Topical Fluoride to Prevent Root Caries: Systematic Review with Network Meta-analysis

Area of Science:

• Dentistry
• Cariology
• Preventive Dentistry

Background:

• Dental root caries is a significant oral health concern, particularly in aging populations.
• Effective preventive strategies are crucial for managing root caries progression.

Purpose of the Study:

• To systematically review and network meta-analyze clinical evidence on professionally applied and self-applied topical fluorides for preventing dental root caries.
• To identify the most effective fluoride agents and application methods.

Main Methods:

• Systematic review and network meta-analysis of controlled clinical trials.
• Searched major databases including MEDLINE, PubMed, Embase, Scopus, and Cochrane Library.
• Included 9 trials with 4,030 participants, assessing 5 professionally applied and 7 self-applied topical fluoride agents.

Main Results:

• Professionally applied 38% silver diamine fluoride (SDF), 5% sodium fluoride (NaF) varnish, and 1.2% acidulated phosphate fluoride reduced root caries increment by 0.59-0.85 mean decayed or filled root (DF-root) after 2 years.
• Self-applied fluoride mouth rinse and toothpaste reduced root caries increment by 0.29-1.90 mean DF-root after 1 year.
• Annual SDF application with oral health education and daily 0.2% NaF mouth rinse showed highest efficacy.

Conclusions:

• Annual 38% silver diamine fluoride (SDF) solution combined with oral health education is the most effective professionally applied method for preventing dental root caries.
• Daily use of 0.2% sodium fluoride (NaF) mouth rinse is the most effective self-applied method, followed by combined fluoride toothpaste and mouth rinse use.