Cochrane Review: Fluoride Toothpastes

The review included 79 studies that met the acceptance criteria involving more than 73,000 children in the studies.52 The authors concluded: "This review confirms the benefits of using fluoride toothpaste in preventing caries in children and adolescents when compared to placebo, but only significantly for fluoride concentrations of 1000 ppm and above. The relative caries preventive effects of fluoride toothpastes of different concentrations increase with higher fluoride concentration. The decision of what fluoride levels to use for children under 6 years should be balanced with 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.