Sealants or fluoride varnishes: which treatment is better for preventing decay in the permanent back teeth of children and adolescents?

Tooth decay is when a small hole develops in a tooth. This happens because bacteria that live in the mouth feed on sugar in the food we eat. As they feed, the bacteria produce acid that attacks teeth. If teeth are not cleaned regularly after eating, or if someone consumes a lot of sugary foods and drinks, the repeated acid attacks can create holes in the hard outer surface of the teeth. If untreated, these holes can deepen and damage the layer of tooth underneath the surface (dentine). Many people around the world develop tooth decay at some point in their life. In most adolescents and children over the age of six years, decay damages the biting surfaces of the permanent teeth at the back of the mouth.

To prevent decay, dentists can apply a dental sealant, or fluoride varnish, directly onto the back teeth. A dental sealant is a coating made from an adhesive material such as resin or glass ionomer, which the dentists applies once to teeth. It seals off the grooves in teeth that tend to collect food, and protects them from the acid. By comparison, a fluoride varnish is a sticky paste that contains high levels of fluoride; fluoride is a mineral naturally present in teeth that protects them from damage. Fluoride varnishes need to be applied to teeth by the dentist two to four times a year. Continue reading

Fluorides for preventing early tooth decay during fixed brace treatment

Wearing a fixed brace makes it harder for people to keep their teeth clean and may also cause pain. Pain can make it more difficult for people to brush their teeth. This can lead to a build-up of dental plaque around the brackets that attach the fixed brace to the teeth. If the plaque stays on the tooth for long enough, it will cause early tooth decay, which looks like white or brown marks (demineralised lesions, also known as white spot lesions). People often wear braces for 18 months or longer and if the decay is left to progress, it can cause holes, which are sometimes bad enough to need fillings to be done in the teeth.

Fluoride helps the tooth to heal, reducing tooth decay in people who are at risk of developing it. People receiving fixed brace treatment may be given different forms of fluoride treatment. It is important to think about how the fluoride gets to the teeth. Does the fluoride need to be placed by a dentist or dental nurse, or can people having treatment with braces apply the fluoride to their own teeth? Continue reading

Sealants versus fluoride varnish – which is better for preventing decay in children’s teeth?

ChildAlthough children and adolescents have healthier teeth today than in the past, tooth decay is still a problem among some individuals and populations, and it affects a large number of people around the world. Most decay in children and adolescents is concentrated on the biting surfaces of permanent back teeth. Preventive treatment options for tooth decay include tooth brushing with a fluoride toothpaste, use of fluoride supplements (e.g. fluoride tablets) and application of dental sealants and topical fluorides at dental clinics. Dental sealants are applied to form a physical barrier that prevents growth of bacteria and accumulation of food particles in the grooves of back teeth. Several sealant materials are available: The main types in use are resin-based sealants and glass ionomer cements. Fluoride varnishes are sticky pastes that are professionally applied to the teeth two to four times a year. Continue reading

Updated systematic reviews from the Oral Health Group

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c. Malcolm Koo under the Creative Commons Share-Alike License

Issue 7, 2013 of the Cochrane Library has been published, and features two new updates from the Cochrane Oral Health Group. Follow the links to read more!

New update: Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications
By Marco Esposito, Maria Gabriella Grusovin and Helen V Worthington

This updated review looks at whether antibiotics should be given prior to dental implants to prevent infections which can threaten implant stability. Six randomized controlled trials were included, with 1,162 participants. All six of these trials compared the use of antibiotics to prevent infection (failures and complications) with no treatment or treatment with a placebo . The antibiotic used in all the trials was amoxicillin; doses and timing of doses varied, although most used a single dose taken just before the implant was placed. One of the trials, with 100 participants, also looked at different doses of amoxicillin taken at different times. It appears that the oral administration of two grams of amoxicillin one hour before placement of dental implants is effective in reducing implant failures. More specifically, giving antibiotics to 25 people will avoid one person experiencing early implant losses. It is still unclear whether postoperative antibiotics are beneficial, or which antibiotics work best.

New update: Fluoride varnishes for preventing dental caries in children and adolescents
by Valeria CC Marinho, Helen V Worthington, Tanya Walsh and Jan E Clarkson

This is an update of a review which looks at whether fluoride varnish is effective in preventing tooth decay in children. 22 randomized controlled trials were included, with a total of 12,455 participants. 13 of the trials looked at older children who have permanent (adult) teeth, and fluoride varnish was found to reduce decayed or missing teeth by 43%. Children who still have their baby or milk teeth were covered in 10 of the trials. For this group of children, fluoride varnish reduced decayed or missing teeth by 37%. The evidence produced has been found to be of moderate quality due to issues with trial designs.

Other highlights of the Cochrane Library, Issue 7 include: