A systematic review and meta‐analysis of the effects of fluoride toothpastes on the prevention of dental caries in the primary dentition of preschool children

Abstract

Objectives: To assess the effects of fluoride (F) toothpastes on the prevention of dental caries in the primary dentition of preschool children. Study design: Systematic review and meta‐analysis. Methods: A search for randomized or quasi‐randomized clinical trials was carried out, without idiom restraints, in six electronic databases, registers of ongoing trials, meeting abstracts, dentistry journals and reference lists of potentially eligible studies. The search yielded 1932 records and 159 full‐text articles were independently read by two examiners. Data regarding characteristics of participants, interventions, outcomes, length of follow‐up and potential of bias were independently extracted by two examiners on the basis of predetermined criteria. Any disagreement was solved by consensus after consulting a third examiner. Pooled prevented fractions (PF) and relative risks (RR) were estimated separately for studies testing low F toothpastes (<600 ppm) and those testing standard F toothpastes (1000–1500 ppm). Results: Eight clinical trials fulfilled the inclusion criteria and most of them compared F toothpastes associated with oral health education against no intervention. When standard F toothpastes were compared to placebo or no intervention, significant caries reduction at surface (PF = 31%; 95% CI 18–43; 2644 participants in five studies), tooth (PF = 16%; 95% CI 8–25; 2555 participants in one study) and individual (RR = 0.86; 95% CI 0.81–0.93; 2806 participants in two studies) level were observed. Low F toothpastes were effective only at surface level (PF = 40%; 95% CI 5–75; 561 participants in two studies). Conclusion: Standard F toothpastes are effective in reducing dental caries in the primary teeth of preschool children and thus their use should be recommended to this age group.