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News / March 13, 2017

US study casts doubts on early prevention

by Guy Hiscott

Early dental prevention has been called into question by a study in the US.

Researchers found that children with early preventive dental care were more likely to have future dental treatment compared to children who did not receive early prevention.

Early prevention by primary care providers has been gradually accepted in US states such as Alabama due to rising caries rates among children.

But researchers from the University of Alabama, Birmingham School of Public Health, wanted to ‘measure the effectiveness of early preventive dental care in reducing caries-related treatment visits among Medicaid-enrolled children from Alabama’.


Annual caries-related visits and expenditures were measured from September 2007 to October 2012 in children from birth to three or more years old.

‘Almost 20,000 eligible children were identified, with more than 3,600 receiving early preventive dental care from a dentist,’ reported in a recent article.

The study found that children with early preventive care had more caries-related treatment, more visits per child year, and higher dental expenditures.

‘We observed no evidence of a benefit of early preventive dental care, regardless of the provider,’ study authors concluded. ‘In fact, preventive dental care from dentists appears to increase caries-related treatment.’


The authors noted the limitations to the study and added: ‘The most reasonable conclusion is that children with early tooth decay are identified early and subsequently are more likely to be referred for treatment at an earlier stage.

‘… We cannot rule out the possibility that there is a true effect in which preventive visits lead to higher caries-related treatment as a result of ineffective anticipatory guidance and fluoride varnish applications. Fluoride varnish may not be effective if applied infrequently of if the varnish prescribed is ineffective.’

The authors acknowledged that additional research is needed. The study was published JAMA Pediatrics in February 2017.

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