Evidence Synthesis on Fluoride Use in Traditional Communities and Indigenous Populations: A Systematic Review
Emily Souza Silva1, Helene Soares Moura1, Paulo Frazão1
1Department of Policy, Management and Health, Public Health School, University of Sao Paulo, São Paulo, Brazil.
Objectives:
To synthesize the evidence on the use of fluoride in the prevention of dental caries among Indigenous populations and traditional communities through a systematic literature review.
Methods:
An electronic search was conducted in the PubMed, Embase, Web of Science, and Latin American and Caribbean Health Sciences Literature (LILACS) databases. The inclusion criteria were experimental studies comparing the effects of fluoride-based interventions on dental caries prevention with no intervention or with other forms of treatment. Publications up to June 30, 2026 were included. Publications in Portuguese, English, and Spanish were included. No restrictions were applied regarding publication date, country, or any other filters. The methodological quality and risk of bias of the included studies were assessed using tools by the Joanna Briggs Institute (JBI).
Results:
No reports involving traditional communities were identified. Eleven articles met the inclusion criteria; all involved Indigenous populations and the use of fluoride varnish (FV). One report performed a comparison between Indigenous and non-Indigenous populations. Interventions included FV with fissure sealant and povidone-iodine, counselling of parents and family groups, community health promotion, provision of dental care to mothers during pregnancy, and implementation of motivational interviewing. Overall, the study findings suggest that the preventive effect of FV may be greater when applied on the sound surface as soon as the tooth emerges after 6 months of age. Two studies showed a low risk of bias.
Conclusions:
The semiannual application of FV associated with educational guidance prevents dental caries and the certainty of the evidence was moderate to high. Other preventive strategies such as fluoride sealants and povidone-iodine contributed to the effectiveness of caries prevention in Indigenous children. Studies on fluoride use among traditional communities and adolescents, adults, and older adults from Indigenous populations are needed.
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