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Tidskrift

Sammanfattning

The caries-preventive benefits of fluoride are recognized by dental researchers and practitioners worldwide. Fluoride, ranked among one of the globe’s greatest public health achievements, acts locally by affecting the balance between mineral loss and mineral gain in tooth tissues. In high concentrations, fluoride may also act as a metabolic inhibitor in the oral biofilm, thereby reducing ecological acid stress. In recent years, the clinical efficacy has been established through systematic reviews conducted by several Health Technology Agency’s. This chapter presents the evidence for caries prevention, using community based, self- and professionally applied fluoride interventions. The quality of evidence was graded in four levels according to the GRADE system; strong, moderate, limited, and insufficient. For primary prevention, twice daily use of fluoride toothpaste presented the highest level of evidence, irrespective of age. Professional applications of fluoride varnish 2-4 times a year displayed moderate level of evidence, especially in children/adolescents and frail elderly with root caries. The prevented fraction was 24 % for toothpaste and 40 % for varnish. The evidence for the community-based methods was insufficient due to lack of highquality research. Likewise, for secondary caries prevention, evidence for fluoride was insufficient, forming a gap of knowledge for future research.

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