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Preventing dental caries

SBU Assessment

Presents a comprehensive, systematic assessment of available scientific evidence for effects on health, social welfare or disability. Full assessments include economic, social and ethical impact analyses. Assessment teams include professional practitioners and academics. Before publication the report is reviewed by external experts, and scientific conclusions approved by the SBU Board of Directors.

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Dental caries remains a health problem for many children and adolescents in Sweden. Adults also have major care needs as a result of caries, particularly those who were not covered by preventive services while young. While the methods for preventing caries are relatively simple, considerable disagreement is found in the scientific literature about their effects, and practices among dental services vary. The report, \"Preventing Caries\", systematically reviews and critically assesses the scientific evidence concerning the preventive effects of various methods.

Methods

The Project Group systematically searched the literature in the MEDLINE and Cochrane Library databases up to October 2001 and reviewed the reference lists in the studies identified. Studies that met predetermined quality standards for high- and moderate-grade evidence were used as a basis for the conclusions of the report.

Results

There is strong scientific evidence that the daily use of fluoride toothpaste is an effective method for preventing caries in permanent teeth in children and adolescents. Toothpaste with a higher fluoride concentration (1500 ppm) shows better effects than toothpaste with 1000 ppm.

Fluoride rinsing daily, weekly, or once every second week can reduce the prevalence of caries in children and adolescents, but provides no additional protection beyond that achieved by the daily use of fluoride toothpaste.

Professional application of fluoride lacquer at least twice per year is effective in preventing caries in young permanent teeth, even with the concurrent use of fluoride toothpaste.

Prevention programs that include the use of fluoride can help prevent caries in children and adolescents. (Caries preventive effects)

The use of resin-based dental sealants to seal fissures is shown to have an effect in caries prevention.

There is insufficient evidence to draw any conclusions concerning the preventive effects that fluoride tablets, sorbitol, and xylitol in chewing gum and sweets might have on dental caries, or how caries prevention should be designed for groups with special needs. No studies have reported evidence that is strong enough to permit assessment of the economic effects of interventions to prevent caries.

How to cite this report: SBU. Preventing dental caries. Stockholm: Swedish Council on Health Technology Assessment in Health Care (SBU); 2002. SBU report no 161 (in Swedish).

Published: Report no: 161

Project group

  • Susanna Axelsson (Project Coordinator)
  • Helena Dahlgren
  • Göran Hammarsjö
  • Anna-Karin Holm (Chair)
  • Carina Källestål
  • Folke Lagerlöf
  • Peter Lingström
  • Ingegerd Mejàre
  • Gunnila Nordenram
  • Anders Norlund
  • Lars G Petersson
  • Åsa Svensson (Project Assistant)
  • Birgitta Söder
  • Svante Twetman

More on the subject

Scientifc Articles

Axelsson S, Soder B, Nordenram G, Petersson LG, Dahlgren H, Norlund A, et al. Effect of combined caries-preventive methods: a systematic review of controlled clinical trials. Acta Odontol Scand 2004;62:163-9.
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Twetman S, Axelsson S, Dahlgren H, Holm AK, Kallestal C, Lagerlof F, et al. Caries-preventive effect of fluoride toothpaste: a systematic review. Acta Odontol Scand 2003;61:347-55.
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Mejare I, Lingstrom P, Petersson LG, Holm AK, Twetman S, Kallestal C, et al. Caries-preventive effect of fissure sealants: a systematic review. Acta Odontol Scand 2003;61:321-30.
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Lingstrom P, Holm AK, Mejare I, Twetman S, Soder B, Norlund A, et al. Dietary factors in the prevention of dental caries: a systematic review. Acta Odontol Scand 2003;61:331-40.
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Kallestal C, Norlund A, Soder B, Nordenram G, Dahlgren H, Petersson LG, et al. Economic evaluation of dental caries prevention: a systematic review. Acta Odontol Scand 2003;61:341-6.
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