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An Update on Demineralization/ Remineralization

Course Number: 73

The Next Relevant Cochrane Review: Fluoride Gels

This review was done to evaluate the effects of fluoride gels for caries prevention in children and adolescents.56 Twenty-eight studies were analyzed which included over 9,000 children. Key results from this review “confirmed that fluoride gel can reduce tooth decay in children and adolescents. We combined the results of 25 trials and found that on average there is a 28% reduction in decayed, missing and filled tooth surfaces (21% reduction in trials that used a placebo gel in the control group and 38% reduction in trials where the control group received no treatment) in permanent teeth. From the three trials looking at the effect of fluoride gel on first or baby teeth, the evidence suggests that using fluoride gel results in a 20% reduction in decayed, missing and filled tooth surfaces. We found little information about unwanted or harmful effects or how well children and young people were able to cope with the application of the gel.” The authors concluded: "The application of fluoride gel results in a large reduction in tooth decay in both permanent and baby teeth. We found little information about potential unwanted or harmful effects from accidental swallowing of the gel during treatment. As children often swallow gel during application, more research is needed on these effects." Clearly, fluoride gels have a caries preventive effect. They are office applied and should be selected based on individual patient situations and caries risk assessments when the decision is made to use them in practice.