Fluoride mouthrinses provide clear reduction in caries in children

Abstract

Data sources Sources of studies were the Cochrane Oral Health Group’s Trials Register, Cochrane Central Register of Controlled Trials, Medline, Embase, SCISEARCH, SSCISEARCH, ISTP, BIOSIS, CINAHL, ERIC, Dissertation Abstracts and LILACS. Searches were also made by hand of journals and reference lists of articles, and contact was made with selected authors and manufacturers.Study selection Studies included were randomised or quasi-randomised controlled trials with blind outcome assessment that compared fluoride mouthrinse with placebo or no treatment at least 1 year in children aged up to 16 years over. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces [D(M)FS].Data extraction and synthesis The primary measure of effect was the prevented fraction (PF; ie, the difference in mean caries increments between the treatment and control groups expressed as a proportion of the mean increment in the control group). Meta-analyses were performed where data could be pooled. Potential sources of heterogeneity were examined by meta-regression.Results Thirty-six studies were included, with 34 contributing data for meta-analysis (involving 14 600 children). The D(M)FS pooled PF was 26% (95% confidence interval, 23–30%; P<0.0001). Heterogeneity was not substantial but was confirmed statistically (P=0.008). No significant association between estimates of D(M)FS PF and baseline caries severity, background exposure to fluorides, rinsing frequency and fluoride concentration was found. There is little information concerning possible adverse effects or acceptability of treatment in the trials included (Table 1).Conclusions This review shows that the supervised regular use of fluoride mouthrinse at two main strengths and rinsing frequencies is associated with a reduction in caries increment in children. There is a need for complete reporting of side-effects and acceptability data in fluoride mouthrinse trials.