Topical fluoride for caries prevention: executive summary of the updated clinical recommendations and supporting systematic review
Robert J Weyant, Sharon L Tracy, Theresa Tracy Anselmo, Eugenio D Beltrán-Aguilar, Kevin J Donly, William A Frese, Philippe P Hujoel, Timothy Iafolla, William Kohn, Jayanth Kumar, Steven M Levy, Norman Tinanoff, J Timothy Wright, Domenick Zero, Krishna Aravamudhan, Julie Frantsve-Hawley, Daniel M Meyer, American Dental Association Council on Scientific Affairs Expert Panel on Topical Fluoride Caries Preventive Agents, Robert J Weyant, Sharon L Tracy, Theresa Tracy Anselmo, Eugenio D Beltrán-Aguilar, Kevin J Donly, William A Frese, Philippe P Hujoel, Timothy Iafolla, William Kohn, Jayanth Kumar, Steven M Levy, Norman Tinanoff, J Timothy Wright, Domenick Zero, Krishna Aravamudhan, Julie Frantsve-Hawley, Daniel M Meyer, American Dental Association Council on Scientific Affairs Expert Panel on Topical Fluoride Caries Preventive Agents
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 0.05 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.
Keywords: Caries prevention; caries; evidence-based dentistry; fluoride; practice guidelines; preventive dentistry.
Source: PubMed