Cochrane · intervention · CD005101

Slow‐release fluoride devices for the control of dental decay

Chong, LY, Clarkson, JE, Dobbyn‐Ross, L, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library

Oral Health Dental caries4 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 5 · 55.6%Ungraded 0 · 0%Very low 4 · 44.4%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 adults	Children (mean age 8.8 years at start, 10.9 at termination) with DMFT/dmft greater than 1 and greater than 1 million colony-forming units of mutans streptococci per mL saliva, from a deprived inner-city area (Leeds, UK) with low water fluoride (n=174; 63 analysed)
Intervention	Slow-release fluoride devices (co-polymer acrylic reservoir types; slow-dissolving glass beads)	Fluoride-releasing glass beads bonded to buccal surfaces of right maxillary first permanent molars (n=31)
Comparison	Alternative fluoride treatment (topical fluoride: toothpaste, mouthrinse, gel, or varnish; NaF, SMFP, SnF, APF, amine F); Placebo; No intervention or usual care	Placebo glass beads without fluoride (n=32)
Outcomes	Changes in decayed, missing, and filled teeth or surfaces or both (DMFT/DMFS in permanent teeth - dmft/dmfs in primary teeth); Progression of caries lesion through enamel or into dentine; Dental pain due to decay; Retention of slow-release fluoride devices; Harms of slow-release fluoride devices; Participant satisfaction; Use of healthcare resources (cost effectiveness, time to fit, number of dental visits)	Changes in DMFT/DMFS (n=63); Retention of slow-release fluoride devices (n=132)
Study designs	Parallel RCT (split-mouth excluded)	RCT (n=1)
Timing	Minimum intervention and follow-up of 1 year	2 years

Search date: 2018-01. Databases: Cochrane Oral Health's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE Ovid; Embase Ovid; ClinicalTrials.gov; World Health Organization (WHO) International Clinical Trials Registry Platform

Questions and results

Current version only

Slow-release fluoride device (fluoride glass beads) vs Placebo or usual care (control)

Population: Children with high risk of dental decay

CD005101.PUB4 (current) · 8 questions

Outcome	Effect	Evidence	Status / GRADE
Increase in DMFT at 2 years compared with baseline 2 years same question in other reviews	MD -0.72 [-1.23, -0.21] -0.72 [-1.23, -0.21] DMFT (mean difference, scale 0 to 32)	1 study · 63 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Progression of caries lesion through enamel or into dentine same question in other reviews	No evidence found	0 studies	No studies
Dental pain due to decay same question in other reviews	No evidence found	0 studies	No studies
Increase in DMFS at 2 years compared with baseline 2 years same question in other reviews	MD -1.52 [-2.68, -0.36] -1.52 [-2.68, -0.36] DMFS (mean difference, scale 0 to 128)	1 study · 63 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Retention of slow-release fluoride devices (devices staying intact) 2 years same question in other reviews	132 (1 study); very low; Only 63/132 (47.7%) children who were still available at 2-year follow-up had the devices intact	1 study · 132 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Harms of slow-release fluoride devices same question in other reviews	132 (1 study); very low; Study reported that no irritations or other harms were reported	1 study · 132 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Use of healthcare resources (cost effectiveness, time taken to fit, number of dental visits) same question in other reviews	The study reported no data on use of healthcare resources	0 studies	No studies
Participant satisfaction same question in other reviews	No RCT evidence found	0 studies	No studies

Slow-release fluoride devices vs Alternative fluoride therapy (topical fluoride: toothpaste, mouthrinse, gel, or varnish)

Population: Children or adults

CD005101.PUB4 (current) · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR same question in other reviews	We found no studies comparing a slow-release fluoride device versus alternative fluoride therapy	0 studies	No studies

Slow-release fluoride device (fluoride glass beads) vs Placebo or usual care (control)

Population: Children with high risk of dental decay

CD005101.PUB3 · 8 questions

Outcome	Effect	Evidence	Status / GRADE
Increase in DMFS at 2 years compared with baseline 2 years	MD -1.52 [-2.68, -0.36] -1.52 [-2.68, -0.36] DMFS (mean difference, scale 0 to 128)	1 study · 63 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Participant satisfaction	No RCT evidence found	0 studies	No studies
Retention of slow-release fluoride devices (devices staying intact) 2 years	132 (1 study); very low; Only 63/132 (47.7%) children who were still available at 2-year follow-up had the devices intact	1 study · 132 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Harms of slow-release fluoride devices	132 (1 study); very low; Study reported that no irritations or other harms were reported	1 study · 132 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Dental pain due to decay	No evidence found	0 studies	No studies
Progression of caries lesion through enamel or into dentine	No evidence found	0 studies	No studies
Use of healthcare resources (cost effectiveness, time taken to fit, number of dental visits)	The study reported no data on use of healthcare resources	0 studies	No studies
Increase in DMFT at 2 years compared with baseline 2 years	MD -0.72 [-1.23, -0.21] -0.72 [-1.23, -0.21] DMFT (mean difference, scale 0 to 32)	1 study · 63 participants	Very low Downgraded: risk of bias, imprecision, indirectness

Slow-release fluoride devices vs Alternative fluoride therapy (topical fluoride: toothpaste, mouthrinse, gel, or varnish)

Population: Children or adults

CD005101.PUB3 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR	We found no studies comparing slow-release fluoride device versus alternative fluoride therapy	0 studies	No studies

Slow-release fluoride device (fluoride glass beads) vs Placebo (glass beads without fluoride)

Population: Children with high risk of dental decay

CD005101.PUB2 · 6 questions

Outcome	Effect	Evidence	Status / GRADE
Increase in DMFT (caries increment) at 2 years compared with baseline 2 years	MD -0.72 [-1.23, -0.21]	1 study · 63 participants	Ungraded
Harms of slow-release fluoride devices	Patient harm was not measured or discussed within the trial report	0 studies	No studies
Mean salivary fluoride level 1 and 2 years	Mean salivary fluoride was significantly higher in those fitted with the fluoride-releasing beads than placebo (1 year: test 0.15 mg/L, control 0.05 mg/L; 2 years: test 0.11 mg/L, control 0.03 mg/L)	1 study · 63 participants	Ungraded
Participant satisfaction	No data presented on this topic	0 studies	No studies
Increase in DMFS (caries increment) at 2 years compared with baseline 2 years	MD -1.52 [-2.68, -0.36]	1 study · 63 participants	Ungraded
Progression of caries lesion through enamel or into dentine	No data presented on this topic	0 studies	No studies

Slow-release fluoride devices vs Alternative fluoride therapy (topical fluoride: toothpaste, mouthrinse, gel, or varnish)

Population: Children or adults

CD005101.PUB2 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR	Only one trial (device vs placebo) met inclusion; no study compared the device against an alternative fluoride therapy.	0 studies	No studies

Slow-release fluoride devices vs Placebo or no intervention

Population: Children or adults

CD005101 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR	Protocol (2005); planned comparison, no studies yet.	0 studies	No studies

Slow-release fluoride devices vs Alternative fluoride therapy (topical fluoride: toothpaste, mouthrinse, gel, or varnish)

Population: Children or adults

CD005101 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR	Protocol (2005); planned comparison, no studies yet.	0 studies	No studies