Prevolution Health discusses Prevora and how it could reshape management of high-risk and difficult-to-treat patients.
Prevolution Health was founded on a shared belief that there is a substantial population for whom good oral hygiene alone is not enough and are currently left with poor oral health. For example, adult patients with oral dryness, poorly managed diabetes, patients on multiple medications, patients with chronic gingival inflammation, continuous bleeding gums or people living in care homes. This can have serious long-term consequences on oral and general health outcomes.
These high-risk patients deserve a new solution to their oral disease. Ben Atkins, Oliver Dennis and George Whitcroft White came together from diverse professional backgrounds, but with one common aim, to improve patient health outcomes where conventional dentistry struggles most.
For Ben, the motivation is rooted in decades of clinical reality. ‘Traditional oral hygiene recommendations alone are failing around 20% of patients. Think about how many people live with swollen and bleeding gums? How many people continue to have decay even when they brush their teeth? How many people don’t go to the dentist because of fear? What about people in care homes who don’t have access to dental care?
‘Prevora is a new tool that dental professionals can add to their toolbox that can support a currently underserved population. These patients have the highest burden of oral disease and deserve us to do our best to help them and not simply accept poor health outcomes.’
How Prevora works
Tooth decay and periodontal disease are two consequences of oral dysbiosis and a disease-promoting biofilm. Prevora is a new management option in the UK but based upon chlorhexidine, an anti-bacterial agent with which all dental professionals are familiar.
Prevora is a professionally applied coating containing a high concentration (10%) of chlorhexidine. Applied in a simple procedure, it binds to the tooth surface to create a slow-release antibacterial reservoir.
Oliver explains: ‘This provides long-lasting protection not achievable with short-contact mouthwashes, without the staining often linked to other chlorhexidine treatments. It is used to reset the oral biofilm so that it becomes health promoting.’
One of the largest phase III studies conducted in dentistry supports Prevora’s role in caries prevention. In the PACS study of 983 adults (Symington et al, 2012), Prevora was associated with a significant reduction in coronal caries over one year, with the greatest protective effect seen in high-risk participants.
When using Prevora to protect against tooth decay, clinicians have also reported gum health improvements, including reduced bleeding and inflammation. The reduction in chronic gingival inflammation was not a surprise to see given that this and tooth decay are both biofilm-mediated diseases. Given the link between oral and overall health, better management of hard-to-treat patients may also help lessen the risks of systemic conditions such as diabetes and cardiovascular disease.
Extending prevention
For Ben, the concept also answers a long-held frustration. ‘For years I wished I could brush my patients’ teeth for them. With some groups, no matter how often we reinforce oral hygiene advice, they continue to struggle. If an individual is non-compliant, then the feeling of reduced swelling and pain can be a great way to instil behavioural change. Prevora is the closest thing to being able to brush for them every day; it finally gives us a way to intervene differently.’
Oliver reflects on the early stages of bringing Prevora to the UK. ‘It is exciting and rewarding to see the difference it is already making to the oral health of patients who struggle to achieve standard dental targets,’ he says.
Ben emphasises the patient response: ‘Many describe a fresher, cleaner and more comfortable mouth, and that motivates them to re-engage with their own care. The aim is to create a product that empowers patients to want to come to the practice; to feel that preventive care offers real, measurable benefits. It is an agent of behavioural change.’
Empowering teams
For George, the real opportunity lies in system-wide change. ‘Our mission is to empower the whole dental team and help patients lead healthier, happier lives. Preventive care must be sustainable, and Prevora creates opportunities for practices to deliver meaningful interventions that reach those most in need.’
Ben adds: ‘Prevora can be applied by dental hygienists, dental therapists and dental nurses when under the direction of a GDC registrant. That widens access while giving the team new tools to make a real difference.’
Oliver notes: ‘For practices, it supports a commercially viable preventive service that can be delivered efficiently at scale.’
Building the evidence
Prevora already has more than 20 years of clinical studies and real-world use outside of the UK. George explains: ‘Managing gingival inflammation is the key management strategy for reducing advanced periodontal disease in the UK. Our next step is then to build the UK evidence base, with investigations planned in gingival inflammation in a general population and community-based investigations to evaluate the impact of Prevora in improving oral care of an older population.’
Oliver adds: ‘Alongside conventional approaches, there is an opportunity for Prevora to play a key role in supporting a minimum intervention oral care (MIOC) approach. If we want prevention to be sustainable, it needs to be viable in a general practice setting.’
Closing the conversation, Ben reflects: ‘Prevora provides us with a new option that, when used alongside standard oral practices, can help us manage hard-to-treat patients.’
For more information, please visit prevora.co.uk/professional.
This article is sponsored by Prevolution Health.
