Canadian dental professionals commonly have these questions about Prevora:
- How does the efficacy of Prevora compare to that of the chlorhexidine mouth rinse?
- Does Prevora stain the teeth?
- Patients still seem to get root caries with Prevora - how do I explain to my patient that this preventive treatment may not completely protect them from this disease?
- What will my patients think about Prevora's level of efficacy - the 41% reduction in root decay over one year?
- If this new treatment is not covered by dental insurance, will my patients pay for it directly?
- Will my patients comply with the 4 weekly treatments in the first month?
- In a typical Canadian family dental practice, how many patients would be at risk of root caries, and therefore, eligible for Prevora?
- What is the procedure code for Prevora, and do insurers pay for this new treatment?
- Do patients stay on Prevora forever?
- Is fluoride compatible with Prevora - should I administer topical fluoride to these patients during the same appointment?
- How should I advise my patients about this new treatment?
- How do we order Prevora, and what are the terms of purchase?
Question: How does the efficacy of Prevora compare to that of the chlorhexidine mouth rinse?
Answer: There are no controlled studies which indicate that the 0.12% w/v chlorhexidine mouth rinse has any preventive effect on root caries. In fact, one controlled study found that regular use of this mouth rinse had no significant effect on dental caries.14
Question: Does Prevora stain the teeth?
Answer: No. Staining or tooth discoloration by Prevora has been very rare - patients reported discoloration in less than 1% of treatments. By contrast, after using the mouth rinse, 10% of patients report staining.15 Prevora does not stain because it is used after a prophylaxis, it is dosed relatively infrequently, and because the Stage 2 sealant prevents the bonding of the dietary chromogens with the chlorhexidine.
Question: Patients still seem to get root caries with Prevora - how do I explain to my patient that this preventive treatment may not completely protect them from this disease?
Answer: Most Canadian dental patients understand there is no magic bullet in fighting infections and that without Prevora there would likely be more decay. They also understand that there is much they can do themselves to manage tooth decay and will realize any decay which happens after Prevora treatment is partly a matter of personal diet and oral hygiene. It is notable, moreover, that patients also get caries after their teeth have been restored. To quote the N.I.H. "restorations repair the tooth structure, do not stop caries, and have a finite life span."16
Question: What will my patients think about Prevora's level of efficacy - the 41% reduction in root decay over one year?
Answer: In surveys and focus groups, Canadian adult patients have found this level of protection significant.
Question: If this new treatment is not covered by dental insurance, will my patients pay for it directly?
Answer: In surveys of Canadian dental patients, the majority of patients in the zone for root caries (over age 40) said they would pay for Prevora prevention directly. Most Canadian seniors do not have dental insurance.
Question: Will my patients comply with the 4 weekly treatments in the first month?
Answer: In surveys, 9 out of 10 Canadian adult dental patients said this treatment regimen is acceptable.
Question: In a typical Canadian family dental practice, how many patients would be at risk of root caries, and therefore, benefit from Prevora?
Answer: At least one patient per day. About half of Canadian adults have been told by their dental professional that they have gum recession, the key risk factor for root caries. And about one in three Canadian seniors are taking multiple medications which also raise the risk of root caries. About 7% of patients in a typical practice are undergoing regular scaling and root planing for periodontal maintenance; these patients are certainly "within the zone" for Prevora.
Question: What is the procedure code for Prevora, and do insurers pay for this new treatment?
Answer: Code 13601, "topical application of an antimicrobial", accurately describes the Prevora treatment. As a new treatment, most dental insurers do not pay for Prevora. Those dental plans which honor the entire fee guide may pay for Prevora. Some employers now offer flexible benefit plans with spending accounts (e.g. the Royal Bank); members of these plans may pay for Prevora from their spending accounts.
Question: Do patients stay on Prevora forever?
Answer: The recommended general regimen after the first month of weekly treatments is to apply a single Prevora treatment at six month intervals until the patient is out of the risk zone for root caries.
Question: Is fluoride compatible with Prevora - should I administer topical fluoride to these patients during the same appointment?
Answer: Prevora should always be administered to a cleaned tooth surface which does not contain any fluoride. Administering fluoride immediately after application of Prevora will likely have little therapeutic effect as the inert coating of Prevora Sealant Stage 2 will likely prevent fluoride's contact with the tooth surface.
Question: How should I advise my patients about this new treatment?
Answer: Use the Patient Fact Sheet as a guide - it was developed with the input of Canadian dental patients. If your patients want more information, give them The Patient Guide which provides additional information. And to get the patient aware of this new treatment, there are two other tools. First, use the Prevora Office Poster in your waiting room and hygiene operatories. Secondly, mail out the Prevora Post Card to your older patients to inform them that this new treatment is now available. In certain communities, there will also be newspaper and radio advertisements about Prevora, to further inform dental patients about this new treatment.
Question: How do we order Prevora, and what are the terms of purchase?
Answer: You can place an order on this website, or by calling 1-800-463-2999. Payment is by credit card (VISA or Master Card) and delivery is over-night via UPS courier. Shipments are limited to Monday, Tuesday, Wednesday and Thursday with the order deadline at 3PM Toronto time.
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