Cochrane · intervention · CD002781

Combinations of topical fluoride (toothpastes, mouthrinses, gels, varnishes) versus single topical fluoride 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 1 · 5.6%Ungraded 17 · 94.4%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 caries level, background fluoride exposure, dental treatment level, nationality or setting); those selected on the basis of special general or oral health conditions excluded	Children aged 14 or less at start in all trials, mostly around 12 years, one trial in preschool children; baseline caries 1-10 D(M)FS (0.9 dfs in the preschool trial); only one trial in a fluoridated community (n=12)
Intervention	Topical fluoride therapy as toothpastes, mouthrinses, gels or varnishes (any fluoride agent, any concentration, amount, duration or technique, frequency at least once a year) used in combination	Fluoride toothpaste + mouthrinse (n=5); fluoride toothpaste + gel (n=3); fluoride toothpaste + varnish (n=2); fluoride gel + mouthrinse (n=2); fluoride mouthrinse + gel (n=1)
Comparison	A single topical fluoride modality alone (mainly fluoride toothpaste)	Fluoride toothpaste alone (n=9 across subgroups); fluoride mouthrinse alone (n=5); fluoride gel alone (n=4); fluoride varnish alone (n=1)
Outcomes	Primary: caries increment (change in D(M)FS permanent; d(e/m)fs deciduous) at the dentin level; Relevant: coronal caries and fillings (permanent and deciduous); tooth loss; proportion of children developing new caries; dental pain/discomfort; specific side effects (fluorosis, tooth staining/discoloration, oral allergic reactions, adverse symptoms); unacceptability of treatment (drop-outs); use of health service resources	Caries increment D(M)FS permanent - prevented fraction (n=9); caries increment d(e)fs deciduous - prevented fraction (n=1); unacceptability of treatment/drop-outs (n=6); adverse effects scarcely reported - stain score (n=1) and side effects (n=1); enamel fluorosis not reported (n=0)
Study designs	Randomized or quasi-randomized controlled trials with (indicated) blind outcome assessment lasting at least 1 calendar or school year; split-mouth designs involving varnish, open/unblinded assessment, or duration <1 year excluded	12 parallel-group randomized or quasi-randomized controlled trials (2 quasi-randomized; blinding 7 double-blind, 3 single-blind, 3 indicated), conducted 1966-1985, duration 2-3 years
Timing	At least 1 calendar or school year (primary analysis nearest to 3 years)	2 to 3 years (analysis nearest to 3 years)

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