Antierosive Effect of Topical Fluorides: A Systematic Review and Meta-Analysis of In Situ Studies

Abstract

BACKGROUND: The effectiveness of the application of topical fluorides in prevention of erosive tooth wear has been an issue of controversy in the literature. The objective of this systematic review was to assess in situ studies investigating the effects of using topical fluorides on prevention of erosive tooth wear
 MATERIAL AND METHODS: Two electronic databases PubMed/MEDLINE and Cochrane Central Register of Controlled Trials were searched. Eligibility criteria included in situ-controlled studies that assessed the effect of the erosive process without additional tooth brushing. The search involved English-written articles only. A total of 684 potentially relevant titles and abstracts were found after removal of duplicates, of which 22 full-text articles were selected. Seventeen studies were included in the qualitative synthesis of which 6 studies included in the meta-analysis. The following data were obtained for each study: authors, year of publication, country, study design, periods of study, duration, blinding, interventions (type/concentration/form), tooth substrate, location of the intraoral appliance, number of samples attached to each appliance, type of acidic media used for erosive challenge, duration of erosive challenge, subjects (number/age/sex), reported side effects -if any-, measuring device, amounts of tissue loss.
 RESULTS: The risk of bias of the included studies was assessed using the Cochrane Collaboration tool for assessing the risk of bias. A meta-analysis of the present study was performed using Comprehensive Meta-Analysis version 2.2.048 software.
 CONCLUSION: The use of oral hygiene products containing AmF/NaF/SnCl2 or NaF may be effective in the prevention of erosive tooth wear.

Awareness, knowledge and treatment decisions for erosive tooth wear: A case‐based questionnaire among Danish dentists

“…The option to treat ETW with topical fluoride varnish applications or solutions, was frequently reported by respondents, which was somewhat surprising in the light of current evidence. According to systematic reviews, the effect of fluoride toothpaste, fluoride mouth rinses and fluoride varnishes in preventing and treating dental erosion is inconclusive (Abdelwahed, Temirek, & Hassan, 2019; Mohammed & Dusara, 2013; Zini, Krivoroutski, & Vered, 2014). It is possible that the remineralizing properties documented from the reversal of early caries lesions have spilled over to the management of erosions but most importantly, a beneficial effect of fluorides cannot be excluded (Hove, Stenhagen, Mulic, Holme, & Tveit, 2015).…”

Reduction in erosive tooth wear using stannous fluoride-containing dentifrices: a meta-analysis

“…The brushing protocols varied considerately in the in situ studies. Two studies 12,14 applied manual brushing of the lingual surface of the teeth for 30 s, associated with mouthwash for 90 s twice per day, and one study 13 used a slurry dentifrice immersion brushing protocol associated with a brushing machine.…”

“…The item that received "no" most frequently was the blinding of the operator of the testing machine, and only 2 studies 7,10 reported the sample size calculation. Of the 3 in situ studies included, 2 papers 13,14 were scored as low risk of bias and one study 12 as medium (Table 3).…”

“…6 To the best of our knowledge, none clinical trial evaluated the protective effect of SnF 2 -containing dentifrices against erosion/abrasion. In this sense, clinicians are taken to rely on their clinical experience and on data from in vitro [7][8][9][10][11] and in situ [12][13][14] studies for decision-making. Most laboratory studies [7][8][9][10][11][12][13][14] compared the helpful effects of use of SnF 2 -containing dentifrices formulated with and without NaF with NaF-containing dentifrices on erosive wear.…”

“…In this sense, clinicians are taken to rely on their clinical experience and on data from in vitro [7][8][9][10][11] and in situ [12][13][14] studies for decision-making. Most laboratory studies [7][8][9][10][11][12][13][14] compared the helpful effects of use of SnF 2 -containing dentifrices formulated with and without NaF with NaF-containing dentifrices on erosive wear. Pooled data of laboratory studies may determine the potential for clinical applicability of the fluoridated dentifrices against initial enamel erosion and abrasion.…”