NEW YORK, U.S.: The National Institute on Minority Health and Health Disparities, part of the National Institutes of Health (NIH), has awarded a research team at New York University College of Dentistry (NYU Dentistry) funding to study cavity prevention and cost-effectiveness in school-based dental programs in New Hampshire.
The $3.6 million five-year grant will fund a statewide program in six rural New Hampshire counties providing dental care to approximately 12,000 children, from preschool to sixth grade, in over 40 schools. Prof. Richard Niederman and Dr. Ryan Richard Ruff of NYU Dentistry will lead the study comparing the effectiveness of two cavity prevention techniques: a “simple” treatment of topical silver and fluoride, and a “complex” treatment of conventional sealants and fluoride.
Nearly 30 percent of school-age children in the U.S. have untreated cavities. For children in rural areas, this figure is even higher: 35 percent. For rural populations, the primary barrier to care is the distance to be travelled to dentists. Children with cavities and associated toothache face multiple disadvantages, including reduced quality of life, school absences, difficulty paying attention in school and lower standardized test scores. Conventional office-based dental care presents barriers to treatment, including cost, fear of dentists and geographic isolation.
“Bringing care to children instead of children to care eliminates these barriers,” said Niederman, Chairperson of the Department of Epidemiology and Health Promotion.
Through prior work in New Hampshire, New York, Massachusetts, Maine and Colorado, NYU Dentistry researchers determined that complex school-based cavity prevention programs are effective in reducing cavities by two-thirds. Preliminary results suggest that simple prevention may be equally effective and is preferred by patients.
The researchers expect that both treatments will be similarly effective in reducing untreated cavities. However, for the same cost and in the same amount of time, nearly four times more children can be treated with the simpler prevention. Therefore, if the simpler, less expensive strategy is found to be as effective as the more complex, more expensive method, the findings could support clinical and policy changes.
“In the short term, this trial will improve the health of New Hampshire children. In the long term, our findings can inform New Hampshire and U.S. policy planning to reduce oral health disparities through the creation of a cost effective, evidenced-based, and school-based cavity prevention model,” said Ruff.
In the NIH-funded study, the New Hampshire schools will be selected at random to receive either treatment with silver diamine fluoride and fluoride varnish or with sealants and fluoride varnish. The first method takes 6 minutes to deliver, compared with 20 minutes for the second method. All children will receive the same preventive dental care twice a year. The researchers will assess oral health to compare the outcomes of both treatments.
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