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An Update on Demineralization/ Remineralization

Course Number: 73

Cochrane Review: Fluoride Toothpastes

The review included 96 studies published between 1955 and 2014 in this updated review.52 The authors concluded: “This Cochrane Review supports the benefits of using fluoride toothpaste in preventing caries when compared to non-fluoride toothpaste. Evidence for the effects of different fluoride concentrations is more limited, but a dose-response effect was observed for D(M)FS in children and adolescents. For many comparisons of different concentrations, the caries-preventive effects and our confidence in these effect estimates are uncertain and could be challenged by further research. The choice of fluoride toothpaste concentration for young children should be balanced against the risk of fluorosis.” This is perhaps one of the most rigorous evaluations of the dental literature completed, and it strongly supports the use and recommendation that patients use fluoridated dentifrices for caries prevention.

It should be noted that most dose response studies, in which higher doses of fluoride have been found to provide greater anticaries benefits, are generally done using the same fluoride agent. One interesting clinical study, however, found that an 1100ppm F toothpaste (formulated with stabilized SnF2), was similar in performance to a 2800ppm F NaF toothpaste;53 suggesting that different sources of fluoride may provide different levels of efficacy.