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
  • Silver diamine fluoride
  • Atraumatic restorative treatment with glass ionomer cement and fluoride varnish

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 Information

Suchitra Nelson, PhD
Case Western Reserve University
Reducing Oral Health Disparities of Older Adults: Comparative Effectiveness of Two Treatments

Key Dates

November 2018
April 2024

Study Registration Information


Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: September 26, 2023