Caries‐preventive effect of fluoride toothpaste: a systematic review

Abstract

With a questionnaire addressed to general dental practitioners in Sweden, the Swedish Council on Technology Assessment in Health Care launched a project group in 1999 to systematically review and evaluate the existing literature on various caries preventive methods. The aim of this article was to report findings concerning the caries preventive effect of fluoride toothpastes in various age groups, with special emphasis on fluoride concentration and supervised versus non-supervised brushing. A systematic search in electronic databases for articles published between 1966 and April 2003 was conducted with the inclusion criteria of a randomized or controlled clinical trial, at least 2 years follow-up and caries increment in the permanent (deltaDMFS/T) or primary (deltadmfs/t) dentition as endpoint. Out of 905 articles originally identified, 54 met the inclusion criteria. These studies were assessed independently by at least two reviewers and scored A-C according to predetermined criteria for methodology and performance. The measure of effect was the prevented fraction (PF), expressed as percent. The results revealed strong evidence (level 1) (i) for the caries preventive effect of daily use of fluoride toothpaste compared to placebo in the young permanent dentition (PF 24.9%), (ii) that toothpastes with 1,500 ppm of fluoride had a superior preventive effect compared with standard dentifrices with 1,000 ppm F in the young permanent dentition (PF 9.7%), and (iii) that higher caries reductions were recorded in studies with supervised toothbrushing compared with non-supervised (PF 23.3%). However, incomplete evidence (level 4) was found regarding the effect of fluoride toothpaste in the primary dentition. In conclusion, this review reinforced the importance of daily toothbrushing with fluoridated toothpastes for preventing dental caries, although long-term studies in age groups other than children and adolescents are still lacking.

Remineralization of initial carious lesions in deciduous enamel after application of dentifrices of different fluoride concentrations

“…The clinical efficacy of these toothpastes in deciduous teeth is a matter of dispute and particularly whether a lower caries preventive effect can be determined for fluoride concentration below 500 ppm. Twetman et al [15] stated in a recent review that inconclusive evidence was found regarding the effect of fluoride toothpaste in primary dentition. In contrast to our study, for permanent teeth Dunipace et al [7] and Wefel et al [16] found that mineral acquisition by initial white spot lesions increased with an increasing fluoride level.…”

Fluoride prevents caries among adults of all ages

“…The authors, however, did not compare their findings with the systematic reviews by Twetman et al 5,6 in which both adults and children were considered. Twetman and colleagues 5 found limited evidence that fluoride mouthrinse prevented root caries in older adults.…”

“…Twetman and colleagues 5 found limited evidence that fluoride mouthrinse prevented root caries in older adults. Regarding fluoride toothpaste, all the studies of adult participants identified by Twetman et al 6 were dealing with materials or additional active ingredients other than fluoride. Therefore, none of these studies fulfilled the inclusion criteria and they were excluded.…”

“Assessment of Oral Hygiene Habits and Oral Health Awareness among Pre-University Students (16-18yrs) Of Mangalore”- A Questionnaire Study

“…Twetman et al 13 reported a strong evidence of caries preventive effect of daily use of fluoride toothpaste, but awareness regarding the role of fluoride was lacking among the study population. However majority of subjects were aware of the fact that smoking harms oral health.…”