Fluoride Rinses, Gels and Foams: An Update of Controlled Clinical Trials

Abstract

Aim: The aim of this conference paper was to systematically review the quality of evidence and summarize the findings of clinical trials published after 2002 using fluoride mouth rinses, fluoride gels or foams for the prevention of dental caries. Methods: Relevant papers were selected after an electronic search for literature published in English between 2003 and 2014. The included papers were assessed for their risk of bias and the results were narratively synthesized due to study heterogeneity. The quality of evidence was expressed according to GRADE. Results: A total of 19 papers were included (6 on fluoride mouth rinse, 10 on fluoride gel and 3 on fluoride foam); 6 had a low risk of bias while 2 had a moderate risk. All fluoride measures appeared to be beneficial in preventing crown caries and reversing root caries, but the quality of evidence was graded as low for fluoride mouth rinse, moderate for fluoride gel and very low for acidulated fluoride foam. No conclusions could be drawn on the cost-effectiveness. Conclusions: This review, covering the recent decade, has further substantiated the evidence for a caries-preventive effect of fluoride mouth rinse, fluoride gel and foam, previously established in systematic reviews. The lack of clinical trials free from bias is, however, still a concern, especially for fluoride mouth rinses and fluoride foam. There is also a scientific knowledge gap on the benefit and optimal use of these fluoride supplements in combination with daily tooth brushing with fluoride toothpaste.

Guidelines for use of fluorides in Australia: update 2019

“…Furthermore, fluoride gels appear more efficacious in the permanent dentition. 43,44 The reviews found no evidence that the effect was dependent on frequency of applications. Like all forms of professionally provided fluoride, gels offer an alternative vehicle for caries prevention for individuals deemed to be at an elevated risk and in whom other fluoride modalities are not available or suitable.…”

Clinical Trials with Herbal Products for the Prevention of Dental Caries and Their Quality: A Scoping Study

“…Moreover, this review was limited to chlorhexidine, which is known to be sensitive to interactions with some of the ingredients of the dentifrices such as anionic compounds, abrasives, calcium, and sodium monofluorophosphate, reducing its availability and/or activity. In the case of fluoride the interest for gels seems to have decreased in the favor of fluoride varnishes [49], which ensure even longer residence times of the active ingredient (fluoride) in the mouth. It seems quite unreasonable to extrapolate from this meager prior knowledge on chlorhexidine to herbal ingredients with different chemical and biological properties.…”

Effect of Fluoride Gel and Foam on Salivary Fluoride Concentration

“…This specialized agent was developed in 1960s with the use of sodium fluoride (NaF), and contains 1.23% (12300 parts per million (ppm)) fluoride ions with the pH of about 3.5 . (5) Topical fluoride compounds that contain APF have been the favored vehicle for professional use in caries prevention programs. (6,7) Topical fluoride application may lead to substantial accumulation of fluoride, both on and inside enamel and dentin samples which have been directly treated with these systems.…”