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  • Research & Results
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  • Comparing Two Treatments for Dental C...

Comparing Two Treatments for Dental Cavities in Older Adults Living in Low-Income Housing

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Project Summary  

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

Most older adults in the United States have had dental cavities. Nearly 28 percent have cavities that have gone untreated. Adults with low incomes often have higher rates of untreated cavities than adults with higher incomes. Untreated cavities can lead to painful toothaches, infection, and tooth loss. Cavities and tooth loss can contribute to other health problems and decrease quality of life.

Frailty, transportation problems, multiple medical problems, and cost can make it hard for older adults to get dental care in an office. In this study, the research team is comparing two ways to treat cavities for older adults living in low-income housing facilities.

Who can this research help?

Results may help dentists and public health professionals when considering ways to improve dental care for older adults in general and especially those with low incomes.

What is the research team doing?

The research team is enrolling 550 older adults with cavities. Participants live in 22 low-income housing facilities in Ohio. The team is assigning facilities by chance to offer one of two treatments. The first treatment is topical silver fluoride. The second treatment is fluoride and a dental filling that doesn’t require a drill. Participants receive their treatments and dental screening twice a year at the facility where they live.

At the start of the study and again six months and one year later, the research team is checking to see if cavities were successfully treated and if participants have any new cavities. Also, the team is asking study participants about their tooth pain and quality of life. The team is comparing these outcomes between the two treatment groups.

Community members, low-income housing administrators, advocacy organizations, policy makers, and health insurers are helping to design and monitor this study.

Research methods at a glance

Design Element Description
Design Randomized controlled trial
Population 550 adults ages 62 and older living in a participating older adult housing facility with at least one untreated active root or coronal carious lesion with ICDAS-II (2015) lesion severity code of 3 or greater
Interventions/
Comparators
  • Silver diamine fluoride
  • Atraumatic restorative treatment with glass ionomer cement and fluoride varnish
Outcomes

Primary: cavity prevention, tooth pain, hypersensitivity

Secondary: prevention of new decay, oral health quality of life

Timeframe 1-year follow-up for primary outcome

Project Details

Principal Investigator
Suchitra Nelson, PhD
Project Status
In progress; Recruiting
Project Title
Reducing Oral Health Disparities of Older Adults: Comparative Effectiveness of Two Treatments
Board Approval Date
November 2018
Project End Date
April 2024
Organization
Case Western Reserve University
Year Awarded
2018
State
Ohio
Project Type
Research Project
Health Conditions  
Cardiovascular Diseases
Dental Health
Infectious Diseases
Multiple/Comorbid Chronic Conditions
Respiratory Diseases
Mental/Behavioral Health
Mild Cognitive Impairment
Neurological Disorders
Dementia
Nutritional and Metabolic Disorders
Diabetes
Intervention Strategies
Drug Interventions
Training and Education Interventions
Populations
Racial/Ethnic Minorities
Low Income
Older Adults
Women
Individuals with Multiple Chronic/co-morbid Conditions
Funding Announcement
Addressing Disparities
Project Budget
$4,199,910
Study Registration Information
HSRP20193073
NCT03916926
Page Last Updated: 
February 20, 2020

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