Low-Fluoride Dentifrice and Caries Lesion Control in Children with Different Caries Experience: A Randomized Clinical Trial

Abstract

Since there is no consensus on the anticaries effectiveness of low-fluoride (F) dentifrice, this randomized clinical trial evaluated its effect in children at different caries activity status. One hundred and twenty 2- to 4-year-old children, half with and half without active caries lesions, were randomly divided into 2 groups which used 500- or 1,100-µg F/g (NaF) dentifrices during 1 year. Caries progression or regression were evaluated as the number of lesions becoming active/cavities or inactive, respectively. The anticaries effect of the low-F dentifrice was similar to the conventional F dentifrice when used by caries-inactive children. However, in children with active caries lesions the low-F dentifrice was less effective than the 1,100-µg F/g dentifrice in controlling the progression of lesions. The data suggest that the child caries activity may be taken into account to recommend a low-F dentifrice.

Fluoride toothpastes and fluoride mouthrinses

“…A recent report of a trial in Brazil made the interesting comment that "The anticaries effect of the low-F dentrifice [500 ppm] was similar to the conventional F dentrifice [1100 ppm] when used by caries-inactive children. However, in children with active caries lesions the low-F dentrifice was less effective than the 1100-µgF/g dentrifice in controlling the progression of lesions" (30). This rather reinforces evidence from Australia that there is little penalty of a rise in caries experience, or reduced caries prevention, in recommending use of 500 ppm toothpastes rather than 1000 ppm toothpastes for use by young children (31).…”

Fluoride: its role in dentistry

“…250 ppm F) were clearly not as effective as the conventional toothpastes to control caries. A clinical study published in 2008 30 brought some light to this subject, by demonstrating that low fluoride and conventional toothpastes were equally effective to control caries in caries-inactive children, but low fluoride toothpastes used by caries-active children resulted in an increased number of incipient lesions after one year, while the conventional one could control the appearance of new lesions. This was further explained by a recent study 31 showing that low F toothpastes are not able to control caries under a high cariogenic challenge (biofilm accumulation and exposure to sucrose 8 times/ day).…”

Development of caries adjacent to composite restorations after exposure to dentifrices with different fluoride concentrations

“…Thus, these results provide scientific evidence to corroborate the efficacy of dentifrices having high concentration, because a dentifrice must have at least 1000 ppm of fluoride in soluble form in order to have an anticarie effect 18 . Concentrations less than 1000 ppm F are not capable of inhibiting the development of caries in highly challenging cariogenic situations 19 or in the presence of active caries 20 . These processes are constantly active mainly in children with increased risk of caries.…”