Caries prevention by professional fluoride gel application on enamel and dentinal lesions in low-caries children

In a double-blind randomized controlled clinical trial, the caries-reducing effect of semi-annually applied fluoride gel in a low-caries child population initially aged 4.5-6.5 years (n = 773) has been investigated. Secondary analyses of the data were performed to study the caries reduction including non-cavitated lesions. The treatment effect of fluoride gel was calculated as preventive fraction (PF). When enamel lesions were included in DFS count (D(2) grade), the PF was 22% as compared to 26% counting dentinal lesions. The PFs showed that the mean effect of professionally applied fluoride gel was highest (71%) for D(3)S in the permanent dentition and lowest for d(3)s in the primary dentition (5%). The PFs for approximal and buccal and lingual surfaces of the permanent dentition significantly decreased from 80 to 25% and from 60 to 37% when enamel lesions (D(2)S) were included. With the exception of the buccal and lingual surfaces, in the primary dentition the PFs varied slightly when enamel lesions were included. Inclusion of non-cavitated lesions in the treatment effect statistics did not change the former conclusion that the treatment effect of fluoride gel application on dental caries reduction in a low-caries child population was considered not clinically relevant.