Design Systematic review of clinical trials.Case selection Clinical trials with adults 60 years of age or older who professionally received fluoride therapy for caries prevention or arrest. Controls were adults of the same age group who received another professionally applied fluoride agent, placebo, or nothing.Data analysis The expected outcomes were the mean difference in the number of new caries, caries prevented fraction and caries arrest rate. Independently, two researchers assessed the risk of bias in the included studies.Results Seven studies met the selection criteria where 5% sodium fluoride varnish, 38% sodium diamine fluoride solution and 1.23% acidulated phosphate fluoride gel were used with root caries and coronal caries. Given the nature of the studies, the three agents were effective in preventing root caries in older adults. None of the agents were particularly superior to the others.Conclusions Professionally applied fluoride is effective in preventing dental caries in older adults.