Recent Cochrane Systemic Review validates that fluoride mouthrinses reduce caries

As dental professionals, we see the benefits of fluoride in practice. We have also seen research supporting the evidence of the benefits of fluoride. However, it is still critically important that research is ongoing and constantly systemically-reviewed. It is also important that we are aware of the newest research and systemic reviews to ensure our recommendations to patients remain evidence-based.

The Cochrane Oral Health Group published its most recent review July 29, 2016, in which the objective was to determine the effectiveness and safety of fluoride mouthrinses in preventing dental caries in the child and adolescent population. The secondary objective of the review was to examine if fluoride rinses were influenced by initial level of caries severity, background exposure to fluoride in water or salt, and fluoride concentration and frequency of use.

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Cochrane included 37 trials involving 15,813 children and adolescents. All trials tested the supervised use of fluoride mouthrinses, mostly in school-based trials. Twenty-eight of the studies included were of children and adolescents at high caries risk.

In most of the studies reviewed, the children were given a sodium fluoride (NaF) solution of 230 parts per million daily or a higher concentration of 900 ppm fluoride weekly or fortnightly. The studies reviewed lasted from two to three years in length and took place in several different countries.

No significant association between estimates of decayed, missing and filled tooth surfaces were found regarding baseline caries severity, background exposure to fluorides, rinsing frequency or fluoride concentration. The review update did confirm that supervised, regular use of a fluoride mouthrinse can reduce tooth decay in both children and adolescents. The combined results of the 35 trials showed a 27 percent reduction in decayed, missing and filled tooth surfaces in permanent teeth compared to no rinse or a placebo rinse. Limited information was found concerning adverse effects or the tolerance of rinsing of the children in the reviewed trials. No trials that were looked at studied the effect of fluoride mouthrinses on primary dentition. As always, this means there is still room for more research.

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Again, dental professionals see the benefits of fluoride every day in practice, especially in public health. Systemic reviews, like this one, are important to provide our patients with evidence-based care, even if we think we know the benefit outright. Just as important as the review itself, is staying current on the most recent research and systemic reviews.