Prevention of Dental Caries: A Review of Effective Treatments
Prevention of Dental Caries: A Review of Effective Treatments
Prevention of Dental Caries: A Review of Effective Treatments
doi:10.4317/jced.52890
http://dx.doi.org/10.4317/jced.52890
MD, Indipendent Clinical Dentistry, Forno Canavese and Bruino, Turin, Italy
Dental University of Turin, Turin, Italy
3
MD, Nuclear Medicine Unit Department of Biomedical Sciences and of Mophologic and Functional Images, University of Messina, Italy
4
MD, Ph, Positron Emission Tomography Centre IRMET S.p.A., Affidea, Turin, Italy, PET Pediatric AIMN InterGroup, Italy,
Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy
1
2
Correspondence:
Positron Emission Tomography Centre IRMET S.p.A.
Euromedic Int
V. O. Vigliani 89/A, 10138 Turin, Italy
a.cistaro@irmet.com
Received: 24/12/2015
Accepted: 12/03/2016
Abstract
Background: The objective of this study is to review medical and non medical treatments for prevention of caries.
Material and Methods: A comprehensive literature search of the most relevant and updated published studies from
01/01/2002 through December 2015 in PubMed/MEDLINE, Embase and Scopus databases regarding the efficacy
of strategies and treatments aiming to prevent the development of caries was performed selecting papers on the
basis of the Evidence-based Medicine Criteria.
Results: We identified thirty systematic reviews on prevention of caries. Analyzing the data the retrieved literature,
performance of prevention treatments seems to be high.
Conclusions: Prevention treatments may have a relevant impact on the avoiding the development of caries planning.
Key words: Dental caries, prevention, fluoride.
Introduction
The objective of this study is to identify proofs of efficacy of medical and non medical treatments on prevention
of caries providing a review of relevant literature published in the last fourteen years.
Dental caries is a pathologic process depending on several etiologic factors, which cause the destruction of the
dental tissues and produces local and general complications (1). It is one of the most widespread diseases in the
civilized populations with a prevalence of 40% at the
age of seven years and 85% in seventeen year-old boys
(2). However there is some evidence that that incidence in children aged five-seventeen years has decreased
about 36% in the last decades and approximately 50% of
children can be considered caries-free in the permanent
dentition (3-5).
A comprehensive computer literature search of the PubMed/MEDLINE, Embase, Scopus and Cochrane databases was conducted using a search algorithm based on
the term dental caries used as keyword and MeSH
term (oriented in control and prevention) in order to
find relevant published articles on methods for prevene604
Results
Discussion
Most of earlier evidences on utility of methods for prevention and control of caries come from the Cochrane
group, which produced several systematic reviews on
this matter so far (7-15,18,19,21,27,29,31-36).
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N.
1
Source
Cochrane Collaboration
Oral health group
Cochrane Collaboration
Oral health group
Cochrane Collaboration
Oral health group
Cochrane Collaboration
Oral health group
Cochrane Collaboration
Oral health group
Author
Marinho et al.7
Year
2002
Title
Fluoride gels for preventing dental caries in children and adolescents
Marinho et al.8
2003
Marinho et al.9
2003
Marinho et al.10
2003
Marinho et al.11
2004
Cochrane Collaboration
Oral health group
Marinho et al.12
2004
Cochrane Collaboration
Oral health group
Cochrane Collaboration
Oral health group
Yeung et al.13
2005
Bonner et al.14
2006
Cochrane Collaboration
Oral health group
2008
Pit and fissure sealants for preventing dental decay in the permanent teeth
of children and adolescents
10
AhovuoSalaronta
et al.15
Azarpazhooh
et al.16
2008
Pit and fissure sealants in the prevention of dental caries in children and
adolescents: a systematic review.
11
J Am Dent Assoc
Deshpande
et al.17
2008
12
Cochrane Collaboration
Oral health group
Cochrane Collaboration
Oral health group
Caries Res
Walsh et al.18
2010
Hiiri et al.19
2010
James et al.20
2010
Tubert-Jeannin
et al. 21
Gibson et al.22
2011
16
Cochrane Collaboration
Oral health group
J Public Health Dent.
17
Int Dent J
2012
18
Nutr Rev
Mickenautsch
et al.23
Hujoel et al.24
2013
19
J Am Dent Assoc
Weyant et al.25
2013
20
21
Cagetti et al.26
Marinho et al.27
2013
2013
Chou et al.28
2013
Cochrane Collaboration
Oral health group
Caries Res
Cooper et al.29
2013
Santos et al.30
2013
25
Cochrane Collaboration
Oral health group
2013
26
Cochrane Collaboration
Oral health group
Cochrane Collaboration
Oral health group
Cochrane Collaboration
Oral health group
Cochrane Collaboration
Oral health group
Cochrane Collaboration
Oral health group
AhovuoSalaronta
et al.31
Riley et al.32
2015
Walsh et al.33
2015
Marinho et al.34
2015
Iheozor-Ejiofor
et al.35
Yeung et al.36
2015
2015
2
3
4
5
13
14
15
22
23
24
27
28
29
30
2011
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moderate quality evidence for fluoride gel in the inhibition of large caries in the permanent dentition (34).
The superiority of fluoride toothpaste containing xylitol
over fluoride-only toothpaste for preventing caries was
not demonstrated neither in a subsequent systematic review assessing this comparison in the permanent teeth
of children (32).
Another systematic review compared the effectiveness
of chlorhexidine against a placebo or no treatment in
the prevention of caries in children and adolescents but
found negligible evidence (33).
-Pit and fissure sealants
In 2008, Ahovuo-Salaronta (15) and colleagues evaluated the caries prevention of pit and fissure sealants in
children and adolescents performing systematic reviews
including sixteen studies. They found significant higher
benefit of second or third generation resin-based sealants
on first permanent molars, compared to a control without
sealant. Further, one of the studies included in the review
with nine years of follow up revealed more caries in the
control group compared to resin sealant group; 27% of
sealed surfaces were decayed compared to 77% of surfaces without sealant. The results of the studies comparing
different sealant materials were conflicting. The authors
concluded that sealing is an effective method to prevent
caries of the occlusal surfaces of permanent molars. According to their analysis, at high caries risk the effectiveness of sealants is clear, however there is lack of information regarding the benefits of sealing in patients
with different caries risks (15). In 2008, Azarpazhooh
(16) and collaborators detected 303 articles by the literature research about the effectiveness of pit and fissure
sealants in preventing dental caries. The authors agreed
about the application of dental sealants on all permanent
molar teeth of high-risk populations without any decays
and within four years after their eruption. Besides, the
review showed off that resin-based sealants should had
been preferred to glass ionomer cements sealants. In
conclusion, their analysis underlined the importance of
dental sealing without omitting the influence of fluoride
varnish, education, nutritional and regular clinical consultation (16).
In 2013, Ahovuo-Saloranta et al. (31) analyzed the comparison between applying pit and fissure sealants versus
no treatment and among different types of sealant materials for preventing dental caries in children and adolescents younger than twenty years. The resinbased sealant
compared with no treatment prevented caries in the first
permanent molars [ at two years of follow-up OR=0.12
( 95% CI 0.70-0.19)] and it was revealed their effectiveness for the nine years of follow-up. On the other hand,
no evidence could be issued regarding the potential prevalence among the different types of sealants because
long follow-up time trials were needed. According to
this review, the authors recommended the application of
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Conclusions
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