Caries incidence after professional fluoride treatment: a systematic review

Abstract

Aim: The purpose of this study was to assess whether individuals with active caries lesions treated with professional topical application of fluoride at high concentrations show a lower incidence of caries than individuals who have not received professional treatment with fluoridated products. Literature review: Randomized clinical trials in which patients were followed up for at least 6 months were included. Studies were identified with MEDLINE, Embase, LILACS, SCOPUS, and Cochrane Database of Systematic Reviews. Pairs of reviewers independently conducted study selection, data extraction, and risk-of-bias assessments. Eight trials, which included 5018 children and adolescents, were eligible. Results were evaluated by calculating the preventive fraction to standardize the outcomes. Results: Fluoride varnish yielded a better preventive fraction (90.18% to 14.6%) in both primary and permanent dentitions in comparison with methods using gel (22.3% to 6%) and foam (24%) after a mean follow-up period of 20.6 months. Regardless of the product used, increased frequency of application yielded greater benefit. Discussion: These results do not agree with previous findings that, in 8 weeks periods, did not observe an additional effect of the professional use of fluorides over the control treatments (biofilm control). The present review indicates the need for long-term monitoring of the effect of treatment, whereby the effects of high fluoride concentrations may appear. Conclusion: Professional fluoride treatment proved to be effective in preventing new long-term injuries in both primary and permanent dentition, irrespective of the vehicle used (varnish, gel, or foam). (PROSPERO Register number CRD42021210740).

Keywords

• dental caries
• fluorides, topical
• dentition, permanent
• tooth, deciduous