Can government‐supported preventive fluoride varnish application service reduce pulp‐involved primary molars?. (23rd April 2019)

• Record Type: Journal Article
• Authors: Chi, Lin‐Yang; Lin, Po‐Yen; Wang, Jui; Chu, Yu‐Roo; Chang, Yung‐Ming
• Is Part Of: Journal of public health dentistry. Volume 79:Number 3(2019)
• Page Start: 238
• Page End: 245
• Publication Date: 2019-04-23
• Subjects: fluoride varnish -- preschool children -- pulpectomy -- early extraction -- primary molars -- primary prevention -- Taiwan National Health Insurance Research Database; Dental public health -- Periodicals; 362.1976
• DOI: 10.1111/jphd.12319
• Languages: English
• ISSNs: 0022-4006

Abstract

Abstract: Objectives: Fluoride varnishes are reported to reduce 37–43% of dental caries; however, it remains unclear whether they can prevent severe decay. The study investigated the association between the government‐supported preventive fluoride varnish application service (FVAS) and the risk of undergoing treatments of pulp‐involved primary molars. Methods: Children who were younger than 6 years and did not receive any dental treatment between the first and last services within 2 years were defined as the "preventive‐FVAS group." After the matching process, 45, 296 children were selected for further analysis until the end of 2013. The log‐rank test and Cox proportional hazard models were employed to estimate the effects of preventive‐FVAS on the treatments of pulp‐involved primary molars, including pulpectomy and early extraction before the age of 8 years. Results: After adjusting for confounding factors, adjusted hazard ratios for the treatments of pulp‐involved primary molars for children who received preventive‐FVAS were 0.96 (95% CI = 0.92–1.00) for initiation of pulpectomy, 0.93 (95% CI = 0.86–1.00) for completion of pulpectomy, and 0.87 (95% CI = 0.82–0.92, P < 0.0001) for early extraction, especially for those who received three or more FVAS. Conclusions: Although preventive‐FVASs were associated with a 4–13% decreased risk of undergoing treatments of pulp‐involved primary molars within a lower risk subset, we suggest the implementation the current Taiwan government‐supported FVAS program needs to be modified. Further studies are warranted to evaluate whether it would be a better strategy if the program focused only on the high‐risk group.