ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Periodic Application of 5% Sodium Fluoride Varnish is Effective in Reducing Root Caries
Clinical Question Will 5% sodium fluoride varnish applied at 3- to 6-month intervals reduce root dental caries in adults with root exposure?
Clinical Bottom Line Applying 5% sodium fluoride varnish every 3 to 6 months on adults with root exposure results in prevention of and reduction in the development of root caries.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20671206Tan/2010306 generally healthy elders having at least 5 teeth with exposed sound root surfacesRandomized Controlled Trial
Key resultsThis study was initiated to determine the best preventative measure to reduce root caries. Preventative measures included chlorhexidine, sodium fluoride, and silver diamine fluoride (SDF) groups, compared to oral hygiene alone. This study was based on elderly patients who had at least 5 teeth with exposed roots. Two-thirds of the elderly group were monitored for 3 years. Significantly lower relative risks for developing new root caries were determined for the elderly patients who used chlorhexidine, sodium fluoride, or SDF, vs OHI alone. “The mean numbers of new root caries surfaces in the four groups were 2.5, 1.1, 0.9 and 0.7 respectively (ANOVA, p < 0.001)."
#2) 23600985Gluzman/2013Studies of Older Adults who showed effectiveness of preventative agentsSystematic review of randomized trials
Key resultsIn this systematic review, a total of 31 eligible studies were included. In this case, "eligible studies" meant those that assess the effectiveness of preventative agents in the prevention or control of root caries. Fluoride varnish resulted in a reduction of primary root caries of 56%-64% (vs no active agent), and arrested 54%-92% of secondary root caries.
Evidence Search Randomized Controlled Trial "root caries" and "sodium fluoride varnish" “root caries” and “Sodium Fluoride Varnish”
Comments on
The Evidence
Validity: Both studies were able to specify the significant effect sodium fluoride varnish had on root caries and root exposure. Tan was able to determine what preventative measure was most effective for the prevention of root caries. The Tan study was a randomized controlled trial that followed 203 patients for over 3 years and drew conclusions on the effectiveness of preventative measures. The Gluzman article was a systematic review of the literature that used a single assessment-of-outcome format to allow direct comparison of effectiveness across agents. Gluzman provided a summary of 31 studies that all proved to be effective in reducing root caries by the use of preventative measures such as sodium fluoride varnish. With the use of preventative measures along with good oral hygiene, there is a reduction in the amount of root caries. Perspective: Although research has proven fluoride in general is beneficial in the prevention of caries, there needs to be more studies that provide the amounts and how often one should or can apply fluoride supplements in order to prevent harmful effects to each individual’s dentition.
Applicability The use of fluoride varnish in itself is beneficial for all groups, except for those aged 6 and under, in reducing caries. For older adults or the elderly who have had time to develop changes in their teeth like erosion, attrition, abfraction and recession, fluoride varnish is still considered to be useful as a preventive measure. In this case, when older adults have exposed roots, it is of extreme importance to maintain and avoid demineralization of such areas. Performing daily oral hygiene care and the application of 5% sodium fluoride varnish every 3 to 6 months is beneficial in the reduction and the prevention of root caries.
Specialty/Discipline (Public Health) (General Dentistry)
Keywords Root Caries, Fluoride, Sodium Fluoride Varnish, Prevention
ID# 2767
Date of submission: 09/16/2014spacer
E-mail Garciaj44@livemail.uthscsa.edu
Author Janet Garcia
Co-author(s) Monica D. Martinez, Ayesha J. Allawala
Co-author(s) e-mail MartinezM2@livemail.uthscsa.edu, Allawala@livemail.uthscsa.edu
Faculty mentor/Co-author Carol A. Nguyen, MPH, MS
Faculty mentor/Co-author e-mail NGUYENC@uthscsa.edu
Basic Science Rationale
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