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| Title |
Topical Fluorides Are More Effective Than Community Water Fluoridation In Preventing caries |
| Clinical Question |
Is topical fluoride more effective in preventing caries than water fluoridation? |
| Clinical Bottom Line |
Topical fluoride is more effective in reducing and preventing caries than water fluoridation. Fluoride varnish is the most effective. Water fluoridation is good for poorer populations who do not get regular dental care. (See Comments on the CAT below) |
| 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) 17333303 | Pizzo/2007 | Not applicable | Narrative Review | | Key results | Water fluoridation is effective in populations with poor oral hygiene and limited access to dental care. It is more effective to use topical fluoride in industrialized and developing countries, and fluoride containing products such as toothpaste need to be expanded. Fluoride toothpaste and mouth rinse reduce caries by 24-26% while water fluoridation only reduces caries by 15%. caries reduced 26-28% for foams and gels and 46% with fluoride varnish. | | #2) 14583954 | Marinho/2003 | Children from 5-16 | Systematic Review with Meta-Analysis | | Key results | Children aged 5 to 16 years who applied fluoride in the form of toothpaste, mouth rinses, gels or varnishes had fewer decayed, missing and filled teeth regardless of whether their drinking water was fluoridated. The prevented fraction estimate was 14% higher (P=.25) in fluoride varnish trials compared to others and 10% lower (P=.003) in trials of unsupervised home use compared to self supervised and operator applied. | |
| Evidence Search |
("Fluoridation"[Mesh] OR "Fluorides, Topical"[Mesh]) AND "Dental Caries"[Mesh] AND Meta-Analysis[ptyp] ...view in PubMed |
Comments on
The Evidence |
The articles used were a critical review and a meta-analysis of randomized controlled trials. The individual studies had to meet specific criteria for validity. Articles from 2001 to 2006 were included in the first review, and 133 trials were included in the second review. It is important to note that none of the articles directly compared fluoride varnish and water fluoridation. |
| Applicability |
It is important to use in office topical fluorides such as varnishes and gels and it is important to recommend fluoridated toothpaste and mouth rinse to your patients. Water fluoridation is applicable to poorer populations who do not get routine dental care. |
| Specialty/Discipline |
(Public Health) (General Dentistry) (Pediatric Dentistry) (Restorative Dentistry) (Dental Hygiene) |
| Keywords |
caries prevention, fluoride, topical, water fluoridation
|
| ID# |
763 |
| Date of submission: |
04/12/2011 Revised: 01/05/2012 |
| E-mail |
cadenhead@livemail.uthscsa.edu |
| Author |
Amy Cadenhead |
| Co-author(s) |
|
| Co-author(s) e-mail |
|
| Faculty mentor/Co-author |
Bennett T. Amaechi, BDS, MSc, PhD |
| Faculty mentor/Co-author e-mail |
Amaechi@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 |
by Roger Flippen, Scott Fischbuch, Atish Patel (San Antonio, TX) on 01/06/2014
The general information and content remains the same as of today. As far as "effectiveness" the author should have stated whether this is in regards to effectiveness of fluoride reaching the teeth or effectiveness of fluoride reaching the most amount of people. Topical fluoride maximizes the amount of fluoride that reaches the tooth however water fluoridation reaches a large population. Creating a more specific clinical question would help clarify the "effectiveness". | |
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