BACKGOUND

• Young children swallow toothpaste
• Fluoride has been recommended for 50 years
• Use of fluoride reduces caries
• Use of fluoride at to early of an age can promote fluorosis

BACKGROUND

• 25% of children have cavities by the time they enter kindergarten
• Lack of info stemmed the need for this study
• Lack of info leads to mis leading info in dental community
• Below 2 years grain of rice
• 2 and above is pea sized

METHODS

• ADA proposed question
• ----Does fluoride toothpaste by children 6and under affect caries rate?
• ADA proposed question
• ---- does fluoride toothpaste affect fluorosis rates with children 6 and under

METHODS

• Development of a search strategy
• Medline search

METHODS

• Exclusions
• ---- in vitro studies, animal studies, studies other than language
• ---- case studies, narrative reviews, medical record reviews,
• ---- meeting abstracts, historical articles, editorials, letters and commentaries

METHODS

• Inclusions
• Recorded exposure to fluoride toothpaste in children 6 and younger

DATA COLLECTION

• 2 people
• Screened abstracts
• Once approved evaluation of full te
• Bibliographies were reviewed for potential articles
• Qualitative a quantitive data checked for consistency

DATA COLLECTION

• Checked for bias
• Any discrepancy was handled via third party

STATISTICAL ANALYSIS

• Uses standard mean differences
• Compared dfms and dmft
• Dichotomized fluoride as present or absent
• Did not assess severity

RESULTS

• 2732 abstracts read
• 402 recalled for full text review
• 14 clinical caries trials

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RESULTS

• Caries
• Fluoride toothpaste vs placebo
• High vs low fluoride concentration
• Inception of brushing w/ fluoride
• Brushing frequency

FLUORIDE

• Toothpaste amount
• Fluoride concentration

RESULTS (CARIES)

• High risk of bias
• Fluoride concentration
• Brushing frequency
• Length of time
• Participants Supervised

RESULTS (FLUORIDE VS CONTROL)

• 8 studies
• Fluoride concentrations of 1,000- 1,500 ppm
• Significance difference in decayed(ing) surfaces
• 95% confidence level

RESULTS (FLUORIDE CONCENTRATION)

• Head to head comparisons of toothpastes
• 12 studies
• 500 ppm or more produced statisticallysignificant data
• Less than 500 ppm failed to produce a difference when compared to control

RESULTS (INCEPTION OF FLUORIDE)

• 3 studies
• Brushing w/ fluoride after 24 months decreased fluorosis
• Brushing w/ fluoride before 24 months increased fluorosis
• 95 % confidence interval

RESULTS (BRUSHING FREQUENCY)

• No difference when brushing is compared by times per day
• Significant difference when comparing daily or less than daily brushing

RESULTS (TOOTHPASTE AMOUNT)

• 95 confidence interval
• Use of a small amount compared to a large amount was
• ---- not significantly associated with fluorosis