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Effectiveness of preventive dentistry delivery system.

A preventive dentistry delivery system was developed for maximum effectiveness in private practice. Four new pit or fissure carious lesions developed in 20 patients who were 10 to 20 years old at the start of a two-year exploratory test; there were no new lesions of smooth surfaces. Of the incipient lesions that were under observation, no increase was observed in 23 of 26 pit or fissure lesions, 24 to 25 proximal and all of 26 buccal or lingual smooth surface lesions. In 33 patients 21 to 30 years old at the start of the test, no new lesions appeared and growth of the 142 incipient lesions appeared to be arrested. A low level of gingivitis was maintained in all patients who were tested.

Acidulated Phosphate Fluoride

How to deliver a comprehensive preventive dentistry service that dental insurance carriers can underwrite.

The successful practice management of preventive dentistry requires that it be comprehensive and include both chairside and counseling procedures. The chairside clinical procedures are a prophylaxis, topical application of fluorides, application of pit and fissure sealants, and fabrication of mouth-guards and space maintainers. The counseling procedures include plaque control and nutritional guidance. The caries activity test can be used as a means of monitoring excessive sugar intake. It is the responsibility of the dentist to determine the preventive dentistry needs of his patient based on the latter's caries score, periodontal, gingival, and plaque indexes, and diet evaluation. Since patients are prone to certain dental problems during particular age periods, the preventive management procedures must consider the existing and anticipated dental problems on the basis of the patient's age. Each of the preventive services is objective in nature because it involves either chairside or counseling procedures. During the counseling service,worksheets and clinical case notes are kept as part of the patient's dental record. The progressive effectiveness of the home-care preventive dentistry counsling procedures can be measured by scores and indexes. The frequency of repeating the service depends on proven clinical merit and the individual needs of the patient. The delivery of preventive dentistry services can be monitored by dental insurance carriers through peer review of clinical services, data sheets, case notes, a preventive dentistry record, and by patient questionnaire. A method for managing, measuring, and monitoring an objective, comprehensive preventive dentistry service has been presented so that the insurance carrier can underwrite this type of coverage as part of its dental insurance plan.

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