We have been very happy with the results of Perio Protect, which helps us deliver more effective gum disease treatment to our patients. So we’re watching with cautious optimism as Prevora is seeking approval from the US Food and Drug Administration (FDA).
Prevora is a special tooth coating that is supposed to help prevent cavities, especially in high-risk individuals. There is the potential to help us protect your teeth from damaging decay so we can reduce your need for reconstructive dentistry.
What Is Prevora?
Prevora is a chlorhexidine based varnish. It’s painted on your tooth similar to the way we paint on topical fluoride, but the mechanism for protecting your teeth is completely different. Topical fluoride supplies your teeth with an important catalyst that helps your teeth restore minerals lost in the early stages of tooth decay. In Prevora, it is hoped that there will be less bacteria to damage your teeth in the first place.
Chlorhexidine is a powerful antiseptic that’s already pretty commonly used in dentistry. It’s most often used as a mouthwash for people who have gum disease. It’s quite effective in that context, so it will likely have a significant impact in Prevora.
Initial treatment with Prevora requires four weekly visits to the dentist. At each visit, Prevora is applied to the teeth. The slow-release chlorhexidine is depleted over the course of the week, which is why another treatment is applied.
But once you have had your initial treatment, one application of Prevora every six months as part of your regular checkup is considered adequate to protect your teeth.
Is It Effective?
This is the big question. We’ll have a better idea once the FDA completes its review of the research submitted by the manufacturer and compiled by its own experts. Right now, it seems that the data is mixed.
There are some studies that show Prevora is highly effective. For example, the manufacturer claims that for high-risk adults, Prevora can reduce the risk of cavities in the tooth enamel (“coronal cavities”) by 70%. In addition, they say it can result in an overall 58% reduction in cavities for high-risk adults, and 41% reduction of root cavities for adults with dry mouth.
Those are the good studies. The bad studies paint a different picture. Two trials conducted in 2012 showed poor performance for the varnish. One study showed that researchers thought typical care essentially erased the benefits of the chlorhexidine varnish. In other words, the study showed no benefit beyond typical care. The other study just showed there was no protection provided to the study population.
Based on these studies, it’s likely that an approval for Prevora might stipulate that it’s only for use on high-risk populations.
Prevention Is the Better Route
There is something exciting about restorative dentistry. We love being able to transform people’s smiles that they thought were hopeless. But it’s less expensive, causes less discomfort, and much more convenient for our patients to just prevent tooth decay, which makes us all happier.