Prevention: Dental Caries
This study was performed by the RTI-University of North Carolina at Chapel Hill (RTI-UNC) Evidence-based Practice Center under contract to the Agency for Healthcare Research and Quality, Contract No 290-97-0011, Task Order No. 3, Rockville MD.
We acknowledge the assistance of: Charles J. Homer, M.D., M.P.H., and Tracy Orleans, Ph.D., two Task Force members who served as liaisons for this topic; David Atkins, M.D., M.P.H., Director of the AHRQ Clinical Prevention Program and Jean Slutsky, P.A., M.S.P.H., Task Order Officer for the USPSTF contract; and our colleagues Russell Harris, M.D., M.P.H., and Audrina Bunton, B.A., of the UNC Cecil G. Sheps Center for Health Services Research, and Sonya Sutton, B.S.P.H., and Loraine Monroe of RTI International.
This article is based on a more comprehensive systematic evidence review, which is available online at http://www.uspreventiveservicestaskforce.org.
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1. Edelstein BL. Evidence-based dental care for children and the age 1 dental visit. Pediatr Ann 1998;27:569-74.
2. Newacheck PW, Hughes DC, Hung YY, Wong S, Stoddard JJ. The unmet health needs of America's children. Pediatrics 2000;105:989-97.
3. Vargas CM, Crall JJ, Schneider DA. Sociodemographic distribution of pediatric dental caries: NHANES III, 1988-1994. J Am Dent Assoc 1998;129:1229-38.
4. Mouradian WE, Wehr E, Crall JJ. Disparities in children's oral health and access to dental care. JAMA 2000;284:2625-31.
5. U.S. Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, MD: USDHHS, National Institute of Dental and Craniofacial Research, 2000;Pub No 00-4713.
6. Edelstein BL. The age one dental visit: information on the web. Pediatr Dent 2000;22:163-4.
7. Edelstein BL, Manski RJ, Moeller JF. Pediatric dental visits during 1996: an analysis of the federal Medical Expenditure Panel Survey. Pediatr Dent 2000;22:17-20.
8. General Accounting Office. Oral health: factors contributing to low use of dental services by low-income populations. Report No. GAO/HEHS-00-149. Washington, DC: GAO; 2000.
9. General Accounting Office. Oral health: dental disease is a chronic problem among low-income populations. Report No. GAO/HEHS-00-72. Washington, DC: GAO; 2000.
10. McCormick MC , Kass B, Elixhauser A, Thompson J, Simpson L. Annual report on access to and utilization of health care for children and youth in the United States—1999. Pediatrics 2000;105:219-30.
11. Ismail AI, Bandekar RR. Fluoride supplements and fluorosis: a meta-analysis. Community Dent Oral Epidemiol 1999;27:48-56.
12. Serwint JR, Mungo R, Negrete VF, Duggan AK, Korsch BM. Child-rearing practices and nursing caries. Pediatrics 1993;92:233-37.
13. Beltran ED, Malvitz DM, Eklund SA. Validity of two methods for assessing oral health status of populations. J Public Health Dent 1997;57:206-14.
14. McCunniff MD, Damiano PC, Kanellis MJ, Levy SM. The impact of WIC dental screenings and referrals on utilization of dental services among low-income children. Pediatr Dent 1998;20:181-7.
15. Margolis FJ, Burt BA, Schork MA, Bashshur RL, Whittaker BA, Burns TL. Fluoride supplements for children. A survey of physicians' prescription practices. Am J Dis Child 1980;134:865-8.
16. Siegel C, Gutgesell ME. Fluoride supplementation in Harris County, Texas. Am J Dis Child 1982;136:61-3.
17. Gift HC, Milton B, Walsh V. Physicians and caries prevention. Results of a physician survey on preventive dental services. JAMA 1984;252:1447-8.
18. Rigilano JC, Friedler EM, Ehemann LJ. Fluoride prescribing patterns among primary care physicians. J Fam Pract 1985;21:381-5.
19. Levy SM. Systemic fluoride supplementation in an academic family practice setting. J Fam Pract 1987;24:532, 534, 536.
20. Dillenberg JS, Levy SM, Schroeder DC, Gerston EN, Andersen CJ. Arizona providers' use and knowledge of fluoride supplements. Clin Prev Dent 1992;14:15-26.
20. Kuthy RA, McTigue DJ. Fluoride prescription practices of Ohio physicians. J Public Health Dent 1987;47:172-6.
21. Margolis FJ, Chesney BK, Schork A. Fluoride supplements. Changes in physicians' attitudes and practices following an intensive, multifaceted educational program. Am J Dis Child 1987;141:72-6.
22. Dillenberg JS, Levy SM, Schroeder DC, Gerston EN, Andersen CJ. Arizona providers' use and knowledge of fluoride supplements. Clin Prev Dent 1992;14:15-26.
23. Jones KF, Berg JH. Fluoride supplementation. A survey of pediatricians and pediatric dentists. Am J Dis Child 1992;146:1488-91.
24. Roberts MW, Keels MA, Sharp MC, Lewis JL Jr. Fluoride supplement prescribing and dental referral patterns among academic pediatricians. Pediatrics 1998;101:E6.
25. Pinkerton RE, Tinanoff N, Willms JL, Tapp JT. Resident physician performance in a continuing education format. Does newly acquired knowledge improve patient care? JAMA 1980;244:2183-5.
26. Messimer S, Hickner J. Oral fluoride supplementation: improving practitioner compliance by using a protocol. J Fam Pract 1983;17:821-5.
27. Hamberg L. Controlled trial of fluoride in vitamin drops for prevention of caries in children. Lancet 1971;1:441-2.
28. Hennon DK, Stookey GK, Muhler JC. Prophylaxis of dental caries: relative effectiveness of chewable fluoride preparations with and without added vitamins. J Pediatr 1972;80:1018-21.
29. Margolis FJ, Macauley J, Freshman E. The effects of measured doses of fluoride. A five-year preliminary report. Am J Dis Child 1967;113:670-2.
30. Margolis FJ, Reames HR, Freshman E, MaCauley CD, Mehaffey H. Flouride. Ten-year prospective study of deciduous and permanent dentition. Am J Dis Child 1975;129:794-800.
31. Hennon DK, Stookey GK, Beiswanger BB. Fluoride-vitamin supplements: effects on dental caries and fluorosis when used in areas with suboptimum fluoride in the water supply. J Am Dent Assoc 1977;95:965-71.
32. Hu D, Wan H, Li S. The caries-inhibiting effect of a fluoride drop program: a 3-year study on Chinese kindergarten children. Chin J Dent Res 1998;1:17-20.
33. Lin YT, Tsai CL. Comparative anti-caries effects of tablet and liquid fluorides in cleft children. J Clin Dent 2000;11:104-6.
34. Beltran-Aguilar ED, Griffin SO, Lockwood SA. Prevalence and trends in enamel fluorosis in the United States from the 1930s to the 1980s. J Am Dent Assoc 2002;133:157-65.
35. Heller KE, Eklund SA, Burt BA. Dental caries and dental fluorosis at varying water fluoride concentrations. J Public Health Dent 1997;57:136-43.
36. McDonagh M, Whiting P, Bradley M, Cooper J, et al. A systematic review of public water fluoridation. NHS Centre for Reviews and Dissemination, University of New York. September, 2000. Available at: http://www.york.ac.uk/inst/crd/fluorid.pdf. Accessed August 28, 2002.
37. Rozier RG. The prevalence and severity of enamel fluorosis in North American children. J Public Health Dent 1999;59:239-46.
38. Pendrys DG. Risk of enamel fluorosis in nonfluoridated and optimally fluoridated populations: considerations for the dental professional. J Am Dent Assoc 2000;131:746-55.
39. Holm AK. Effect of fluoride varnish (Duraphat®) in preschool children. Community Dent Oral Epidemiol 1979;7:241-5.
40. Grodzka K, Augustyniak L, Budny J, et al. Caries increment in primary teeth after application of Duraphat® fluoride varnish. Community Dent Oral Epidemiol 1982;10:55-9.
41. Frostell G, Birkhed D, Edwardsson S, et al. Effect of partial substitution of invert sugar for sucrose in combination with Duraphat® treatment on caries development in preschool children: the Malmo Study. Caries Res 1991;25:304-10.
42. Twetman S, Petersson LG, Pakhomov GN. Caries incidence in relation to salivary mutans streptococci and fluoride varnish applications in preschool children from low- and optimal-fluoride areas. Caries Res 1996;30:347-53.
43. Petersson LG, Twetman S, Pakhomov GN. The efficiency of semiannual silane fluoride varnish applications: a two-year clinical study in preschool children. J Public Health Dent 1998;58:57-60.
44. Autio-Gold JT, Courts F. Assessing the effect of fluoride varnish on early enamel carious lesions in the primary dentition. J Am Dent Assoc 2001;132:1247-1253.
45. Center for Disease Control and Prevention (CDC). Recommendations for using fluoride to prevent and control dental caries in the United States. Morb Mortal Wkly Rep 2001;50(RR-14):1042.
46. Beltran-Aguilar ED, Goldstein JW, Lockwood SA. Fluoride varnishes. A review of their clinical use, cariostatic mechanism, efficacy and safety. J Am Dent Assoc 2000;131:589-96.
47. Ekstrand J, Koch G, Petersson LG. Plasma fluoride concentration and urinary fluoride excretion in children following application of the fluoride-containing varnish Duraphat®. Caries Res 1980;14:185-9.
48. Ekstrand J, Koch G, Lindgren LE, Petersson LG. Pharmacokinetics of fluoride gels in children and adults. Caries Res 1981;15:213-20.
49. Sgan-Cohen HD, Mansbach IK, Haver D, Gofin R. Community-oriented oral health promotion for infants in Jerusalem: evaluation of a program trial. J Public Health Dent 2001;61:107-13.
50. Brown LF. Research in dental health education and health promotion: a review of the literature. Health Educ Q 1994;21:83-102.
51. Kay EJ, Locker D. Is dental health education effective? A systematic review of current evidence. Community Dent Oral Epidemiol 1996;24:231-5.
52. Sprod AJ, Anderson R, Treasure E. Effective oral health promotion: a literature review. Cardiff, University of Wales: Health Promotion Wales, 1996; Technical Report 20. Available at: http://126.96.36.199/niche_docs/EB_DATABASE_CONTENT/HTML_database _content/oralhealthpromowales.html. Accessed October 22, 2002.
53. Kay E, Locker D. A systematic review of the effectiveness of health promotion aimed at improving oral health. Community Dent Health 1998;15:132-44.
54. National Institutes of Health. Diagnosis and management of dental caries throughout life. NIH Consensus Statement, 2001:1-30.
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[a] Department of Operative Dentistry, School of Dentistry and Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC.
[b] Department of Health Policy and Administration, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
[c] RTI International, Research Triangle Park, and Department of Health Policy and Administration, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
[d] Tri-County Family Medicine, Cohocton, NY.
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Copyright and Source Information
This document is in the public domain within the United States.
Requests for linking or to incorporate content in electronic resources should be sent via the USPSTF contact form.
Source: Bader JD, Rozier G, Lohr KN, Frame PS. Physicians' roles in preventing dental caries in preschool children. A summary of the evidence for the U.S. Preventive Services Task Force. AJPM 2004;26(3):315-25.
The USPSTF recommendation based on this evidence review is online and in the Guide to Clinical Preventive Services, Third Edition: Periodic Updates.
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Current as of April 2004
Bader JD, Rozier G, Lohr KN, Frame PS. Physicians' Roles in Preventing Dental Caries in Preschool Children. A summary of the evidence for the U.S. Preventive Services Task Force. April 2004. Originally in AJPM 2004;26(3):315-25. http://www.uspreventiveservicestaskforce.org/3rduspstf/dentalchild/dentchsum.htm