Lining the cavity to protect the tooth pulp: what’s the evidence?

Tooth decay is the most common disease affecting children and adults worldwide. If left untreated, acid produced by bacteria in the dental plaque or biofilm forms cavities or holes in the teeth. A number of techniques and a variety of materials can be used to restore or fill teeth affected by decay. One of these materials is tooth-colored, resin-based composite or RBC. This material is increasingly used as an alternative to amalgam (a mixture of mercury and metal alloy particles).

Since the 19th century liners have often been placed in cavities in the teeth under the filling material. The liners are thought to protect the living pulp of the tooth from filling materials themselves and also from their potential to allow more heat or cold through than the natural tooth would. Although RBC filling materials are thought to be similar to the natural material of teeth in terms of how they conduct heat, sensitivity to temperature change is sometimes still an issue for people after treatment.
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New publications from the Oral Health Group in Issue 5 of the Cochrane Library for 2013

The latest edition of The Cochrane Library is out today, and features 1 new review and 3 new protocols from the Cochrane Oral Health Group. Follow the links to read more!

Children ToothbrushesNew Review:
Primary school-based behavioural interventions for preventing caries
Anna M Cooper, Lucy A O’Malley, Sarah N Elison, Rosemary Armstrong, Girvan Burnside, Pauline Adair, Lindsey Dugdill, Cynthia Pine

This review considers the clinical effects of school based interventions aimed at changing behaviour related to toothbrushing and the frequency of consumption of sugary food and drink. Are programmes aimed at making lasting changes to toothbrushing habits and reducing sugary food and drink consumption in 4-12 year olds effective?

Four clinical trials were included in the review. Three of these showed that there was less dental plaque in the children who had received the programme, and one small study showed there was less tooth decay when children had undergone the educational intervention. However, more high quality research is needed.

New protocol:
Dental cavity liners for Class I and Class II resin-based composite restorations
Andrew B Schenkel, Ivy Peltz, Analia Veitz-Keenan

This review will be undertaken by a team from the College of Dentistry at the University of New York. It will assess the effects of using dental cavity liners in the placement of restorations.

New protocol:
Oral health educational interventions for nursing home staff and residents
Martina Albrecht (nee Bunge), Ramona Kupfer, Daniel Reissmann, Burkhard Haastert, Ingrid Mühlhauser, Sascha Köpke

This new review will assess the effects of educational interventions to improve the oral and dental health of nursing home residents. These interventions could include training programmes for staff or for the residents in oral hygiene, oral care practice, diet and skills training.

New protocol:Triclosan/copolymer containing toothpastes for oral health
Philip Riley, Thomas Lamont

This review will assess the effects (i.e. including both the efficacy and safety) of triclosan/copolymer containing fluoride toothpastes, compared to fluoride toothpastes, for the long-term control of tooth decay, plaque and gingivitis in children and adults.

Other highlights of Issue 5 of the Cochrane Library include:

New titles registered at the Cochrane Oral Health Group

After the Cochrane Oral Health Group Editorial Meeting, a total of EIGHT new titles were registered. It has been a bumper month!

Approximal sealing for managing dental decay in primary and permanent dentition
by Mojtaba Dorri, Wael Sabbah, Bahar Kiani

This new review is from a team based in London, Portland (USA) and Mashhad (Iran). It will assess  the effectiveness of different methods and materials used for sealing approximal surfaces in order to manage dental decay.

Dental cavity liners for Class I and Class II resin-based composite restorations
by Andrew B. Schenkel, Ivy Peltz and Analia Veitz-Keenan

This team, based at New York University, will look at whether there is any benefit in placing dental cavity liners in resin-based composite restorations, considering any type of liner (to include calcium hydroxide, glass ionomer, flowable composite, zinc phosphate cement and zinc eugenol cement).

Maxillary distraction osteogenesis versus orthognathic surgery in cleft lip and palate patients
by Dmitrios Kloukos, Piotr Fudalej, Patrick Sequeira and Christos Katsaros

There are two widely used types of surgical reconstruction for cleft lip and palate patients: maxillary distraction osteogenesis and orthognathic surgery. This review will compare the two. The team is based at the University of Bern in Switzerland, and in Nijmegen, Netherlands.

Prevention and treatment of oral candidiasis in edentulous patients
by Analia Veitz-Keenan, Silvia Spivakovsky, Leila Jahangiri, Winnie Furnari

Is any one treatment better than another in preventing and treating oral candidiasis in edentulous patients? This review, from a team based at New York University, will look at this question.

We look forward to receiving the protocols of these new systematic reviews.

In addition to these four titles, another four have been registered as part of a grant from the Centers of Disease Control and Prevention. Led by Dr. Anne-Marie Glenny, the project to update five systematic reviews is now underway. Joining Anne-Marie on the review team will be Dr. Tanya Walsh and Professor Helen Worthington. They will be working on:

  • School-based and school-linked fissure sealant delivery programs for the prevention of dental caries
  • Community wide fissure sealant promotion programs
  • Water fluoridation for the prevention of dental caries
  • Population based interventions for the prevention of sports-related craniofacial injuries