ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Clinician-Administered Topical Fluoride Applications During Treatment with Fixed Orthodontic Appliances Prevent the Development of White Spot Lesions
Clinical Question In a patient undergoing fixed orthodontic treatment, do clinician-administered regular topical fluoride applications reduce the development of white spot lesions adjacent to orthodontic brackets?
Clinical Bottom Line Clinician-administered topical fluoride applied at regular 6-8 week intervals is effective at preventing white spot lesions in patients undergoing fixed orthodontic treatment.
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) 23756315Jiang/2013100 pts undergoing orthodontic treatmentRandomized Controlled Trial
Key resultsThe incidence of white spot lesions was approximately 13% in the fluoride foam group and 51% in the placebo group (P<.001). The relative risk reduction was approximately 24%, and the number needed to treat was calculated as 2.6.
#2) 17827963Stecksen-Blicks/2007273 pts (12-15 yrs old) undergoing orthodontic treatmentRandomized Controlled Trial
Key resultsThe incidence of white spot lesions during the treatment period was 7.4% in the fluoride varnish group compared with 25.3% in the placebo group (P <0.001). The absolute risk reduction was 18% and the number needed to treat was calculated to be 5.5 (95% CI: 3.7-10.9).
Evidence Search "Orthodontics"[Mesh] AND "Dental Caries"[Mesh] AND fluoride
Comments on
The Evidence
In the Stecksen-Blicks study, 273 patients were included in the double-blind randomized control trial. Application frequency was every 6 weeks, and outcomes were measured after orthodontic treatment. In this study, measurements were based on digital photographs by 2 independent examiners. No competing interests were found. In the Jiang study, the double-blind groups consisted of 48 pts in the treatment group (1.23% Acidulated Phosphate Fluoride foam) and 47 in the placebo group (foam without fluoride). Application frequency was every 8 weeks, and outcomes were measured after orthodontic treatment, which averaged 18 months. In this study, clinical examinations were based on direct visual inspection rather than static photographs. No competing interests were found.
Applicability The results are applicable to patients undergoing fixed orthodontic treatment.
Specialty/Discipline (General Dentistry) (Orthodontics) (Pediatric Dentistry) (Restorative Dentistry)
Keywords Orthodontics, fluoride, caries, white spot lesions
ID# 2730
Date of submission: 05/17/2014spacer
E-mail allahdina@livemail.uthscsa.edu
Author Karim Allahdina
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Cara Gonzales, PhD, DDS
Faculty mentor/Co-author e-mail gonzalesc5@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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