Topical fluoride is effective in preventing caries in moderate and high caries risk adults


While dental caries in usually associated with children it is still a common problem for adults.  Several systematic reviews have evaluated the use of fluorides for the prevention of caries in children but fewer of fluoride use in adults.  The aim of this review was to evaluate the research regarding professional and/or supplemental self-applied fluoride for preventing and remineralizing caries in moderate and high caries risk adults.

A comprehensive search of several databases was conducted for randomized control trials or clinical trials conducted in moderate or high caries risk adult populations, evaluating self- or professionally applied fluoride with the outcomes of caries were included. Studied in English and foreign languages were considered.  Studies were evaluated for quality.

The authors included 17 studies which 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.

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%
  • 1.1  percent NaF pastes/gels  RRR for root lesion remineralization: 35-122 %
  • fluoride varnishes
    • RRR for Root caries  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.

They concluded

Although the reviewed clinical trials varied greatly in design, conduct, and quality scores, all demonstrated that the use of supplemental and professionally applied fluoride in moderate and high caries risk adults is effective in preventing and/or remineralizing dental caries.

Gibson G, Jurasic MM, Wehler CJ, Jones JA. Supplemental fluoride use for moderate and high caries risk adults: a systematic review. J Public Health Dent. 2011 Summer;71(3):171-84. PubMed PMID: 21972457.



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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.

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