Abstract
BackgroundThe aim of this conference paper was to examine the evidence base for primary and secondary prevention of dental caries, erosions and dentin hypersensitivity through professional and self-care measures.MethodsA mapping of systematic reviews (SR) of literature was carried out in PubMed and the Cochrane library through April 2014 using established MeSH-terms and disease-related search words in various combinations. The search was restricted to SR's published in English or Scandinavian and all age groups were considered. The reference lists of the selected papers were hand-searched for additional review articles of potential interest. Meta-analyses, guidelines and treatment recommendations were considered only when SR's were lacking. In the event of updates or multiple systematic reviews covering the same topic, only the most recent article was included. No quality assessment of the systematic reviews was carried out. The quality of evidence was rated in four levels according to the GRADE scale.ResultsIn total, 39 SR were included. For primary caries prevention, the quality of evidence was high for the use of fluoride toothpaste (with and without triclosan) and moderate for fluoride varnish and fissure sealants. The quality of evidence for fluoride gel, fluoride mouth rinse, xylitol gums and silver diamine fluoride (SDF) was rated as low. For secondary caries prevention and caries arrest, only fluoride interventions and SDF proved consistent benefits, although the quality of evidence was low. Likewise, the GRADE score for preventing erosions located in the enamel with fluoride supplements was low. The quality of evidence for various professional and self-care methods to prevent and manage dentine hypersensitivity was very low.ConclusionsThere are knowledge gaps in many domains of cariology and preventive dentistry that must be addressed and bridged through clinical research of good quality.
Highlights
Dental caries, dental erosion and dentin hypersensitivity are prevalent oral conditions occurring at all ages
They are all multifactorial; caries is a biofilm-mediated disease resulting from a complex interaction between the commensal microbiota, host susceptibility and environmental factors such as diet [1], dental erosion is the non-reversible loss of enamel and dentin when exposed to non-bacterial extrinsic or intrinsic acids [2] and dentin hypersensitivity is a short sharp pain arising from exposed dentine in response to stimuli [3]
It is almost a paradox to find strong evidence for selected caries-preventive measures when a recent report has calculated that 2.5 billion people (35%) on the planet have untreated caries in their permanent dentition [5]
Summary
Dental erosion and dentin hypersensitivity are prevalent oral conditions occurring at all ages. They are all multifactorial; caries is a biofilm-mediated disease resulting from a complex interaction between the commensal microbiota, host susceptibility and environmental factors such as diet [1], dental erosion is the non-reversible loss of enamel and dentin when exposed to non-bacterial extrinsic or intrinsic acids [2] and dentin hypersensitivity is a short sharp pain arising from exposed dentine in response to stimuli [3]. The three conditions share public health programs or school-based interventions were not addressed. The aim of this conference paper was to examine the evidence base for primary and secondary prevention of dental caries, erosions and dentin hypersensitivity through professional and self-care measures
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