Abstract
To quantify procedures used for caries prevention for adult patients among dentists from a Brazilian community. Dentists (n=197) who reported that at least 10% of their patients are more than 18 years old participated in the first Brazilian study that used a translated version of the "Assessment of Caries Diagnosis and Caries Treatment" from the U.S. National Dental Practice-Based Research Network. A questionnaire about characteristics of their practice and patient population were also completed by the dentists. Generalized linear regression models and a hierarchal clustering procedure were used (p<0.05). In-office fluoride application was the preventive method most often reported. The main predictors for recommending some preventive agent were: female dentist (dental sealant; in-office fluoride; non-prescription fluoride) and percentage of patients interested in caries prevention (dental sealant; in-office fluoride; non-prescription fluoride). Other predictors included private practice (dental sealant), percentage of patients 65 years or older (in-office fluoride), graduation from a private dental school (non-prescription fluoride), years since dental school graduation (chlorhexidine rinse) and using a preventive method (recommending sealant/fluoride/chlorhexidine rinse/sugarless, xylitol gum). Cluster analysis showed that dentists in the largest subgroup seldom used any of the preventive agents. Dentists most often reported in-office fluoride as a method for caries prevention in adults. Some practitioner, practice and patients' characteristics were positively associated with more-frequent use of a preventive agent.
Highlights
Caries prevalence in adults is high worldwide
In-office fluoride application was the preventive method most reported by dentists for caries prevention in adults
Female dentists and those in private practice apply dental sealants to a higher percentage of adult patients compared to dentists in other practice models (p=0.001) and male dentists (p=0.044)
Summary
Caries prevalence in adults is high worldwide. More than 90% of adults experience caries at some point in their lifetimes. Mean DMFT scores for 35- to 44-year-old adults ranged from 6.6 to 17.6 among twenty-three European countries and is 16.75 among Brazilian adults, according to the last national epidemiological survey. A recent report estimated that about 25 percent of adults in the U.S had untreated caries. Treatment needs were reported by 75% and 47% of Brazilian adults and elderly, respectively. Treatment needs were reported by 75% and 47% of Brazilian adults and elderly, respectively1 These findings may be related to the fact that dental caries prevention efforts historically have focused on children rather than adults. A major increase in the focus of public health efforts in adults should be on those who are transitioning into higher caries risk status
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