Topical fluoride for caries prevention

Abstract

Background A panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs presents evidence-based clinical recommendations regarding professionally applied and prescription-strength, home-use topical fluoride agents for caries prevention. These recommendations are an update of the 2006 ADA recommendations regarding professionally applied topical fluoride and were developed by using a new process that includes conducting a systematic review of primary studies. Types of Studies Reviewed The authors conducted a search of MEDLINE and the Cochrane Library for clinical trials of professionally applied and prescription-strength topical fluoride agents—including mouthrinses, varnishes, gels, foams and pastes—with caries increment outcomes published in English through October 2012. Results The panel included 71 trials from 82 articles in its review and assessed the efficacy of various topical fluoride caries-preventive agents. The panel makes recommendations for further research. Practical Implications The panel recommends the following for people at risk of developing dental caries: 2.26 percent fluoride varnish or 1.23 percent fluoride (acidulated phosphate fluoride) gel, or a prescription-strength, home-use 0.5 percent fluoride gel or paste or 0.09 percent fluoride mouthrinse for patients 6 years or older. Only 2.26 percent fluoride varnish is recommended for children younger than 6 years. The strengths of the recommendations for the recommended products varied from “in favor” to “expert opinion for.” As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences.

Reducing early childhood caries in a Medicaid population

“…Data on each intervention's effect and cost from the peer-reviewed literature and from experts informed the model ( Table 2). [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] …”

Focus on Fluorides: Update on the Use of Fluoride for the Prevention of Dental Caries

“…The recommendation of at least weekly use for older than 18 years or for root caries prevention is based on ‘Expert Opinion’ because the scientific evidence is lacking. 12 …”

“…The most recent systematic review on topical fluoride indicates that the evidence favors F-varnish applications at least every three to six months for all children younger than 18 years of age. 12 This same review found that the evidence is lacking for use of F-varnish for adults 18 and older or for prevention of root caries, however, expert opinion is in favor of these uses to prevent caries.…”

Preventing caries in preschoolers: Successful initiation of an innovative community-based clinical trial in Navajo Nation Head Start

“…FV, a professionally available topical agent, has been employed in the prevention of caries since 1964. The unique and favorable clinical characteristics of FV have prompted the publication of clinical practice recommendations from the American Dental Association and the American Academy of Pediatric Dentistry [10] that support off-label use of FV as the preferred technique for cost-effective caries prevention in children under the age of six [11, 12]. The goals of OHP programs for children and caregivers are to increase knowledge, encourage positive attitudes toward oral health care, and improve parental behaviors related to ECC and contributing factors such as regular dental visits, feeding and nutrition, and oral hygiene practices [6].…”