Strong evidence that daily use of fluoride toothpaste prevents caries

Abstract

Data sources Medline, Cochrane Library, reference lists of identified articles and selected textbooks were used to source studies. Study selection Selected studies were randomized or controlled clinical trials of at least 2 years' duration with caries increment in the permanent (DMFS/T) or primary (dmfs/t) dentition as the endpoint. Reports published in Danish, English, French, German, Italian, Norwegian, Spanish or Swedish were included. For multiply reported trials the one with the longest follow-up period was included. Data extraction and synthesis Inclusion decisions and grading of the studies was performed independently by two of the authors. The main outcome was prevented fraction (PF). A pooled estimate was calculated for included studies. Results Fifty-four studies were included. There was strong evidence for a caries-preventive effect of daily use of fluoride toothpaste compared with placebo in the young permanent dentition (PF, 24.9%; standard deviation, 711.5%). Toothpastes containing 1500 ppm of fluoride had a superior preventive effect (additional PF, 9.7%; range 0-22%) compared with standard dentifrices of 1000 ppm fluoride. There was also strong evidence for higher caries reductions with supervised toothbrushing compared with unsupervised brushing. There was incomplete evidence regarding the effect of fluoride toothpaste in the primary dentition. Conclusions This review reinforces the importance of daily toothbrushing with fluoridated toothpastes for preventing dental caries, although long-term studies in age groups other than children and adolescents are still lacking.Commentary This is an important paper which highlights the strength of evidence supporting the daily use of fluoride toothpaste. Data were drawn from studies conducted in different geographical locations as well as in various age groups of children and adolescents. A clear benefit was observed, in terms of the preventive effect of fluoride, in studies that compared fluoride-toothpaste test groups with intervention controls that used a placebo or other fluoride-free toothpastes, with or without supervised brushing, in the young permanent dentition. In general, studies that used supervised brushing showed a higher preventive effect than those with unsupervised interventions.Brushing is an important measure in prevention of caries because it contributes to the disruption of the dental biofilm. Evidence is still lacking, however, to show the isolated effect of brushing in the prevention of dental caries. This is probably because studies would be considered unethical if they compared treatment with control groups that did not use any preventive method at all. Nevertheless, future research is needed to measure the real effect of brushing, supervised or unsupervised, as an isolated variable from the effect of fluoride.It has been suggested that the use of dentifrices with low fluoride concentrations (o1000 ppm) for children under 6 years of age may reduce fluoride ingestion and risk of dental fluorosis. The effectiveness of these is unclea...

Social Support and Optimism in Relation to the Oral Health of Young Adults

“…More frequent toothbrushing was associated with fewer decayed teeth and less impact on oral health-related quality of life, consistent with evidence of preventive effects of regular brushing [19]. Males had lower caries experience reflected in lower numbers of missing teeth.…”

The effect of toothbrushing and flossing sequence on interdental plaque reduction and fluoride retention: A randomized controlled clinical trial

“…24 It has long been proven that a therapeutic agent, in order to be effective, needs to reach the targeted sites and remain there. [27][28][29] In fact, they combine the removal of dental plaque with the cariostatic effect of fluoride. Literature has shown that the application of topical fluorides, such as daily use of fluoridated toothpastes and dental floss can prevent dental caries.…”

“…Literature has shown that the application of topical fluorides, such as daily use of fluoridated toothpastes and dental floss can prevent dental caries. [27][28][29] In fact, they combine the removal of dental plaque with the cariostatic effect of fluoride. 30 It has been well established that plaque, after fluoride exposure, serves as a reservoir for fluoride that releases its contents into oral fluids and maintains a prolonged protective effect against dental caries.…”

Assessment of Autofluorescence to Detect the Remineralization Capabilities of Sodium Fluoride, Monofluorophosphate and Non-Fluoride Dentifrices

“…The group agreed that no matter which of these strategies were employed it was essential to validate any new study design by ensuring that it could replicate the findings of previous studies and thus ensure maintenance of standards for both efficacy and safety . It was further suggested that as several studies had previously demonstrated the monotonic dose response for fluoride that a simple, two-fluoride-level product comparison would be an appropriate means of validating a new, abbreviated caries clinical trial Topping and Assaf, 2005].…”