A comparison of the caries-preventive effects of fluoride mouthrinsing, fluoride tablets, and both procedures combined: final results after eight years

Abstract

This paper presents final results of an eight-year clinical trial designed to compare the caries-preventive benefits of two self-administered fluoride procedures when used separately and in combination with one another. Children in kindergarten and first grade residing in Springfield, Ohio, a nonfluoridated community, were assigned randomly within school to one of three groups that either (a) rinsed once a week in school with a 0.2 percent neutral NaF solution; (b) chewed, rinsed with, and then swallowed daily in school a neutral 2.2 mg NaF tablet; or (c) carried out both procedures. At baseline (1981), 1,640 participants were examined clinically using the DMF surface index. Findings for 640 children remaining after eight years show that subjects in the combination group experienced a mean caries increment of 2.40 DMFS, 15.2 percent lower than the mean score of 2.83 DMFS for children in the tablet group and 32.8 percent lower than the 3.57 DMFS for those in the rinse group. Only the difference in incremental caries scores between the combined fluoride procedure and the fluoride rinse was statistically significant (P less than .05). The pattern of these findings is similar to that found on the two interim examinations. Even though the combined regimen showed an additional caries-preventive benefit compared with the rinse, considerations of cost effectiveness and feasibility do not support changing an ongoing rinse program to one that employs both procedures. For new programs the best choice appears to be the tablet procedure alone.