Cochrane · intervention · CD002780

One topical fluoride (toothpastes, or mouthrinses, or gels, or varnishes) versus another for preventing dental caries in children and adolescents

Marinho, VCC, Higgins, JPT, Sheiham, A, et al. · Cochrane Database of Systematic Reviews · 2004 · Cochrane Library

Oral Health Dental caries2 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

as reported

No studies 0 · 0%Ungraded 13 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Children or adolescents aged 16 or less at the start of the study (irrespective of initial level of dental caries, background exposure to fluorides, dental treatment level, nationality, setting or time when it started)	Participants aged 14 or less at start in all trials, similar numbers of both sexes; at least 10 trials involved children around age 12; one trial (Petersson 1985) involved pre-school children; baseline caries 0.9 to 15 D(M)FS; only one trial in a fluoridated community
Intervention	Topical fluoride therapy as toothpastes, mouthrinses, gels or varnishes only, using any fluoride agent (NaF, SMFP, SnF2, APF, amine F; any compatible abrasive for toothpastes), at any concentration (ppm F), amount, duration or technique of application, provided frequency was at least once a year	Fluoride toothpaste arm (n=11 trials); fluoride varnish arm (n=6); fluoride gel arm (n=6); fluoride mouthrinse arm (n=11)
Comparison	Another topical fluoride therapy (toothpaste, mouthrinse, gel or varnish); any of the six possible pairwise comparisons of the four modalities	Another topical fluoride modality (varnish, gel, mouthrinse or toothpaste)
Outcomes	Caries increment measured by change from baseline in the decayed, (missing) and filled surface (D(M)FS) index in permanent teeth (primary; deciduous d(e/m)fs in younger children); coronal dental caries and fillings in permanent and deciduous dentitions; tooth loss; proportion of children developing new caries; dental pain/discomfort; specific side effects (fluorosis, tooth staining, oral allergic reactions, nausea, vomiting); unacceptability of treatment (drop-outs); use of health service resources	Caries increment D(M)FS permanent (n=16); caries increment dfs deciduous (n=1); caries increment D(M)FT (n=3); caries incidence/attack rate (n=2); caries progression (n=1); proportion of children developing new caries (n=2); stain score (n=1); signs of sensitivity in oral soft tissue (n=1); any side effects (n=1, none observed); unacceptability/drop-outs (n=8); fluorosis reported in no trial
Study designs	Randomized or quasi-randomized controlled trials using or indicating blind outcome assessment, comparing one form of topical fluoride therapy head-to-head with another, lasting at least 1 calendar or school year; split-mouth/within-group paired designs and open outcome assessment excluded	All 17 included trials used parallel-group designs; 5 had more than two arms; 10 used inactive/placebo interventions (double-blind), 7 used no treatment; three varnish-vs-mouthrinse trials used cluster randomization
Timing	At least 1 calendar or school year	Study duration ranged from 1 to 3 years (only two lasted less than 2 years); outcome taken at follow-up nearest 3 years

Search date: 2001-10. Databases: Cochrane Oral Health Group's Trials Register; CENTRAL; MEDLINE; EMBASE; SCISEARCH; SSCISEARCH; ISTP; BIOSIS; CINAHL; ERIC; DISSERTATION ABSTRACTS; LILACS/BBO; OLDMEDLINE; SIGLE; Community of Science database; meta Register of Current Controlled Trials