Fluoride application for adults
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Fluoride Application for Adults: Efficacy and Methods
High-Fluoride Toothpaste for Root Caries
Effectiveness of High-Fluoride Toothpaste
High-fluoride toothpaste, containing 5000 ppm fluoride, has been shown to significantly improve the surface hardness of root caries lesions in adults when used twice daily. A multicenter randomized controlled trial demonstrated that adults using high-fluoride toothpaste had better outcomes in terms of surface hardness scores compared to those using regular fluoride toothpaste with 1350 ppm fluoride. This suggests that high-fluoride toothpaste is more effective in managing root caries in adults.
Systematic Reviews on Fluoride Use
General Effectiveness of Fluoride
A meta-analysis examining the effectiveness of fluoride in preventing dental caries in adults found that both self-applied and professionally applied fluoride, as well as water fluoridation, are effective in reducing caries. The analysis showed that fluoride annually prevented 0.29 carious coronal surfaces and 0.22 carious root surfaces among adults. This indicates that fluoride is beneficial for caries prevention across different age groups.
Supplemental Fluoride for High-Risk Adults
A systematic review focusing on moderate and high caries risk adults highlighted the effectiveness of various fluoride modalities. Low-strength sodium fluoride (NaF) rinses, 1.1% NaF pastes/gels, and fluoride varnishes were found to be moderately effective in reducing caries and remineralizing root lesions. The review emphasized that these fluoride treatments are particularly beneficial for older adults and those at higher risk of caries.
Silver Diamine Fluoride (SDF) Applications
SDF for Root Caries in Older Adults
Silver diamine fluoride (SDF) has been extensively studied for its effectiveness in preventing and arresting root caries in older adults. Randomized controlled trials have shown that SDF significantly outperforms placebo in preventing and arresting root caries, with prevented fractions ranging from 25% to 71% for prevention and up to 725% for caries arrest. This makes SDF a highly effective option for managing root caries in older populations.
Combined SDF and Atraumatic Restorative Treatment (ART)
A study protocol for a randomized controlled trial aims to assess the effectiveness of combining 38% SDF with atraumatic restorative treatment (ART) in managing cavitated carious lesions in adults. This combination is expected to provide both preventive and restorative benefits, particularly in rural settings with limited access to comprehensive dental care.
Sodium Fluoride Applications
Historical and Recent Findings
Early studies on the topical application of sodium fluoride (NaF) in adults showed mixed results. While some studies indicated no significant benefit, others reported reductions in caries experience comparable to those seen in children . More recent research has confirmed that NaF applications, particularly in the form of gels and varnishes, are effective in reducing caries in adults, especially those at higher risk.
Conclusion
Fluoride application, whether through high-fluoride toothpaste, supplemental fluoride treatments, or silver diamine fluoride, is effective in preventing and managing dental caries in adults. High-fluoride toothpaste significantly improves root caries surface hardness, while SDF is highly effective in preventing and arresting root caries in older adults. Supplemental fluoride treatments, including NaF rinses, gels, and varnishes, are beneficial for high-risk adults. These findings underscore the importance of fluoride in adult dental care, offering various effective options for caries prevention and management.
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