Suchergebnisse

AbstractAimsThe aim of this study was to examine the effectiveness of topical fluorides in prevention of root caries‐related treatment in high caries risk Veterans.MethodsThis retrospective analysis of longitudinal data examined the effectiveness of professionally applied or prescription (Rx) fluoride treatment, in VHA clinics from FY 2009–2018. Professional fluoride treatments included 5% Sodium Fluoride (NaF) varnish (22 600 ppm fluoride), 2% NaF gel/rinse (9050 ppm fluoride), and 1.23% APF gel (12 300 ppm fluoride). The Rx for daily home use was 1.1% NaF paste/gel (5000 ppm fluoride). Outcomes studied were new root caries restorations or extractions and percent of patients with treatment over 1 year. Logistic regressions were adjusted for age, gender, race, ethnicity, chronic medical or psychiatric conditions, number of medication classes, anticholinergic drugs, smoking, baseline root caries treatment, preventive care, and time between first‐last restoration in the index year.ResultsRoot caries at baseline was associated with a high risk for new root caries. Veterans without root caries during the index year who received a fluoride gel/rinse intervention were 32–40% less likely to receive caries‐related treatment for root caries during the follow‐up period. Once Veterans had root caries, fluorides did not exhibit a positive effect.ConclusionIn older adults with high caries risk, early fluoride prevention is key, before root caries requires treatment.

AbstractIntroductionDry socket and infection are complications of tooth extractions. The objective was to determine risk factors for post‐extraction complications in patients without antibiotic prophylaxis stratified by early‐ and late‐complications and complication type (oral infection and dry socket).MethodsRetrospective, case (with complications)‐control (without complications) study of patients (n = 708) who had ≥1 extraction performed at any Veterans Health Administration facility between 2015–2019 and were not prescribed an antibiotic 30 days pre‐extraction.ResultsEarly complication cases (n = 109) were more likely to be female [odds ratio (OR) = 2.06; 95% confidence interval (CI):1.05–4.01], younger (OR = 0.29; 95% CI:0.09–0.94 patients ≥ 80 years old, reference:18–44 years), Native American/Alaska Native (OR = 21.11; 95% CI:2.33–191.41) and have fewer teeth extracted (OR = 0.53 3+ teeth extracted; 95% CI:0.31–0.88, reference:1 tooth extracted). Late complication cases (n = 67) were more likely to have a bipolar diagnosis (OR = 2.98; 95% CI:1.04–8.57), history of implant placement (OR = 8.27; 95% CI:1.63–41.82), and history of past smoking (OR = 2.23; 95% CI:1.28–3.88).ConclusionPredictors for post‐extraction complications among patients who did not receive antibiotic prophylaxis were similar to prior work in cohorts who received prophylaxis. Unique factors identified in a medically complex population included being younger, Native American/Alaska Native, having mental health conditions, history of a dental implant, and fewer teeth extracted.