Efficacy of APF treatments without prior toothcleaning targeted to high-risk children

Abstract

A clinical field trial was conducted, over a 2-yr period, to evaluate the efficacy of bi-annual APF gel topical applications without previous prophylaxis in reducing dental caries among high-risk children living in non-fluoridated communities. 488 children 6 yr old, presenting at least three cavities on proximal surfaces of their primary teeth, were randomly assigned to two groups. The experimental group received bi-annual topical APF gel applications and the control group received a placebo. All treatments were given at school without any prior toothcleaning. The APF gel provided a 34.3% reduction in caries incidence (P-value = 0.03) among the children with 3-14 cavities on their primary teeth at the beginning of the study. However, the treatment did not show any efficacy in reducing caries incidence among the higher-risk children having initially more than 14 cavities. These findings suggest that the efficacy of APF gel applications without previous prophylaxis varies according to the individual risk of the subjects and that more comprehensive programs should be targeted to very high-risk children.