Topical Fluoride Effectiveness in High Caries Risk Adults

Area of Science:

• Dental Public Health
• Cariology
• Preventive Dentistry

Background:

• High caries risk adults require effective preventive strategies to reduce restorative treatment and extractions.
• Topical fluoride applications are a cornerstone of caries prevention, but optimal types, combinations, and intensities require further elucidation.

Purpose of the Study:

• To determine the effectiveness of different types, combinations, and intensities of topical fluorides in preventing new caries-related restorations and extractions.
• To analyze longitudinal data from high caries risk adults within the US Department of Veterans Affairs healthcare system.

Main Methods:

• Retrospective analysis of longitudinal data from electronic dental, medical, and pharmacy records (October 1, 2008–June 30, 2018).
• Inclusion criteria: eligible for comprehensive care, high caries risk (≥2 restorations/365 days), and 3 years of follow-up.
• Multivariable logistic regression models controlled for demographic, clinical, and treatment variables to estimate odds of caries-related treatment.

Main Results:

• Veterans receiving fluoride varnish or gel/rinse interventions showed approximately 29% decreased odds of caries-related treatment compared to no fluoride (AORs 0.72 and 0.71, respectively).
• Combined varnish and gel/rinse interventions did not demonstrate statistically superior outcomes compared to individual interventions.
• A dose-response effect was observed, with two or more applications of varnish or gel/rinse being more effective than a single application.

Conclusions:

• Topical fluoride varnishes and gel/rinses are effective in reducing caries-related treatment in high caries risk adults.
• Multiple applications of topical fluorides demonstrate a dose-response relationship, enhancing preventive efficacy.
• These findings support the use of regular topical fluoride applications as a key strategy in managing caries risk.