ADA topical fluoride recommendations gain visibility
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Posted March 29, 2007 |
By Jennifer Garvin The ADA Council on Scientific Affairs clinical recommendations for professionally applied topical fluoride—the Association's first guidelines based on an evidence-based approach—are gaining respect throughout the profession.
The guidelines were posted on the National Guideline Clearinghouse's Web site, a comprehensive database of evidence-based clinical practice guidelines. In addition, the guidelines are included in the March issue of the Journal of the American Dental Education Association. The NGC is an initiative of the Agency for Healthcare Research.
"What is great about having these guidelines up on the NGC Web site is that this information will now be available to everyone interested in the value of topical fluoride applications, as noted in the scientific literature," said Dr. Daniel Meyer, associate executive director, ADA Division of Science. "All dentists and health care providers will be able to see the value of summarizing peer-reviewed data according to the evidence-based systematic review process."
The recommendations are the result of the ADA's October 2005 topical fluoride workshop that gathered an expert panel to evaluate all of the relevant and existing scientific evidence for professionally applied topical fluoride applications. They represent a new approach to guidelines for the ADA.
The evidence-based dentistry process involved analyzing and weighing the scientific data to support each specific recommendation. The panel relied on systematic reviews and randomized controlled trials and used its expertise when studies weren't available. The recommendations were designed to assist dentists in making informed decisions about patient treatments.
The group reviewed all methods of professionally applied topical fluoride including gel, foam and varnish and determined that topical fluoride should be used as a caries-preventive method for at-risk patients of all ages. The recommendations state that patients should be evaluated according to their caries risk status (low-caries risk, moderate-caries risk and high-caries risk) and treatment recommendations are stratified by age groups: under the age of 6, between the ages of 6 and 18, or over 18.
"The critical analysis of published scientific data supports the benefits of topical fluoride applications," Dr. Meyer said. "It is readily apparent from these guidelines that topical fluoride is not just for children but for all age groups, especially for those adolescents and adults at risk of developing caries. There is considerable data on caries reduction for professionally applied topical gel treatments of 4 minutes or longer. That is important to know."
The CSA will continue to develop future recommendations through an evidence-based approach so that the ADA can continue to provide dentists with the synthesis of the best available evidence.
The recommendations previously appeared in the August 2006 issue of The Journal of the American Dental Association  and are available online at www.ada.org/goto/ebd.To visit the NGC Web site's summary and link to the guidelines, visit www.guideline.gov/summary/summary.aspx?view_id=1&doc_id=10199 .
For more information, call the ADA toll-free number at Ext. 2878.
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