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ADA panel issues recommendations on topical fluoride and caries prevention

November 15, 2013

By Kelly Soderlund, ADA News staff

Julie Frantsve-Hawley, Ph.D., senior director for the ADA Center for Evidence-based Dentistry, polls the audience during the ADA Annual Session course Evidence-Based Caries Prevention Strategies in New Orleans Nov. 2.
Applying prescription topical fluoride may benefit patients with a higher risk for developing caries, according to new clinical recommendations.

The ADA Council on Scientific Affairs convened a multi-disciplinary expert panel to develop the recommendations. Their conclusion: topical fluoride, used in conjunction with drinking optimally fluoridated water and using toothpaste with fluoride, is helpful in preventing tooth decay in patients at risk.

“Specifically, 2.26 percent fluoride varnish or 1.23 percent fluoride (APF) gel are recommended for in-office treatments, and 0.5 percent fluoride gel or paste or 0.09 percent are recommended for use at home,” said Julie Frantsve-Hawley, Ph.D., senior director for the ADA Center for Evidence-based Dentistry.

Dr. Frantsve-Hawley, along with Dr. Domenick Zero, taught a continuing education course, Evidence-Based Caries Prevention Strategies, at Annual Session in New Orleans Nov. 2 that discussed the latest recommendations and corresponding research article in the November issue of The Journal of the American Dental Association titled “topical Fluoride for Caries Prevention: Executive Summary of the Updated Clinical Recommendations and Supporting Systematic Review.”

The panel recommends four-minute applications because all of the studies were conducted with this length of time.

“We know that four minutes works, but we do not have any clinical studies done on people to indicate if one minute is effective,” Dr. Frantsve-Hawley said. “For children under 6 years old, 2.26 percent varnish is the best option. It provides the best protection and minimizes the risk of enamel fluorosis.”

The recommendations also specify that APF foam not be used in children younger than 6 years old because they could potentially swallow it. Foam is also not recommended for children older than 6 and adults because of lack of evidence for the benefit.

The full report of the clinical recommendations, a chairside guide dentists can use as a resource when talking to patients and a podcast summary of the recommendations are available on the EBD website at EBD ADA.