Clinical anticaries efficacy of NaF and SMFP dentifrices: overview and resolution of the scientific controversy.

Since the introduction of commercially marketed fluoride-containing dentifrices in the 1950s, the evolution of these products has seen a number of formulation changes, particularly with regard to the specific types of active fluoride agents they contain. Most currently marketed dentifrices contain one of two major fluoride compounds--sodium fluoride (NaF), or sodium monofluorophosphate (SMFP)--and much research effort has gone into continued investigations geared toward determining which, if either, of these two agents provides dentifrices with greater levels of anticaries efficacy. Historically, among clinical studies, most single-investigation attempts to resolve this issue have yielded equivocal results. During the past two years, however, renewed attempts on a larger scale have been made, including scientific symposia in Toronto, London, and Stockholm sponsored by major manufacturers of dentifrices. The conflicting conclusions derived from these undertakings have resulted in a scientific controversy as to which represents the most accurate resolution to the fluoride-comparison issue. The present paper considers processes for addressing this controversy, and identifies the key points of difference among those processes by which the three symposia arrived at their respective conclusions. An objective procedure for addressing the fluoride-comparison issue is offered, and applied to the clinical data which is currently available in the literature. The results of this analysis indicate that: 1) There is no statistically significant difference between the anticaries effectiveness of dentifrices containing fluoride as SMFP, and those containing fluoride as NaF; and 2) There is no clinically meaningful difference between the anticaries effectiveness of dentifrices containing fluoride as SMFP, and those containing fluoride as NaF.