The December 2011 issue of the Journal of Public Health Dentistry offers a systematic review of studies of fluoride’s preventive effect in high risk adults. 1 (Prevora’s therapeutic indication defines high risk with two examples: having 3 or more cavities at the start of the treatment plan or suffering from dry mouth).
Here are the findings of the systematic review:
- There are 17 studies which had a randomized, controlled design and involved high risk adult participants.
- 4 were conducted since 2000, 6 in the 1990s, 5 in the 1980s, and 2 before 1980.
- 5 studies tested sodium fluoride mouth rinse, 6 tested sodium fluoride paste or gel, 2 evaluated fluoride varnish, 1 tested amine/potassium fluoride mouth rinse, and 3 tested stannous fluorides. The products were evaluated with varying dosages and regimens over periods ranging from 6 months to 3 years.
- 8 had a placebo control; others used a negative control or a positive control
- None recruited a generalizable adult population – that is one which the dental practice deals with on a daily basis.
- There was a wide range of endpoints ranging from the cavitated lesion to remineralization (the non-cavitated lesion).
The two most recent controlled fluoride studies give some measure as to how effective regular administration of 0.2% NaF rinse, 1.1% NaF paste and 5% NaF varnish are in preventing caries in institutionalized elderly. Refer to Chart 1 which also shows data from Prevora’s placebo controlled clinical trials of community-dwelling adults.
Prevora is unique in evaluating efficacy in a placebo-controlled group of community-dwelling adults. Its preventive effect is also significantly above that of fluoride.
Ross Perry
Sources: Wyatt CCL, MacEntee MI. 2004. Caries management for institutionalized elders using fluoride and chlorhexidine mouth rinses. Comm Dent Oral Epidemiol., 32: 322-8; Ekstrand K, Martignon S, Holm-Pedersen P. 2008. Development and evaluation of two root caries controlling programs for home-based frail people older than 75. Gerodontology, 25: 65-75; CHX Technologies, Clinical Studies #001 and #006, 2010.
1. Gibson G et al. 2011. Supplemental fluoride use for moderate and high caries risk adults: a systematic review. J Public Health Dent, 71: 174-184.