Non-fluoride agents may provide some adjunctive benefit to those at higher risk of caries

shutterstock_58869371 caries

The use of topical fluoride together with  fluoridated water and fissure sealants are mainstays of caries management.  A range of non-fluoride agents  caries preventive agents are also in use and these are reviewed to provide  evidence-based clinical recommendations. The authors evaluated studies of sucrose-free polyol chewing gums, xylitol dentifrices, chlorhexidine, chlorhexidine in combination with thymol, calcium-containing agents, phosphate-containing agents, casein derivatives, sialogogues, iodine and triclosan. Vaccines, genetically modified Streptococcus mutans, probiotics, and lasers, ozone and other mechanical devices were not within the scope of the review

The review was authored by a a multidisciplinary panel of subject matter experts convened by the American Dental Association (ADA) Council on Scientific Affairs (CSA) . They considered two clinical questions:-

  1. In the general population, does the use of a nonfluoride caries preventive agent reduce incidence, arrest or reverse caries?
  2. In individuals at higher caries risk, does the use of a nonfluoride caries preventive agent reduce incidence, arrest or reverse caries?

They searched MEDLINE and the Cochrane Library from 1966 through April 9, 2010 and identified  2697 articles. 71 articles describing  50 randomized controlled trials (RCTs) and 15 non-randomized studies were included.

They concluded:-

.. that certain non-fluoride agents may provide some benefit as adjunctive therapies in children and adults who are at higher risk of experiencing caries. The panel found at least 10 ongoing clinical trials that may in the future provide additional evidence for or against the effectiveness of many of these modalities. Therefore, on the basis of available evidence, the panel recommended sucrose-free chewing gum (containing either only or polyol combinations) or xylitol lozenges for caries prevention. In addition, the panel found that a 1:1 mixture of chlorhexidine/thymol varnish may be efficacious in the prevention of root caries. The panel will update its recommendations when information from ongoing clinical trials becomes available.

Read the executive summary

Read the full report


Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+
Mark as read
Create a personal elf note about this blog
Profile photo of Derek Richards

Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

More posts - Website

Follow me here –