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An Update on Demineralization/Remineralization

Mark E. Jensen, MS, DDS, PhD; Robert V. Faller, BS

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The Next Relevant Cochrane Review: Fluoride Gels38

 

This review was done to evaluate the effects of fluoride gels for caries prevention in children and adolescents.  Twenty-five studies were analyzed which included 7,747 children.  The conclusions were as follows, "There is clear evidence of a caries-inhibiting effect of fluoride gel.  The best estimate of the magnitude of this effect, based on the 14 placebo-controlled trials, is a 21% reduction (95% CI, 14 to 28%) in D(M)FS.  This corresponds to an NNT (Number Needed to Treat) of 2 (95% CI, 1 to 3) to avoid 1 D(M)FS in a population with a caries increment of 2.2 D(M)FS/year, or an NNT of 24 (95% CI, 18 to 36) based on an increment of 0.2 D(M)FS/year.  There is little information concerning the deciduous dentition on adverse effects or on acceptability of treatment.  Future trials should include assessment of potential adverse effects."  Clearly, fluoride gels have a caries preventive effect but are office applied and should be selected based on individual patient situations and caries risk assessments when the decision is made to use them in practice.

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