Supplemental fluoride use for moderate and high caries risk adults: a systematic review
Article first published online: 11 MAY 2011
© 2011 American Association of Public Health Dentistry
Journal of Public Health Dentistry
Volume 71, Issue 3, pages 171–184, Summer 2011
How to Cite
Gibson, G., Jurasic, M. M., Wehler, C. J. and Jones, J. A. (2011), Supplemental fluoride use for moderate and high caries risk adults: a systematic review. Journal of Public Health Dentistry, 71: 171–184. doi: 10.1111/j.1752-7325.2011.00261.x
- Issue published online: 24 AUG 2011
- Article first published online: 11 MAY 2011
- Received: 4/16/2010; accepted: 8/20/2010.
- caries prevention;
- root caries;
- tooth remineralization
Objectives: Multiple systematic reviews have evaluated fluorides for caries prevention in children, but a need to review the literature regarding supplemental fluoride use in adults still remains. The purpose of this systematic review is to evaluate the research regarding professional and/or supplemental self-applied fluoride for preventing and remineralizing caries in moderate and high caries risk adults.
Methods: Utilizing multiple databases, a comprehensive search was undertaken in both foreign and English languages. Studies included were randomized control trials (RCT) or clinical trials conducted in moderate or high caries risk adult populations, evaluating self- or professionally applied fluoride with the outcomes of caries reduction/remineralization. Studies were excluded if they were in situ, in vitro, split mouth design, or with unclear outcomes specific to fluorides. A quality evaluation of the studies used a checklist of critical domains and elements for an RCT.
Results: Seventeen studies were included in the systematic review. Findings were categorized into the following groups: sodium fluoride (NaF) and amine/potassium fluoride mouthrinses of varying strengths, NaF gels and pastes, NaF varnish, and stannous fluoride. Quality evaluation scores varied from 50.2 percent to 88.9 percent.
Conclusions: The strongest studies demonstrated the following modalities as moderately effective in higher caries risk adults: low strength NaF rinses [relative risk reduction (RRR) for carious lesions: 50-148 percent]; 1.1 percent NaF pastes/gels (RRR for root lesion remineralization: 35-122 percent); fluoride varnishes [RRR for RC remineralization: 63 percent; RRR for decrease in decayed, missing, and filled surfaces: 50 percent]. Evidence regarding 1.1 percent NaF and 5 percent NaF varnishes related primarily to root caries and older adults.