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Oral Health and Preventive Dentistry



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Oral Health Prev Dent 16 (2018), No. 4     7. Sep. 2018
Oral Health Prev Dent 16 (2018), No. 4  (07.09.2018)

Page 307-314, doi:10.3290/j.ohpd.a40937, PubMed:30175328

Caries Preventive Effects of High-fluoride vs Standard-fluoride Toothpastes - A Systematic Review and Meta-analysis
Singh, Abhinav / Purohit, Bharathi M.
Purpose: To determine the efficacy of high-fluoride toothpastes (≥ 2500 ppm) as compared to standard fluoride toothpastes (≤ 1500 ppm) in preventing dental caries.
Materials and Methods: Randomised controlled trials (RCTs) and cluster-randomised trials comparing high-fluoride dentifrices (≥ 2500 ppm) with lower-concentration fluoride dentifrices (≤ 1500 ppm) with a follow-up period of at least 6 months were included. A random effects model was used to assess the mean differences in caries increment between the two types of dentifrices used. A fixed effects model was used to determine the preventive effect of high-concentration fluoride toothpastes compared with low-fluoride toothpastes. Subgroup and sensitivity analyses were conducted when results indicated heterogeneity. Statistical significance was set at p < 0.05.
Results: Eight studies met the inclusion criteria. High-fluoride toothpaste use was statistically significantly associated with lower caries increment scores (pooled mean difference: -0.52 [95% CI, -0.67, -0.37], p = 0.00001). Subgroup analysis for the included studies reflected a significant reduction in I2 values from 99% to 18%. High-fluoride toothpastes were also associated with a greater preventive effect compared with low-fluoride toothpastes (pooled odds: 52.76 [95% CI, 19.74, 141.04], p = 0.95).
Conclusion: This meta-analysis suggests that high-fluoride toothpastes are superior to low-fluoride toothpastes in reducing caries. The results of this work when used judiciously should encourage the use of high-fluoride toothpaste, specifically among the vulnerable populations, to maximise preventive benefits.

Keywords: dental caries, fluoride dentifrices, high-fluoride toothpaste, systematic review