[Anticaries effectiveness of fluoride toothpaste: a meta-analysis].
OBJECTIVE
To carry out a meta-analysis on the effectiveness of fluoride toothpaste for reducing dental caries to calculate the effect size of different hypothesis.


METHODS
MEDLINE and LILACS databases were studied in the period from 1980 to 1998. To evaluate the quality of the studies, methodological rigor criteria proposed by Kay & Locker (1996) were applied after the criteria were submitted to an expert committee of CNPq (National Scientific Council of Brazil) senior researchers. Of 43 papers selected, 22 met the proposed criteria. The effect size of intervention was calculated from differences among the groups and the overall effect of five groups of hypothesis.


RESULTS
The high concentration of fluoride in the toothpaste is associated with a larger effect (overall effect = -0.17 CI 95% -0.22/-0.12). The largest caries reductions were observed when comparing fluoride toothpastes and no fluoride toothpastes (overall effect = -0.29 IC 95% -0.34/-0.24). The addiction of antimicrobial agents (overall effect = -0.03 IC 95% -0.07/+0.02), differences in abrasive systems (overall effect = -0.02 IC 95% -0.09/+0.04) and active components do not increase the effectiveness of fluoride toothpastes (overall effect = -0.04 IC 95% -0.10/+0.01).


CONCLUSIONS
The highest caries reductions were seen in studies where there was supervised tooth brushing. This review reinforced the importance of tooth brushing with fluoride toothpastes for controlling dental caries. However it showed the emphasis put on medical approaches for disease control rather than specific educational actions. The heterogeneity of the results shows the need to consider issues such as the scenario for implementing preventive methods in the evaluation process.
Chaves
Sônia Cristina Lima
SC
Departamento de Odontologia Social, Faculdade de Odontologia, Universidade Federal da Bahia, Salvador, BA, Brasil. socris@ufba.br
Vieira-da-Silva
Lígia Maria
LM
D002327:Cariostatic Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D016206:Databases, Bibliographic; D003731:Dental Caries / Q000517:prevention & control*; D003802:Dentifrices / Q000627:therapeutic use*; D005459:Fluorides / Q000627:therapeutic use*; D006801:Humans; D010710:Phosphates / Q000627:therapeutic use; D012969:Sodium Fluoride / Q000627:therapeutic use; D014099:Toothbrushing
D002327:Cariostatic Agents; D003802:Dentifrices; D010710:Phosphates; D012969:Sodium Fluoride; D005459:Fluorides