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Practice Guideline
. 2013 Nov;144(11):1279-91.
doi: 10.14219/jada.archive.2013.0057.

Topical fluoride for caries prevention: executive summary of the updated clinical recommendations and supporting systematic review

Robert J Weyant  1 , Sharon L Tracy, Theresa Tracy Anselmo, Eugenio D Beltrán-Aguilar, Kevin J Donly, William A Frese, Philippe P Hujoel, Timothy Iafolla, William Kohn, Jayanth Kumar, Steven M Levy, Norman Tinanoff, J Timothy Wright, Domenick Zero, Krishna Aravamudhan, Julie Frantsve-Hawley, Daniel M Meyer; American Dental Association Council on Scientific Affairs Expert Panel on Topical Fluoride Caries Preventive Agents
Affiliations
Practice Guideline

Topical fluoride for caries prevention: executive summary of the updated clinical recommendations and supporting systematic review

Robert J Weyant et al. J Am Dent Assoc. 2013 Nov.

Erratum in

  • J Am Dent Assoc. 2013 Dec;144(12):1335. Dosage error in article text

Abstract

Background: A panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs presents evidence-based clinical recommendations regarding professionally applied and prescription-strength, home-use topical fluoride agents for caries prevention. These recommendations are an update of the 2006 ADA recommendations regarding professionally applied topical fluoride and were developed by using a new process that includes conducting a systematic review of primary studies.

Types of studies reviewed: The authors conducted a search of MEDLINE and the Cochrane Library for clinical trials of professionally applied and prescription-strength topical fluoride agents--including mouthrinses, varnishes, gels, foams and pastes--with caries increment outcomes published in English through October 2012.

Results: The panel included 71 trials from 82 articles in its review and assessed the efficacy of various topical fluoride caries-preventive agents. The panel makes recommendations for further research.

Practical implications: The panel recommends the following for people at risk of developing dental caries: 2.26 percent fluoride varnish or 1.23 percent fluoride (acidulated phosphate fluoride) gel, or a prescription-strength, home-use 0.05 percent fluoride gel or paste or 0.09 percent fluoride mouthrinse for patients 6 years or older. Only 2.26 percent fluoride varnish is recommended for children younger than 6 years. The strengths of the recommendations for the recommended products varied from "in favor" to "expert opinion for." As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences.

Keywords: Caries prevention; caries; evidence-based dentistry; fluoride; practice guidelines; preventive dentistry.

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References

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