As part of the National Institutes of Health (NIH), the National Institute on Minority Health and Health Disparities has awarded the New York University College of Dentistry (NYU Dentistry) a five-year, $3.6 million grant to study cavity prevention and cost-effectiveness in school-based dental programs in New Hampshire.
The grant will fund a statewide program in six rural counties providing dental care to about 12,000 children from preschool through sixth grade in more than 40 schools. The study will compare a “simple” treatment of silver and fluoride and a “complex” treatment of sealants and fluoride.
Nearly 30% of school-age children in the United States have untreated cavities, NYU Dentistry reports. In rural areas, more than 35% have untreated cavities. The primary barrier to care in rural areas is the distance required to travel to dentists, followed by costs and dental anxiety.
“Bringing care to children instead of children to care eliminates these barriers,” said Richard Niederman, DMD, professor and chair of the Department of Epidemiology & Health Promotion at NYU Dentistry and leader of the study.
Through previous studies, NYU Dentistry researchers determined that “complex” school-based cavity prevention programs can reduce cavities by two-thirds. Yet “simple” prevention can be equally effective and is preferred by patients.
The New Hampshire schools will be selected at random to receive the simple or the complex treatment. The simpler method takes six minutes to deliver, while the complex method takes 20 minutes. All children will receive the same preventive care twice each year. The researchers will assess oral health to compare the outcomes of both treatments.
While the researchers expect both treatments to be similarly effective in reducing untreated caries, nearly four times more children can be treated via the simple technique for the same time and cost. So if the simpler and less expensive strategy is found to be as effective as the more complex and effective method, clinical and policy changes may follow.
“In the short term, this trial will improve the health of New Hampshire children,” said Ryan Richard Ruff, MPH, PhD, assistant professor of epidemiology and health promotion at NYU Dentistry and another leader of the study.
“In the long term, our findings can inform New Hampshire and US policy planning to reduce oral health disparities through the creation of a cost-effective, evidence-based, and school-based cavity prevention model,” said Ruff.
The same researchers also received NIH funding to compare these cavity prevention techniques in urban elementary schools. That five-year study will focus on 60 high-need elementary schools in the Bronx, also assessing educational outcomes and quality of life. If both studies show similar results, the researchers believe, their findings should be applicable nationwide.