
- Programs varied in treatment intensity (primary vs. primary and secondary prevention) and were administered biannually.
- Generalized additive models assessed nonlinear trends in untreated decay and caries experience.
Main Results:
- Combined primary and secondary prevention reduced untreated decay in permanent dentition compared to primary prevention alone.
- The rate of new caries progression was slower with combined prevention.
- Statistically significant nonlinear trends in dental caries were observed over time (p < .001).
Conclusions:
- Combined primary and secondary prevention may offer superior protection against untreated tooth decay over time.
- The effectiveness of caries prevention interventions may diminish over medium and long terms.
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