The FiCTION trail compared 3 caries management strategies for dentinal caries in primary teeth finding no evidence of a difference between the approaches. This emphasises the importance of primary prevention of caries to avoid dental caries althogther.
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This Cochrane review update evaluates whether topical fluoride reduces the proportion of orthodontic patients with new demineralised lesions (white spot lesions). In included 10 studies finding some low certainty evidence that some topical fluorides reduced white spot lesions.
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This umbrella review of silver diamine fluoride (SDF) for the management of carious lesions in children and adults included 11 systematic reviews reporting on 30 unique primary studies. A consistent and growing body of research supports supports SDF’s effectiveness for arresting coronal carious lesions in the primary dentition and arresting and preventing root carious lesions in older adults.
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This review of the efficacy of preventive interventions against the development of white spot lesions (WSLs) during fixed appliance orthodontic treatment included 23 RCTs tha majority of which were at high risk of bias. The findings suggest some benefit from sealants and fluoride varnishes but more high quality research is neeeded.
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This review of the effectiveness of fluoride varnish in reducing the risk of new caries in primary teeth included 20 studies suggesting modest effects in pre-school children.
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This review of glutaraldehyde or fluoride varnish for dentine hypersensitivity included just 4 small RCTs . The findings suggest a benefit in favour of glutaraldehyde at 7 days but the short-term nature of the studies and their limited quality means these findings should be interpreted cautiously.
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This large trial investigated the use of a ‘preventive package’ of fluoride varnish, fluoride toothpaste, toothbrush and standard dental health education in children between 2-3 years attending general practice. The intervention did not keep young children caries free but did reduce caries levels.
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This large, well-conducted study in a primary care setting found a small, but not statistically significant difference, between fissure sealants and fluoride varnish for the prevention of caries in first permanent molars at 36 months.
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This review of treatments for post orthodontic white spot lesions included 20 studies examining a wide variety of approaches. Modest benefits were seen in addition to daily use of fluoride toothpaste and furhter high quality studies are needed to identify the best approaches.
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This review looked at topical fluoride for remineralising or arresting caries. 17 RCTs were included and overall remineralised early enamel caries using % fluoride varnish = 63.6 % (95% CI; 36.0 to 91.2 %) and 38% silver diamine fluoride had an overall proportion of arrested dentine caries = 65.9% (95% CI; 41.2 to 90.7 %).
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