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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) 23756315 | Jiang/2013 | 100 pts undergoing orthodontic treatment | Randomized Controlled Trial | | Key results | The 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) 17827963 | Stecksen-Blicks/2007 | 273 pts (12-15 yrs old) undergoing orthodontic treatment | Randomized Controlled Trial | | Key results | The 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) (Dental Hygiene) |
| Keywords |
Orthodontics, fluoride, caries, white spot lesions
|
| ID# |
2730 |
| Date of submission: |
05/17/2014 |
| 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?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
| None available | |
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