Topical Fluoride Effectiveness in High Caries Risk Adults

The study retrospective analysis of longitudinal data was developed to determine which types, combinations, and intensities of topical fluorides more effectively prevent new caries-related restorations and extractions in high caries risk adults. The study included data from October 1, 2008, through June 30, 2018, from electronic dental and medical records and the US Department of Veterans Affairs pharmacy database. Veterans eligible for continuing and comprehensive care met the criteria of high caries risk (received two or more caries-related restorations within a 365-d period). They had three y of follow-up included. The study sample included 68,757 veterans, who were primarily male (91.5%), were White (73.6%), had a mean age of 59.2 ± 13.5 y, and had significant medical comorbidity as measured by the Selim index (3.7 ± 2.4 physical and 1.3 ± 1.2 mental diagnoses). They had 10.8 ± 6.3 prescription VA drug classes, took 0.6 ± 0.8 strong anticholinergic medications, and had 3.9 ± 2.6 teeth restored due to caries during the index year. A dose-response effect was observed. Two-plus applications of varnish versus none (AOR = 0.73; 95% CI, 0.69–0.77) and 2-plus applications of gel/rinse versus none (AOR = 0.71; 95% CI, 0.67–0.75) were more effective than 1 application of either modality versus none.