Cavity Cops Dis 'Drill and Fill'
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"The insurance companies are not, as a whole, as interested in preventive techniques, and that's one of the areas that's going to have to be adjusted," Messina tells WebMD.
Panel member Alan Lurie, DDS, of the University of Connecticut School of Dental Medicine, pointed out that controlling the amount of sugar that children eat is important in preventing disease. And according to the report, sugarless chewing gum with xylitol (a type of sugar that doesn't seem to promote tooth decay) also is effective in preventing caries. However, the gum is not yet widely available in the U.S.
The panel did note that brushing teeth with fluoridated toothpaste and widespread community water fluoridation have made significant dents in dental caries in recent decades. Moreover, dentists have been effective in preventing some disease by "sealing" teeth with plastic film.
"The awareness with parents of the value of taking their kids to the dentist on a regular basis and starting at a young age has really grown, along with proper brushing," Messina tells WebMD. "We're producing a generation of kids that has had very little experience at the dentist, and a very low decay rate."
"The reduction in dental caries is as much as two-thirds in the past 30 years," Alfano says, "so we've been doing something right as a society."
At the same time, he says, "We've got pockets of disease in economically underprivileged and minority individuals that need to be addressed."
The panel noted that low socioeconomic status is linked to a higher risk of tooth disease. For adults and the elderly, it said that risk factors include poor oral hygiene, a lack of adequate salivary flow, and gum recession.
The expert panel also lamented that scientific research on tooth disease often has been flawed. Future dental care advances may be dependent on higher standards, it warned, calling for a new focus on tooth decay research.
"Despite the fact that it just about affects everybody in this room, caries is not life threatening, so in terms of garnishing a lot of attention both public and in terms of funding for research, it is at a slight disadvantage," says panel member Ian Coulter, PhD, from the University of California Los Angeles School of Dentistry.
The panel's consensus statement can be found online via http://consensus.nih.gov.