Relationship Between Receipt of 5,000 Ppm Sodium Fluoride Dentifrice Prescription and Time to First Dental Restoration among Older Adults: A Retrospective Cohort Study

TL;DR

This study found that older adults prescribed high-fluoride toothpaste had a faster time to needing dental restorations, along with other risk factors like having more cavities and frequent snacking.

Contribution

The study identifies high-fluoride dentifrice prescriptions as a novel predictor of faster time to dental restoration in older adults.

Findings

Prescription of 5,000 ppm sodium fluoride dentifrice was associated with a faster time to first dental restoration.

Having 5 or more teeth with caries significantly increased the hazard of needing a restoration.

Eating more than 3 snacks per day was linked to a faster time to first restoration.

Abstract

To evaluate the relationship between receipt of a 5,000 ppm sodium fluoride dentifrice prescription and time to first dental restoration in a population of older adults.

Electronic dental records of patients aged ≥ 65 years who received a caries risk assessment at their initial comprehensive examination between 2009 and 2019 were analyzed to assess differences in the time to first restoration between patients who received a 5,000 ppm sodium fluoride dentifrice prescription and those who did not. Multivariable Cox regression was used to evaluate the time to first restoration after the caries risk assessment, controlling for covariates of interest.

The dataset included 3,741 participants, of whom 48% were women and 77% were self‐pay. In the final multivariable Cox regression model generated using the Bayesian Information Criterion for variable selection, having a 5,000 ppm sodium fluoride dentifrice prescription within 14 days after the caries risk assessment (HR 1.16, 95% CI 1.00–1.36), having 5 or more teeth with caries (HR 1.30, 95% CI 1.18–1.45), not having a dental home (HR 1.29, 95% CI 1.16–1.44), and eating > 3 snacks per day (HR 1.23, 95% CI 1.10–1.39), were the most important predictors of a faster time to first restoration.

This study identified having a prescription for high‐fluoride dentifrice, number of teeth with caries, not having a dental home, and eating > 3 snacks per day as being associated with greater hazard of first restoration among older adult patients seeking comprehensive care in a dental school clinic.