Author(s): Persson RE, Persson GR, Powell LV, Kiyak HA
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Abstract The present study tested preventive regimens in older subjects using dental services sporadically. 297 persons aged 60-90 (mean age 72.8; 43\% ethnic minorities), were randomly assigned to either a control group or four interventions with incrementally more complex preventive strategies; behavioral training (group 2), added weekly chlorhexidine rinse (group 3), added semi-annual fluoride varnish (group 4), and added semi-annual prophylaxis (group 5). The control group received dental care as they preferred, primarily emergency care. All subjects were re-examined annually for 3 years. At baseline, 190 (64\%) of the subjects were considered at risk for future periodontal disease progression. At baseline there were no group differences for any clinical parameter studied. Gingival bleeding varied between 19\% and 23\% over time and with no group differences. After 1 year, the greater decrease in probing depth for group 5 approached significance compared to the control group (p<0.06). Clinical attachment levels (CAL) improved in group 5 compared to the control group (p<0.01 for mesio-buccal, p<0.05 for mid-buccal tooth surfaces). The group differences did not persist at year 3. At year 3 in group 1, 9.2\% and in group 5, 4.9\% subjects lost > or =2.0 mm CAL. 310 teeth (6.5\%) were extracted during the study period. A 21\% increased risk for tooth loss was found in group 2, a 15\% reduced risk in group 3, a 28\% reduced risk in group 4, and a 44\% reduced risk in group 5 compared to the control group (Wald-statistics robust p-value 0.12). At year 3, the tooth mortality rate in groups 3, 4 and 5 combined was reduced to 59\% and significantly lower than groups 1 and 2 together (p<0.04). Self-efficacy was the best predictor of periodontal disease progression (F=7.02, p<0.01). Thus older persons benefited from a preventive oral health care program.
This article was published in J Clin Periodontol
and referenced in Journal of Nutrition & Food Sciences