Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

342 questions · 403 findings · 24 reviews · Dental caries

No studies found 73 · 18.1%GRADE not reported 164 · 40.7%Very low 60 · 14.9%Low 77 · 19.1%Moderate 27 · 6.7%High 2 · 0.5%

Fluoride varnish applied before 4 years of age vs No fluoride varnish application

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

Fluoride varnish applied before 4 years of age may leads to higher fluorosis (percentage prevalence in permanent teeth) compared with no fluoride varnish application (low certainty).

1 finding from 1 review

Fluoride varnish applied before 4 years of age vs Non-fluoride (placebo) varnish

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

Fluoride varnish applied before 4 years of age (biannual) showed no clear difference in fluorosis (percentage prevalence in permanent teeth) compared with placebo varnish (low certainty).

1 finding from 1 review

Started toothbrushing with fluoride toothpaste before 4 years (earlier start) vs Started after 4 years (later start)

Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years

It is very uncertain whether started toothbrushing with fluoride toothpaste before 4 years… changes fluorosis (percentage prevalence in permanent teeth) compared with started after 4 years (later start) (very low certainty).

1 finding from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Caries increment on permanent whole teeth (D(M)FT), prevented fraction · Children and adolescents aged 16 years or younger (permanent dentition)
3 findings from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Caries increment on permanent tooth surfaces (D(M)FS), prevented fraction · Children and adolescents aged 16 years or younger (permanent dentition)
3 findings from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Unacceptability of treatment (dropouts/exclusions during the trial) · Children and adolescents aged 16 years or less

Fluoride gel (topically applied; operator- or self-applied; any… showed no clear difference in unacceptability of treatment (dropouts/exclusions during the trial) compared with placebo or no treatment; GRADE not reported.

3 findings from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Mucosal irritation / oral soft tissue allergic reaction (signs of sensitivity) · Children and adolescents aged 16 years or less

The review found no eligible studies for this question.

1 finding from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Proportion of children not remaining caries-free · Children with primary (deciduous) teeth (younger children)

Fluoride gel (topically applied; operator- or self-applied; any… showed no clear difference in proportion of children not remaining caries-free compared with placebo or no treatment; GRADE not reported.

1 finding from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Staining · Children and adolescents aged 16 years or less

The review found no eligible studies for this question.

1 finding from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Signs of acute toxicity during gel application (nausea, gagging, vomiting) · Children and adolescents aged 16 years or less

It is very uncertain whether fluoride gel (topically applied; operator- or self-applied; any… changes signs of acute toxicity during gel application (nausea, gagging,… compared with placebo or no treatment (very low certainty).

1 finding from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Proportion developing new caries · Children and adolescents aged 16 years or younger (permanent dentition)

Fluoride gel (topically applied; operator- or self-applied; any… led to lower proportion of children developing new caries compared with placebo or no treatment; GRADE not reported.

1 finding from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Caries increment in primary/deciduous teeth: decayed, (extraction indicated/missing) and filled teeth d(e/m)ft (prevented fraction) · Children with primary (deciduous) teeth (younger children)

The review found no eligible studies for this question.

1 finding from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

Proportion of children not remaining caries-free · Children and adolescents aged 16 years or younger (permanent dentition)

Fluoride gel (topically applied; operator- or self-applied; any… showed no clear difference in proportion of children not remaining caries-free compared with placebo or no treatment; GRADE not reported.

1 finding from 1 review

Fluoride mouthrinse (any fluoride agent, concentration, volume, frequency or technique; swished and expectorated, not swallowed) vs placebo or no treatment

Dental caries: dmfs increment (primary teeth) · Children and adolescents aged 16 years or less

The review found no eligible studies for this question.

1 finding from 1 review

Fluoride mouthrinse (any fluoride agent, concentration, volume, frequency or technique; swished and expectorated, not swallowed) vs placebo or no treatment

Proportion developing new caries · Children and adolescents aged 16 years or less

Fluoride mouthrinse (any fluoride agent, concentration, volume,… showed no clear difference in proportion of children developing one or more new caries compared with placebo or no treatment; GRADE not reported.

1 finding from 1 review

Fluoride mouthrinse (any fluoride agent, concentration, volume, frequency or technique; swished and expectorated, not swallowed) vs placebo or no treatment

Mucosal irritation / oral soft tissue allergic reaction (signs of sensitivity) · Children and adolescents aged 16 years or less
1 finding from 1 review

Fluoride mouthrinse (any fluoride agent, concentration, volume, frequency or technique; swished and expectorated, not swallowed) vs placebo or no treatment

Signs of acute toxicity during gel application (nausea, gagging, vomiting) · Children and adolescents aged 16 years or less

The review found no eligible studies for this question.

1 finding from 1 review

Fluoride mouthrinse (any fluoride agent, concentration, volume, frequency or technique; swished and expectorated, not swallowed) vs placebo or no treatment

Unacceptability of treatment (drop-outs / leaving study early) · Children and adolescents aged 16 years or less

It is very uncertain whether fluoride mouthrinse (any fluoride agent, concentration, volume,… changes unacceptability of treatment as measured by leaving study early… compared with placebo or no treatment (very low certainty).

1 finding from 1 review