Non‐surgical management methods of noncavitated carious lesions

Abstract

Fluoride interventions (varnishes, gels, and toothpaste) seem to have the most consistent benefit in decreasing the progression and incidence of NCCls. Studies using xylitol, CHX, and CPP-ACP vehicles alone or in combination with fluoride therapy are very limited in number and in the majority of the cases did not show a statistically significant reduction. Sealants and resin infiltration studies point to a potential consistent benefit in slowing the progression or reversing NCCls.

Enhancing Fluoride: Clinical Human Studies of Alternatives or Boosters for Caries Management

“…All the arginine studies (8/8) included a combination of arginine and a calcium base, and concluded that the addition of 1.5% arginine to toothpaste containing 1,450 ppm F (as MFP) with an insoluble calcium base has the potential to significantly boost the performance of fluoride-only toothpaste. The re- Chen et al [2013]: high risk of bias; according to Tellez et al [2013]: moderate risk of bias by Cochrane, poor quality by ADA) 0.05% sodium fluoride rinse once daily + F toothpaste (1,000-1,100 ppm F) for 6 months Baseline: 9.4 ± 9.5 12 months: 6.4 ± 7.5 (significantly less than baseline) Difference of 0 -12 months between sites that were scored 0 -1 at end: 25% maining studies focusing on the addition of microbial-related strategies to a fluoride-containing vehicle (2 xylitol studies, plus 1 study using a probiotic milk) favored the combination as a booster to fluoride-only control arms.…”

“…A 2013 systematic review [Tellez et al, 2013] of nonsurgical caries-preventive methods to arrest or reverse the progression of noncavitated caries lesions concluded that fluoride interventions have the most consistent benefit, while other strategies (including xylitol, chlorhexidine and CPP-ACP alone or in combination with fluoride) are very limited in number and in the majority of cases did not show a statistically significant reduction. The most recent systematic review on this topic included 8 studies (3-24 months) and concluded that there was a remineralizing effect of CPP-ACP compared to a placebo, but that the evidence regarding the clinical efficacy of CPP-ACP as a booster/supplement to fluoride-containing products is still unclear (the effect was not significantly different from that of fluorides) [Li et al, 2014].…”

Retracted: Modern Concepts for Caries Tissue Removal

“…7 For example, noninvasive strategies limit the intake of carbohydrates via dietary control, thus rebalancing the composition and activities of dental biofilms. Biofilm removal or inactivation via mechanical or chemical oral hygiene control similarly targets the biofilm, its composition or maturation, and activity.…”

Effectiveness of a preventive program based on caries risk assessment and recall intervals on the incidence and regression of initial caries lesions in children

“…This was expected because the children classified as high risk E are necessarily those who presented active lesions at baseline, and who received more intense professional fluoride applications. In this respect, fluoride products have shown consistent benefits in decreasing the progression of active lesions. Therefore, it is important to detect active caries lesions as early as possible, and dentists should start the non‐operative treatment soon, to promote the regression of the non‐cavitated lesions.…”