Twetman Svante, Keller Mette K
Department of Odontology, School of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Caries Res. 2016;50 Suppl 1:38-44. doi: 10.1159/000439180. Epub 2016 Apr 22.
The aim of this conference paper was to systematically review the quality of evidence and summarize the findings of clinical trials published after 2002 using fluoride mouth rinses, fluoride gels or foams for the prevention of dental caries.
Relevant papers were selected after an electronic search for literature published in English between 2003 and 2014. The included papers were assessed for their risk of bias and the results were narratively synthesized due to study heterogeneity. The quality of evidence was expressed according to GRADE.
A total of 19 papers were included (6 on fluoride mouth rinse, 10 on fluoride gel and 3 on fluoride foam); 6 had a low risk of bias while 2 had a moderate risk. All fluoride measures appeared to be beneficial in preventing crown caries and reversing root caries, but the quality of evidence was graded as low for fluoride mouth rinse, moderate for fluoride gel and very low for acidulated fluoride foam. No conclusions could be drawn on the cost-effectiveness.
This review, covering the recent decade, has further substantiated the evidence for a caries-preventive effect of fluoride mouth rinse, fluoride gel and foam, previously established in systematic reviews. The lack of clinical trials free from bias is, however, still a concern, especially for fluoride mouth rinses and fluoride foam. There is also a scientific knowledge gap on the benefit and optimal use of these fluoride supplements in combination with daily tooth brushing with fluoride toothpaste.
本会议论文的目的是系统评价证据质量，并总结2002年后发表的使用含氟漱口水、含氟凝胶或泡沫预防龋齿的临床试验结果。
在对2003年至2014年期间以英文发表的文献进行电子检索后，筛选出相关论文。对纳入的论文进行偏倚风险评估，由于研究的异质性，对结果进行叙述性综合分析。证据质量根据GRADE标准表示。
共纳入19篇论文（6篇关于含氟漱口水，10篇关于含氟凝胶，3篇关于含氟泡沫）；6篇偏倚风险低，2篇偏倚风险中等。所有含氟措施似乎都有利于预防冠龋和逆转根龋，但含氟漱口水的证据质量为低等级，含氟凝胶为中等等级，酸化氟泡沫为极低等级。关于成本效益无法得出结论。
本综述涵盖近十年，进一步证实了含氟漱口水、含氟凝胶和泡沫预防龋齿作用的证据，此前在系统评价中已有定论。然而，缺乏无偏倚的临床试验仍然令人担忧，尤其是含氟漱口水和含氟泡沫。在这些氟补充剂与每日使用含氟牙膏刷牙联合使用的益处和最佳使用方法方面，也存在科学知识空白。
