As recommended by the American Dental Association (ADA), high-strength topical fluorides like varnishes, gels and pastes are valuable tools for preventing and managing dental caries. One such product is Colgate PreviDent 5000 Booster Plus, a prescription-level fluoride toothpaste for patients at high risk of caries. In this article, we discuss key factors to consider when prescribing this product to your patients.
Colgate PreviDent 5000 Booster Plus is a prescription-only toothpaste containing 1.1% sodium fluoride (5000 ppm fluoride) available in the US. In Canada, the PreviDent brand name is also used, however in other areas it is marketed under a different brand name. For example, it is known as Colgate Duraphat 5000 in the UK and as NeutraFluor 5000 Plus in Australia and New Zealand.
Intended for daily use by adults and children over six years old, this 5000 ppm toothpaste enables rapid dispersion and greater uptake of fluoride to support remineralization. Compared to similar products, it provides better remineralization after 10 days and unsurpassed remineralization after 20 days, and has been shown to reverse incipient caries.
In the ADA’s clinical guidelines on topical fluorides for caries prevention, home-use of prescription-level 5000 ppm toothpaste is among the fluoride interventions recommended for caries prevention in at-risk adults and children over six.
In further evidence-based clinical guidelines on the non-restorative treatment of carious lesions, the ADA also recommends 5000 ppm fluoride toothpaste for the arrestment or reversal of non-cavitated and cavitated carious lesions on the root surfaces of permanent teeth.
For your at-risk patients that could benefit from a 5000 ppm fluoride toothpaste like Colgate PreviDent, there are a number of key factors to consider when writing a prescription.
1. Patient education
Fluoride therapy is only one part of an effective caries management plan. Patients must also understand and address their individual underlying risk factors for dental caries, such as inadequate oral hygiene or a diet high in sugar.
It is important to ensure that the patient fully understands how their risk factors contribute to their current caries status, the potential progression of the disease, and the steps they must take to help ensure the best possible outcome from their treatment.
When you offer your patient oral health, behavioral or dietary advice, be sure to make recommendations that are quick and simple to implement, and support them with helpful resources. Colgate Professional’s Patient Education site features a number of caries information resources and a video library that you can use to help illustrate caries and oral health to your patients in an accessible way. You can also find a range of brochures intended for patients in the ADA’s patient education catalog.
2. Patient compliance
It is important that patients are aware that they must use their 5000 ppm toothpaste every day to benefit from the increased caries protection, that they must make behavioral changes alongside their treatment, and that they must continue to refill prescriptions.
Ask your patient to confirm they understand the importance of compliance and that they are willing and able to follow recommendations, and consider any obstacles that may prevent this. For example, children and adolescents can be reluctant brushers, people in residential nursing care may struggle to fulfil prescriptions, and those with special needs may have particular difficulty modifying behavior.
In a recent Colgate Talks session, Dr. Simon Read discussed the many compliance barriers our patients face, and detailed a number of strategies we can use to help them adhere to treatment. One such strategy is the SIMPLE technique, summarized as follows:
Simplifying regimen characteristics, e.g., encouraging the patient to set brushing reminders, matching your recommendations to their age, abilities, habits and lifestyles.
Imparting knowledge, e.g., explaining caries and sharing accessible resources as described above.
Modifying patient beliefs, e.g., discussing the patient’s knowledge and perceptions about oral care, caries, and fluoride, and providing information where necessary.
Patient and family communication, e.g., actively listening, maintaining contact, and providing convenient care.
Leaving the bias, e.g., making no assumptions about the patient’s knowledge or abilities and making no judgements about their behaviors (or lack thereof).
Evaluating adherence, e.g., implementing prescription monitoring and compliance checks.
We encourage you to watch the full webinar here for a more thorough discussion of these factors and other compliance strategies.
3. Recall interval
With daily use, a single tube of PreviDent should be expected to last one month. Consider when you’ll next see your patient and, if possible, ensure that their prescription provides enough PreviDent to last. This avoids the risk of the patient discontinuing use because they cannot, or do not want to, refill their prescription.
Lastly, it is important to note that product labelling, usage instructions and prescribing rules vary from country to country. For the most accurate information, please refer to the product guidance on the Colgate Professional website in your country of practice.