Methods for Caries Prevention in Children Reported by Dentists from a Brazilian Community

Tagliaferro, Elaine Pereira da Silva; Valsecki Júnior, Aylton; Rosell, Fernanda Lopez; Silva, Silvio Rocha Correa da; Riley, Joseph L.; Gilbert, Gregg H.; Gordan, Valeria Veiga

doi:10.1590/pboci.2021.063

Elaine Pereira da Silva Tagliaferro

Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara, SP, Brazil.

https://orcid.org/0000-0001-6225-6915

Aylton Valsecki Júnior

Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara, SP, Brazil.

https://orcid.org/0000-0002-1776-0925

Fernanda Lopez Rosell

Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara, SP, Brazil.

https://orcid.org/0000-0002-6270-9168

Silvio Rocha Correa da Silva

Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara, SP, Brazil.

https://orcid.org/0000-0002-0227-8896

Joseph L. Riley

Pain Clinical Research Unit, Clinical & Translational Science Institute, College of Dentistry, University of Florida, Gainesville, United States.

https://orcid.org/0000-0003-1815-975X

Gregg H. Gilbert

Department of Clinical & Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, United States.

https://orcid.org/0000-0003-2017-625X

Valeria Veiga Gordan

College of Dentistry, University of Florida, Gainesville, United States.

https://orcid.org/0000-0003-0381-5996

Correspondence: Elaine Pereira da Silva Tagliaferro, School of Dentistry, Araraquara, UNESP - Sao Paulo State University, Rua Humaitá, 1680, Centro, Araraquara, SP, Brazil. 14801-903. E-mail:elaine.tagliaferro@unesp.br

Authors’ Contributions

EPST https://orcid.org/0000-0001-6225-6915 Conceptualization, Methodology, Formal Analysis, Investigation, Resources, Writing - Original Draft, Writing - Review and Editing, Project Administration and Funding Acquisition.

AVJ https://orcid.org/0000-0002-1776-0925 Conceptualization, Methodology, Writing - Original Draft and Writing - Review and Editing.

FLR https://orcid.org/0000-0002-6270-9168 Conceptualization, Methodology, Writing - Original Draft and Writing - Review and Editing.

SRCS https://orcid.org/0000-0002-0227-8896 Conceptualization, Methodology, Writing - Original Draft and Writing - Review and Editing.

JLR https://orcid.org/0000-0003-1815-975X Conceptualization, Methodology, Writing - Original Draft and Writing - Review and Editing.

GHG https://orcid.org/0000-0003-2017-625X Conceptualization, Methodology, Writing - Original Draft and Writing - Review and Editing.

VVG https://orcid.org/0000-0003-0381-5996 Conceptualization, Methodology, Writing - Original Draft and Writing - Review and Editing.

All authors declare that they contributed to critical review of intellectual content and approval of the final version to be published.

Conflict of Interest

The authors declare no conflicts of interest.

Academic Editor: Alessandro Leite Cavalcanti

Instructions: Of patients 6 to 18 years old, for what percentage do you:
Caries Prevention
Apply dental sealants on the occlusal surface of at least one of their permanent teeth?
Apply an in-office fluoride application, such as fluoride gel, fluoride varnish, or fluoride rinse?
Recommend a non-prescription (over-the-counter) fluoride rinse?
Provide a prescription for some form of fluoride?
Recommend an at-home regimen of Chlorhexidine rinse?
Recommend sugarless chewing gum or xylitol chewing gum?
Individualized Preventive Treatment
What percent of patients in your practice are interested enough in caries prevention to justify you recommending to them an individualized caries preventive regimen?
For what percent of patients do you give individualized preventive treatment specifically for their needs?

Variables	N (%)
Age of Dentist (Mean and SD)	42.8 (± 12)
Gender (female)	101 (62.0)
Type of Practice
Private Practice	79 (49.0)
Private/Public Hybrid	43 (27.0)
Public Service	31 (19.0)
Other	9 (6.0)
Years Since Dental School Graduation (Mean and SD)	20.3 (± 11.6)
Type of Dental School
Public Institution	123 (76.0)
Private Institution	39 (24.0)
Specialization
Not Completed Specialization Training	57 (35.0)
Specialization Training (Not Pediatric)	88 (54.0)
Pediatric Specialization	17 (11.0)
Advanced Degree
No Advanced Degree	115 (71.0)
Master's Degree	10 (6.0)
Doctorate	37 (23.0)
Percent of Patients 1-18 Years of Age
50% or Greater Pediatric Patients	26 (15.0)
30% or Greater Pediatric Patients	56 (31.0)
10% to 29% Pediatric Patients	80 (54.0)
Percent of Patients who are Interested in Caries Prevention (Mean and SD)	45% (± 25)^* * Mean percentage and SD are presented as dentists were asked the percentage of patient in their practices who met each criteria.
Percent of Patients who Receive Individualized Preventive Treatment Specifically for their Needs (Mean and SD)	58% (± 34)^* * Mean percentage and SD are presented as dentists were asked the percentage of patient in their practices who met each criteria.

Preventive Agent	Mean % (SD)	95% CI
Dental Sealant	45.1% (SD=34)	42.3 - 47.9
In-office Fluoride	74.2% (SD=33)	71.7 - 76.7
Non-prescription Fluoride	17.7% (SD=29)	15.5 - 19.9
Prescription Fluoride	18.6% (SD=27)	16.5 - 20.7
Chlorhexidine Rinse	17.3% (SD=19)	15.6 - 18.8
Xylitol Gum	16.6% (SD=32)	14.1 - 19.1

Preventive Methods^† † The percentages chosen for each method were transformed to the central value of that interval: 0 percent=0, 1-24 percent=12.5, 25-49 percent=37, 50-74 percent=62, 75-99 percent=87, 100 percent=100;	B	SE	p-value
Dental Sealants
Dentist Gender (Female)	12.922	6.071	0.035
Percent of Patients who Receive Caries Prevention Regimen	0.332	0.082	<0.001
Final model fit (F = 3.297, p =0.005)
In-office Fluoride
Dentist Gender (Female)	9.854	5.012	0.044
Practice Model (Private)	-10.620	5.035	0.053
Occlusal Explorer	0.118	0.067	0.073
Percent of Patients who Receive Caries Prevention Regimen	0.239	0.080	0.004
Final model fit (F = 3.124 p =0.007)
Non-prescription Fluoride
Dentist Gender (Female)	12.695	4.900	0.011
Percent of Patients who Receive Caries Prevention Regimen	0.184	0.072	0.013
Percent of Patients who are Interested in a Caries Prevention Regimen	0.292	0.113	0.007
Final model fit (F = 2.957, p =0.010)
Prescription Fluoride
Advanced Degree Awarded	5.518	2.557	0.032
Practice Model (private)	8.462	4.079	0.047
Final model fit (F = 2.521, p = 0.028)
Chlorhexidine Rinse
Type of Dental School (Private)	8.350	3.505	0.018
Final model fit (F = 2.621, p = 0.023) ^‡ † The percentages chosen for each method were transformed to the central value of that interval: 0 percent=0, 1-24 percent=12.5, 25-49 percent=37, 50-74 percent=62, 75-99 percent=87, 100 percent=100;
Sugarless or Xylitol Gum
Years since Graduation from Dental School	0.421	0.269	0.095
Specialization Training	-5.365	3.004	0.085
Final model fit (F = 1.767, p =0.125)^‡ † The percentages chosen for each method were transformed to the central value of that interval: 0 percent=0, 1-24 percent=12.5, 25-49 percent=37, 50-74 percent=62, 75-99 percent=87, 100 percent=100;

[1] Correspondence: Elaine Pereira da Silva Tagliaferro, School of Dentistry, Araraquara, UNESP - Sao Paulo State University, Rua Humaitá, 1680, Centro, Araraquara, SP, Brazil. 14801-903. E-mail:elaine.tagliaferro@unesp.br

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Methods for Caries Prevention in Children Reported by Dentists from a Brazilian Community

ABSTRACT

Objective:

Material and Methods:

Results:

Conclusion: