IST – Interim Stabilization Therapy – Part 2

IST - Interim Stabilization Therapy

In continuing with my research regarding the long-term viability of IST, as per an extensive literature review that was completed by the Region of Peel in May of this year:

I offer the following “Key Messages” developed by the team:

  1. Interim Stabilization Therapy/Atraumatic Restorative Treatment are effective as a single surface temporary restoration for dental caries, on both primary and permanent teeth.
  2. High viscosity glass ionomer cements should be used as the material of choice for Interim Stabilization Therapy/Atraumatic Restorative Treatment.
  3. While the quality of evidence is weak in this area, the use of Interim Stabilization Therapy/Atraumatic Restorative Treatment may be beneficial in aiding with client-provider rapport and building client self-esteem.

As a public health organization, Peel Public Health (PPH) is mandated by the Ontario Public Health Standards (OPHS) to provide oral health programming to applicable populations.

The OPHS was recently updated, including the Healthy Smiles Ontario Program (HSO) protocol which now includes offering IST/ART to clinically eligible, preventive service stream enrolled children and youth.

The new HSO protocol mirrors the same parameters that I must adhere to for providing IST:

  • When access to permanent restoration is not immediate or practical
  • When there are no medical contraindications
  • When the client consents to the treatment
  • When any of the following apply:
  • There is reasonable risk of further damage to the tooth structure
  • The pulp is not exposed
  • The client is in discomfort or is experiencing difficulty in eating
  • The discomfort is due to recent trauma, fracture or lost dental restoration
  • The client has not received any medical/dental advice that would contraindicate placing a temporary restoration
  • It is in the client’s best interest to proceed

Hopefully, as this therapy becomes better utilized, we will begin to compile data supporting its long term viability.

In conclusion, I applaud the commitment of our public health institutions to offer this treatment for our underserviced and disadvantaged youth, but I am truly concerned about the lack of similar care for our at-risk adult population.

Hopefully, this treatment will be seen as a viable solution for them as well!

I welcome your feedback. You can connect with me via email or telephone, leave a comment right here on the site or join in the conversation on Facebook and Twitter.

Until next time,

Kathleen

IST – Interim Stabilization Therapy

IST- Interim Stabilization Therapy King City

IST stands for Interim Stabilization Therapy.

“IST provides temporary care for decayed teeth and teeth affected by trauma, to relieve pain and reduce the risk of further damage to the tooth structure until the client can gain access to care from a dentist.”

IST was introduced by the Ontario Region First Nations and Inuit Health Branch, Children’s Oral Health Initiative (COHI). In August 2010, the region’s COHI team identified the need to provide a caries control procedure similar to that of Atraumatic Restorative Treatment (ART), which is provided by COHI Health Canada dental therapists in all regions other than Ontario and Quebec.

What is the Difference Between IST and ART?

What differentiates IST and ART is that the IST protocol does not allow for the manual removal of decayed tooth structure, which is within the scope of practice of Dental Therapists but not Dental Hygienists. What is particularly wonderful about the IST though, is that we “are” allowed to provide a temporary filling to a broken-down tooth without using freezing or a drill!

How Does IST Shape Up as a Long-Term Solution?

After taking an Interim Stabilization Therapy course a number of years ago, I began providing these temporary fillings on an emergency basis for my patients until they were able to get to a dentist and have a proper filling done. Interestingly, many of my patients that are without dental insurance did not go to a dentist after to have the filling re-done, so I have had a chance to observe the long-term retention of my IST fillings! Since many are still in place, this has led me to do some research into this form of treatment to see how IST shapes up as a longer-term solution!

Rather than re-invent the wheel, I actually found a study done by the Region of Peel in May of this year whose Research Question was:

What is the effectiveness and recommended use of Interim Stabilization Therapy (IST)/Atraumatic Restorative Treatment (ART) for temporary tooth restoration?

According to the study a grey literature search was conducted that identified fourteen documents, but since I did not know what a grey literature search was I offer this Wikipedia definition before continuing:

What is Grey Literature?

Grey literature are materials and research produced by organizations outside of the traditional commercial or academic publishing and distribution channels. Common grey literature publication types include reports (annual, research, technical, project, etc.), working papers, government documents, white papers and evaluations. Organizations that produce grey literature include government departments and agencies, civil society or non-governmental organisations, academic centres and departments, and private companies and consultants.

Grey literature may be made available to the public, or distributed privately within organizations or groups, and may lack a systematic means of distribution and collection. The standard of quality, review and production of grey literature can vary considerably. Grey literature may be difficult to discover, access, and evaluate, but this can be addressed through the formulation of sound search strategies.

I will continue with my findings next month in my blog, but in the meantime, if you or someone you know has an emergency and can’t get to a dentist, please remember that we dental hygienists may also be able to help!

I welcome your feedback. You can connect with me via email or telephone, leave a comment right here on the site or join in the conversation on Facebook and Twitter.

Until next time,

Kathleen