Professional fluoride varnish treatment for caries control: a systematic review of clinical trials.
The aim of this paper was systematically to evaluate the caries-preventive effect of professional fluoride varnish treatments. A search of the literature for articles published between 1966 and August 2003 was carried out in electronic databases, reference lists of articles, and selected textbooks in accordance with the strategy of the Swedish Council on Technology Assessment in Health Care. Out of 302 identified papers, 24 randomized and controlled clinical trials comparing fluoride varnish with placebo, no active treatment or other fluoride preventive regimens of at least 2 years' study duration were included. The trials that met the inclusion criteria were assessed independently and systematically by at least two reviewers and scored from A to C according to predetermined criteria for methodology and performance. The main outcome measure was the preventive fraction expressed as a percentage. The results displayed limited evidence (evidence level 3) for the caries preventive effect of topical applications of fluoride varnishes in permanent teeth. The average prevented fraction was 30% (0-69%) when compared with untreated controls. Inconclusive evidence (evidence level 4) was found for fluoride varnish treatment in the primary dentition and in adults. This systematic review reinforces the need for future dinical research of high quality, incorporating modern concepts of dinical performance and evaluation to assess dental caries control using professional fluoride varnish.
Petersson
Lars G
LG
Department of Community and Preventive Dentistry, Oral-Maxillo-facial Unit, Central Hosptial, Halmstad, Sweden. lars.g.petersson@lthalland.se
Twetman
Svante
S
Dahlgren
Helena
H
Norlund
Anders
A
Holm
Anna-Karin
AK
Nordenram
Gunilla
G
Lagerlöf
Folke
F
Söder
Birgitta
B
Källestål
Carina
C
Mejàre
Ingegerd
I
Axelsson
Susanna
S
Lingström
Peter
P
D000293:Adolescent; D000328:Adult; D002327:Cariostatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002986:Clinical Trials as Topic; D018849:Controlled Clinical Trials as Topic; D003731:Dental Caries / Q000517:prevention & control*; D005460:Fluorides, Topical / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007764:Lacquer; D016032:Randomized Controlled Trials as Topic; D014094:Tooth, Deciduous / Q000473:pathology; D016896:Treatment Outcome
D002327:Cariostatic Agents; D005460:Fluorides, Topical