July/Aug 2014
Volume 35, Issue 7

Focus on fluorides: update on the use of fluoride for the prevention of dental caries

Carey CM. J Evid Based Dent Pract. 2014;14 Suppl:95-102.

ABSTRACT: The US Centers for Disease Control and Prevention (CDC) and the American Dental Association (ADA) have proposed changes in their long-standing recommendations for the amount of fluoride in community drinking water in response to concerns about an increasing incidence of dental fluorosis in children. Current research is focused on the development of strategies to improve fluoride efficacy. This update informs readers about new research and policies related to the use of fluoride for the prevention of dental caries. Reviews of current research and recent evidence-based systematic reviews on the topics of fluoride are presented. Topics discussed include: updates on community water fluoridation research and policies; available fluoride in dentifrices; fluoride varnish compositions, use, and recommendations; and other fluoride-containing dental products. Proposed policy changes for the use of fluoride for the prevention of dental caries are discussed. CONCLUSIONS: The dental profession is adjusting its recommendations for fluoride use based on current observations of the halo effect and subsequent outcomes. The research community is focused on improving the efficacy of fluoride therapies, thus reducing dental caries and lowering the amount of fluoride required for efficacy.

Prevention of dental caries in children from birth through age 5 years: US Preventive Services Task Force
recommendation statement

Moyer VA; US Preventive Services Task Force. Pediatrics. 2014;133(6):1102-1111.

ABSTRACT: This is an update of the 2004 US Preventive Services Task Force (USPSTF) recommendation on prevention of dental caries in preschool-aged children. The USPSTF reviewed the evidence on prevention of dental caries by primary care clinicians in children 5 years and younger, focusing on screening for caries, assessment of risk for future caries, and the effectiveness of various interventions that have possible benefits in preventing caries. This recommendation applies to children age 5 years and younger. RECOMMENDATION: The USPSTF recommends that primary care clinicians prescribe oral fluoride supplementation starting at age 6 months for children whose water supply is deficient in fluoride. The USPSTF recommends that primary care clinicians apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening examinations for dental caries performed by the primary care clinicians from birth to age 5 years. 

Clinical safety, quality and effect of resin infiltration for proximal caries

Altarabulsi MB, Alkilzy M, Petrou MA, Splieth C. Eur J Paediatr Dent. 2014;15(1):39-44.

ABSTRACT: Resin infiltration of proximal lesions is a new approach to stop caries progression. This clinical trial assessed its safety and quality, as well as the therapeutic effect. In 47 children, adolescents, and young adults, 10 dentists applied the infiltration material ICON (DMG, Germany) on initial proximal lesions according to the manufacturer’s instruction. One lesion with radiographic extension into enamel or the outer third of dentin per participant was allocated for the treatment. The clinical safety and quality of resin infiltration were assessed 1 week, 6 months, and 12 months after the treatment, and the therapeutic effect was analyzed by pair-wise radiographs. RESULTS: The clinical safety and quality of the infiltration were assessed after 12 months. The test surfaces showed no relevant changes in clinical status, plaque accumulation, or gingival status. A high quality of infiltration was found for the marginal adaptation. In contrast to the improvement of color at the 1-week recall, the infiltrated surfaces showed a statistically significant increase in discoloration within the following year. Out of the 43 lesions that could be assessed radiographically, only two showed progression to a different score (4.7%). CONCLUSION: Resin infiltration can be considered a safe, effective treatment to reduce progression of initial proximal caries.

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