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Combinations of topical fluoride (toothpastes, mouthrinses, gels, varnishes) versus single topical fluoride for preventing dental caries in children and adolescents.


Combinations of topical fluoride (toothpastes, mouthrinses, gels, varnishes) versus single topical fluoride for preventing dental caries in children and adolescents

Additional forms of topical fluoride can reduce tooth decay Tooth Decay Definition

Tooth decay, which is also called dental cavities or dental caries, is the destruction of the outer surface (enamel) of a tooth.
 in children and adolescents more than fluoride toothpaste fluoride toothpaste npasta de dientes con flĂșor  alone, but the extra benefit is not great.

Tooth decay (dental caries) is painful, expensive to treat and can seriously damage teeth. Fluoride is a mineral that prevents tooth decay.

Fluoride is added to the water supply in many areas. It can also be applied in the form of toothpastes, mouthrinses, gels or varnishes. The review of trials found that children and adolescents who used another form of topical fluoride in addition to fluoride toothpaste experienced some additional reduction in tooth decay compared with children who only used fluoride toothpaste. However, the additional benefit was not great, and the trials did not provide data about adverse effects.

Cochrane Database of Systematic Reviews 2010 Issue 11, Art. No.: CD002781. DOI (Digital Object Identifier) A method of applying a persistent name to documents, publications and other resources on the Internet rather than using a URL, which can change over time. : 10.1002/14651858.CD002781 .pub2 Copyright [C] 2010 The Cochrane Collaboration The Cochrane Collaboration was developed in response to Archie Cochrane's call for up-to-date, systematic reviews of all relevant randomized controlled trials of health care. . Published by John Wiley John Wiley may refer to:
  • John Wiley & Sons, publishing company
  • John C. Wiley, American ambassador
  • John D. Wiley, Chancellor of the University of Wisconsin-Madison
  • John M. Wiley (1846–1912), U.S.
 and Sons, Ltd.



Topical fluoride therapy (TFT (Thin Film Transistor) The term typically refers to active matrix screens on laptop computers. Active matrix LCD provides a sharper screen display and broader viewing angle than does passive matrix. See LCD and thin film.

TFT - Thin Film transistor
) in the form of toothpastes, mouthrinses, varnishes and gels are effective caries preventive measures. However, there is uncertainty about the relative value of these interventions when used together.


To compare the effectiveness of two TFT modalities combined with one of them alone (mainly toothpaste) when used for the prevention of dental caries in children.

Search strategy

We searched the Cochrane Oral Health Group's Trials Register (May 2000), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2000, Issue 2), MEDLINE The online medical database of the U.S. National Library of Medicine (NLM) whose parent is the National Institutes of Health, Bethesda, MD. MEDLINE contains millions of articles from thousands of medical journals and publications. The consumer section of the site (http://medlineplus.  (1966 to January 2000), plus several other databases. We handsearched journals, reference lists of articles and contacted selected authors and manufacturers.

Selection criteria

Randomized or quasi-randomized controlled trials with blind outcome assessment, comparing fluoride varnish, gel, mouthrinse, or toothpaste in combination with each other in children up to 16 years during at least 1 year. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces (D(M)FS).

Data collection and analysis

Inclusion decisions, quality assessment and data extraction were duplicated in a random sample of one third of studies, and consensus achieved by discussion or a third party. Authors were contacted for missing data. The primary measure of effect was the prevented fraction (PF) that is the difference in mean caries increments between the 'treatment' and 'control' groups expressed as a percentage of the mean increment in the control group. Random-effects meta-analyses were performed where data could be pooled.

Main results

Eleven of the 12 included studies contributed data for the meta-analyses. For the nine trials that provided data for the main meta-analysis on the effect of fluoride mouthrinses, gels or varnishes used in combination with toothpaste (involving 4026 children) the D(M)FS pooled PF was 10% (95% CI, 2% to 17%; P = 0.01) in favour of the combined regimens. Heterogeneity was not substantial in these results (12 = 32%). The separate meta-analyses of fluoride gel or mouthrinse combined with toothpaste versus toothpaste alone favour the combined regimens, but differences were not statistically significant; the significant difference in favour of the combined use of fluoride varnish and toothpaste accrues from a very small trial and appears likely to be a spurious result. Not all other combinations of possible practical value were tested in the included studies. The only other statistically significant result was in favour of the combined use of fluoride gel and mouthrinse in comparison to gel alone (pooled DMFS DMFS Decayed/Missing/Filled Surface (dentistry)  PF 23%; 95% CI, 4% to 43%; P = 0.02), based on two trials. No other combinations of TFT were consistently superior to a single TFT.

Authors' conclusions

Topical fluorides (mouthrinses, gels, or varnishes) used in addition to fluoride toothpaste achieve a modest reduction in caries compared to toothpaste used alone. No conclusions about any adverse effects could be reached, because data were scarcely reported in the trials.
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Author:V.C.C., Marinho; J.P.T., Higgins; A., Sheiham; S., Logan
Publication:Canadian Journal of Dental Hygiene
Article Type:Author abstract
Geographic Code:1CANA
Date:Feb 1, 2011
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