DOCSLIB.ORG

Evidence-Based Caries Management for All Ages-Practical Guidelines

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Evidence-Based Caries Management for All Ages-Practical Guidelines REVIEW published: 27 April 2021 doi: 10.3389/froh.2021.657518 Evidence-Based Caries Management for All Ages-Practical Guidelines John D. B. Featherstone 1*, Yasmi O. Crystal 2,3, Pamela Alston 4, Benjamin W. Chaffee 1, Sophie Doméjean 5,6,7,8, Peter Rechmann 1, Ling Zhan 4 and Francisco Ramos-Gomez 9 1 Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States, 2 Pediatric Dentistry Department, College of Dentistry, New York University, New York, NY, United States, 3 Comprehensive Pediatric Dentistry, Bound Brook, NJ, United States, 4 Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States, 5 Department of Operative Dentistry and Endodontics, UFR d’Odontologie de Clermont-Ferrand, Clermont-Ferrand, France, 6 EA 4847, Clermont-Ferrand, France, 7 Université Clermont Auvergne, Clermont-Ferrand, France, 8 Service d’Odontologie, CHU Estaing, Clermont-Ferrand, France, 9 Section of Pediatric Dentistry, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States Introduction: The purpose of the present paper is to provide step-by-step guidelines for dental healthcare providers to manage dental caries based upon caries risk assessment (CRA) for ages 0–6 years and 6 years through adult. The manuscript reviews and updates the CAMBRA (caries management by risk assessment) system which includes CRA and caries management recommendations that are guided by the assessed risk level. Caries Risk Assessment: CAMBRA CRA tools (CRAs) have been evaluated in several Edited by: clinical outcomes studies and clinical trials. Updated CAMBRA CRAs for ages 0–6 years May Lei Mei, University of Otago, New Zealand and 6 years through adult are provided. These CRAs have been refined by the addition Reviewed by: of a quantitative method that will aid the health care provider in determining the caries Jilen Patel, risk of individuals. University of Western Australia, Australia Caries Management Based Upon Risk Assessment: Guidelines for individualized Bathsheba Turton, patient care are provided based upon the caries risk status, results of clinical exams University of Puthisastra, Cambodia and responses of the patient to questions in the CRA. These guidelines are based upon *Correspondence: John D. B. Featherstone successful outcomes documented in several clinical outcomes studies and clinical trials. [email protected] The paper includes a review of successful caries management procedures for children and adults as previously published, with additional emphasis on correct use of silver Specialty section: This article was submitted to diamine fluoride (SDF) for children. The caries management plan for each individual is Oral Hygiene and Oral Health Policy, based upon reducing the caries risk factors and enhancing the protective factors with a section of the journal the additional aid of behavior modification. Beneficially altering the caries balance is Frontiers in Oral Health coupled with minimal intervention restorative dentistry, if appropriate. These methods Received: 23 January 2021 Accepted: 08 March 2021 are appropriate for the management of dental caries in all patients. Published: 27 April 2021 Keywords: caries management, caries risk assessment, dental caries, fluoride, infants and toddlers Citation: Featherstone JDB, Crystal YO, Alston P, Chaffee BW, Doméjean S, INTRODUCTION Rechmann P, Zhan L and Ramos-Gomez F (2021) Evidence-Based Caries Management Dental caries is a multifactorial, bacterially generated disease, where an unhealthy shift in the for All Ages-Practical Guidelines. oral microbiome is driven by a diet that favors frequent ingestion of fermentable carbohydrates Front. Oral. Health 2:657518. and behaviors, such as ineffective home oral hygiene practices, that allow the preservation of this doi: 10.3389/froh.2021.657518 unfavorable oral environment. In addition, other biological factors like salivary dysfunction or Frontiers in Oral Health | www.frontiersin.org 1 April 2021 | Volume 2 | Article 657518 Featherstone et al. Caries Management-Practical Guidelines factors in the environment, like low health literacy or limited risk level [3, 4, 6, 9, 11, 12, 15, 19–21].Inthispaper,weinclude the access to care, complicate the scenario; therefore, there is no use of a quantitative component with the CAMBRA CRA forms single “magic bullet” that cures dental caries [1, 2]. The disease to aid the clinician in the determination of the caries risk level. can be thought of as a balance between caries pathological and preventive factors as illustrated by the diagram in Tables 1, 2, CARIES MANAGEMENT BASED UPON [3–5]. The management of dental caries can be challenging when patients present with several caries risk factors. This is especially RISK ASSESSMENT—PRACTICAL the case for patients with special needs. GUIDELINES FOR THE HEALTH CARE Dental caries may be managed by swinging the caries balance PROVIDER toward the protective factor side and maintaining it there by reducing pathological risk factors and promoting protective Several segments of this publication are reproduced or modified factors [6]. It is now well-recognized that caries management from Featherstone et al. [3, 4], Rechmann et al. [22], and is best done on a personalized basis building upon a reliable CAMBRA guide [23] with permission of the publishers. caries risk assessment (CRA) where detailed information about the specific risk factors of a patient can be utilized not only to Definitions of Terminology for Caries Risk establish the risk of developing future caries lesions, but also to Assessment establish an effective plan to promote protective habits with the In the present publication caries risk, risk factors, protective aid of behavior modification and to tailor the periodicity of oral factors and disease indicators are defined as follows: evaluations. Assessment of caries risk for each individual patient is essential as the basis for the management of dental caries for a) Caries risk is the likelihood of the patient having new caries patients of all ages [7, 8]. lesions (active white spots, non-cavitated approximal lesions, The procedures and philosophy known as “caries cavitated lesions) in the near future. management by risk assessment” and abbreviated to CAMBRAR b) Protective factors are environmental factors, biological were published in the Journal of the California Dental factors or chemical therapy that help to swing the caries Association in 2007 and updated in 2019 for patients aged balance to caries lesion prevention or reversal. Examples are 6 years through adult [4, 9, 10], as well as for young children fluoride in drinking water, adequate saliva and the use of aged 0–5 years [3, 11] and have been utilized for over 15 years in fluoride toothpaste. the teaching clinics of the School of Dentistry at the University c) Risk factors are environmental or biological factors that of California San Francisco (UCSF) [12] and at the University contribute to the initiation or progression of caries lesions. of California Los Angeles (UCLA) School of Dentistry Pediatric Biological factors include items such as acid producing Dental Clinic, as well as several community health centers in bacteria, visible plaque on the teeth, frequent snacking on California [13, 14]. Successful management of dental caries fermentable carbohydrates. Environmental factors include requires (a) the use of a reliable CRA tool, that then leads to items such as low health literacy (Tables 1, 2). (b) the formulation of an individualized treatment plan that is d) Disease indicators are the clinically observed results of derived from the caries risk level and the information learned previous and/or ongoing dental caries destruction of the tooth during the CRA process. The overall CAMBRA method includes mineral. They do not contribute to the disease, but they are both risk assessment and caries management. direct indicators of the presence of disease in the past or at The CAMBRA CRA tool was developed over decades by the time of the observation. personnel at UCSF as described above, based upon research e) Caries lesion. In this publication the term “caries lesion” is on key factors that contribute to caries progression or reversal used throughout to describe a dental lesion (cavitated or non- on real patients over time. The tool was launched in 2003 cavitated) caused by the dental caries process. The term caries and has been updated since then based upon clinical outcomes lesion may also be referred to as a carious lesion. [3, 4, 10, 11, 15]. It provides a risk assessment form for two age ranges, namely ages 0–6 and 6 years through adult. The General Considerations for Successful CAMBRA CRA tool has been shown to be highly predictive of Caries Management future caries lesions in three different studies, totaling more than Assessment of the caries risk level for future occurrence of 20,000 patients, for the age group 6 years through adult and for caries lesions is an important first step in managing dental the age group 0–5 years [12, 16–18]. A detailed discussion of these caries and monitoring oral health improvement over time. clinical studies has been reported previously [3, 4]. CAMBRA All children should be given their first oral exam upon the CRA can confidently be used by the dental care provider to assess eruption of the first tooth or before 1 year of age to ensure the caries risk of an individual patient and
Load more

Recommended publications
  • A Review of Water Fluoridation” October 1, 2010 November 7, 2014
    Alberta Health, Office of the Chief Medical Officer of Health Notice to the reader on “A Review of Water Fluoridation” October 1, 2010 November 7, 2014 November 7, 2014 Notice to the reader Re: A Review of Water Fluoridation, October 1, 2010 report This report is a compilation of existing resources, materials and research that highlight key aspects of the water fluoridation debate. It was developed as a support to assist Medical Officers of Health in Alberta in dealing with queries on fluoridation. While not written for the public, this report is now widely available to help anyone interested to better understand the issue and to provide answers to questions about fluoridation. The reader must be aware that this report is not drafted as a scientific review article for publication although references are made to previous systematic reviews and their findings. It is also important to note that specific references for quoted material are given in the text at the time they are used. Office of the Chief Medical Officer of Health, Alberta Health © 2014 Government of Alberta PREPARED BY DR. STEVEN K. PATTERSON A Review of Water Fluoridation S UBMITTED: O CTOBER 1, 2010 A Review of Water Fluoridation Dr. Steven Patterson A Table of Contents Page Number Executive summary 3 Introduction/Background 6 Importance of oral health Scope of dental disease in Alberta/Canada 7 Dental disease in Alberta Dental disease in Canada Mechanism of fluoride’s action 12 Benefits of water fluoridation Dental fluorosis 17 Safety of water fluoridation Canadian Health Measure Survey 2007-2009 Fluorosis data from Alberta dental surveys Population vs.
    [Show full text]
  • D3G DISPATCH News About Developmental Dental Defects (D3s), the D3 Group, and the Chalky Teeth Campaign
    THE D3 GROUP ISSUE #13 MARCH 2020 D3G DISPATCH News about Developmental Dental Defects (D3s), The D3 Group, and the Chalky Teeth Campaign. COMMENT FROM THE CUSP: Going viral Commiserations to everyone disrupted by the pandemic crisis, and hallelujah to science and technology for providing humanity an unprecedentedly strong path to recovery. Just 3 weeks ago, a colleague praised D3G's recent progress as "going viral"– not knowing the next day we'd be in the midst of a COVID-19 scare that has consumed life down under since. With D3G now affected by the bad connotation of improvement") emerge, usually directed at authors "going viral", this first issue of 2020 relays a mixture of and/or reviewing. It seems appropriate that D3G use ups, downs and uncertainties – unfortunately the April CE it's clinico-scientific strengths to improve both ends event in Toronto has been postponed and the October of the system and that this will be a great topic for Symposium remains on track but uncertainly so. On the our upcoming symposium. bright side we share some wonderful examples of "D3 Take care, and do the world a favour by communicating love", provide further reasons to "think beyond MIH" the importance of science! and to communicate translationally, and dip a cautious toe into the murky waters of research publication quality. Unsurprisingly the latter is frequently discussed amongst D3-Mike | Mike Hubbard D3ers and diverse grumbles (aka "opportunities for D3G Founder-Director NEWS: Feel the D3 love :-) Given growing tensions with COVID-19, we're thrilled the first 3 months of 2020 delivered a wonderful triad of "feel the D3 love" moments that'll surely help us through this challenge and beyond.
    [Show full text]
  • Soares, R. Et Al
    Original Article DOI: 10.7860/JCDR/2017/23594.9758 Assessment of Enamel Remineralisation After Treatment with Four Different Dentistry Section Remineralising Agents: A Scanning Electron Microscopy (SEM) Study RENITA SOARES1, IDA DE NORONHA DE ATAIDE2, MARINA FERNANDES3, RAJAN LAMBOR4 ABSTRACT these groups were remineralised using the four remineralising Introduction: Decades of research has helped to increase our agents. The treated groups were subjected to pH cycling over a knowledge of dental caries and reduce its prevalence. However, period of 30 days. This was followed by assessment of surface according to World Oral Health report, dental caries still remains microhardness and SEM for qualitative evaluation of surface a major dental disease. Fluoride therapy has been utilised in changes. The results were analysed by One-Way Analysis Of a big way to halt caries progression, but has been met with Variance (ANOVA). Multiple comparisons between groups were limitations. This has paved the way for the development of performed by paired t-test and post-hoc Tukey test. newer preventive agents that can function as an adjunct to Results: The results of the study revealed that remineralisation of fluoride or independent of it. enamel was the highest in samples of Group E (Self assembling Aim: The purpose of the present study was to evaluate the ability peptide P11-4) followed by Group B (CPP-ACPF), Group C (BAG) of Casein Phosphopeptide-Amorphous Calcium Phosphate and Group D (fluoride enhanced HA gel). There was a significant Fluoride (CPP ACPF), Bioactive Glass (BAG), fluoride enhanced difference (p<0.05) in the remineralising ability between the self assembling peptide P -4 group and BAG and fluoride Hydroxyapatite (HA) gel and self-assembling peptide P11-4 to 11 remineralise artificial carious lesions in enamel in vitro using enhanced HA gel group.
    [Show full text]
  • Fluoride Treatment in Osteoporosis Pauline Pitt and Hedley Berry King's College Hospital, Denmark Hill, London SE5 9RS, UK
    Postgrad Med J: first published as 10.1136/pgmj.67.786.323 on 1 April 1991. Downloaded from Postgrad Med J (1991) 67, 323 - 326 i) The Fellowship of Postgraduate Medicine, 1991 Leading Article Fluoride treatment in osteoporosis Pauline Pitt and Hedley Berry King's College Hospital, Denmark Hill, London SE5 9RS, UK Introduction The use offluoride for the treatment ofestablished Fluoride in clinical practice vertebral osteoporosis in adults with the sympto- matic crush fracture syndrome is approved for use Fluoride is known to stimulate osteoblasts in in 8 European countries.' This treatment was culture." Its use has been associated with increase suggested by the low prevalence of osteoporosis in in alkaline phosphatase activity and it stimulates some areas where the drinking water contained both collagen synthesis and calcium deposition." moderately high concentrations of fluoride` and High concentrations may exert a toxic effect on by the enormously increased bone density charac- osteoblast function.'2 teristic of fluorosis.5 At least 4 studies have been carried out to assess There now exists a wealth of evidence and some the long-term effect offluoride treatment on spinal controversy regarding the use of fluoride, and this bone mass. Some ofthe results are conflicting. Two article addresses the main issues involved. prospective controlled trials have been carried out and recently reviewed in detail.' One in France used a daily dose of 50 mg for 2 years and the other copyright. Pharmacokinetics in the USA used a high-dose regimen of 60
    [Show full text]
  • Fluoride Varnish and Silver Diamine Fluoride a Resource Guide
    Fluoride Varnish and Silver Diamine Fluoride A Resource Guide Prepared by Ruth Barzel, M.A. Katrina Holt, M.P.H., M.S., R.D., FAND Cite as Barzel R, Holt K, eds. 2020. Fluoride Varnish Permission is given to photocopy this publication and Silver Diamine Fluoride: A Resource Guide. or to forward it, in its entirety, to others. Requests Washington, DC: National Maternal and Child Oral for permission to use all or part of the information Health Resource Center. contained in this publication in other ways should be sent to the address below. Fluoride Varnish and Silver Diamine Fluoride: A Resource Guide © 2020 by National Maternal and National Maternal and Child Oral Health Child Oral Health Resource Center, Georgetown Resource Center University Georgetown University Box 571272 This publication was supported by the Health Washington, DC 20057-1272 Resources and Services Administration (HRSA) of (202) 784-9771 the U.S. Department of Health and Human Services E-mail: [email protected] (HHS) as part of an award totaling $1,000,000 with Web site: www.mchoralhealth.org no funding from nongovernmental sources. This information or content and conclusions are those of the author and should not be construed as the official policy of HRSA, HHS, or the U.S. govern- ment, nor should any endorsements be inferred. Contents Introduction ............................... 3 Acknowledgments .......................... 4 Materials .................................. 5 Data and Surveillance ..................... 6 Professional Education and Training ........6 Public Education ......................13 Organizations ............................. 15 Introduction The National Maternal and Child Oral Health SDF is safe for children and adults. The Resource Center (OHRC) developed this pub- cost of SDF treatment is lower than the cost of lication, Fluoride Varnish and Silver Diamine conventional dental caries treatment.
    [Show full text]
  • Huma N Se Rum Fluoride
    Bill Osmunson DDS, MPH Washington Action for Safe Water, President September, 2012 4655 SW Griffith #101, Beaverton, OR 97070 Portland Mayor Sam Adams 503.823-4120 Porland Commissioner Amanda Fritz 503.823.3008 Porland Commissioner Nick Fish 503.823.3589 Porland Commissioner Randy Leonard 503.823.4682 Porland Commissioner Dan Saltzman 503.823.4151 RE: Summary of some Evidence Opposed to Fluoridation PREFACE As a dentist with master’s degree in public health, I promoted fluoridation of public water for about the first 25 years of practice. I now consider fluoridation to be one of the greatest public health blunders of the 20th Century. Below is a brief summary of reasons not to fluoridate Portland’s public water. • Too much fluoride is already being ingested, even without fluoridation. Urine, blood serum concentrations and increased dental fluorosis from 10% to 40% of children confirm many are ingesting too much fluoride from many sources. • CDC ASTDR reports <0.02 ppm fluoride serum concentration is normal, many have higher serum fluoride concentrations. Adding additional fluoride will cause significant harm to most of the population. (Appendix 65 examples) • Fluoride can be toxic and like lead and arsenic appears to have no lowest threshold of safety. Few studies have looked at the synergistic effects of fluoride and other toxicants. • Brains are more important than teeth. Over 90% of human studies on fluoride and human brain report fluoride lowers IQ, especially cognitive reasoning. For every dollar spent on fluoridation, we have an estimated $6,000/year negative economic impact. • Fluoride is an enzymatic reactor affecting many body functions.
    [Show full text]
  • Water Fluoridation and Health
    Water fluoridation and health Working group report group Working Medical Research Council Lay summary The practice of adding fluoride to drinking water to improve dental health has been endorsed by numerous national and international health institutions, including the World Health Organization. It has been argued that in communities with piped water supplies it is the most cost effective method of reaching the whole population, particularly children with a high risk of tooth decay. Much of the evidence that links water fluoridation to improved dental health comes from research conducted several decades ago.The Department of Health therefore commissioned the NHS Centre for Reviews and Dissemination at the University of York to produce an up to date review of the topic, looking at all relevant studies. The York review, published in September 2000, confirmed the beneficial effect of water fluoridation on dental caries (cavities), but also highlighted the increased prevalence of dental fluorosis (a defect of the enamel ranging from mild speckling to more gross effects) associated with fluoridation.The review concluded that little high quality research had been carried out on the broader question of fluoride and health, and that the available evidence did not allow confident estimates to be made of other possible risks to health or of the benefits of water fluoridation in reducing dental health inequalities. In light of these findings the Medical Research Council, at the request of the Department of Health, set up the present Working Group to consider what further research is required to improve knowledge about fluoridation and health.This report aims to identify areas of uncertainty regarding the balance of benefits and risks of water fluoridation, and to make appropriate recommendations for research to address these uncertainties.
    [Show full text]
  • Tigations of the Potential Effects of Different
    INVESTIGATIONS OF THE POTENTIAL EFFECTS OF DIFFERENT PREVENTIVE PRODUCTS ON TREATMENT AND PREVENTION OF ENAMEL SURFACE LOSS By Fowziya M. Ali Submitted in accordance with the requirements for the Degree of Doctor of Philosophy Faculty of Medicine and Health Department of Paediatric Dentistry, Leeds Dental Institute, Leeds, UK University of Leeds April 2018 "I hereby confirm that this submitted work is my own and that appropriate credit has been given where reference has been made to the work of others." This copy has been supplied on the understanding that it is copyright material and that no quotation from the thesis may be published without proper acknowledgement” © 2018 The University of Leeds and Fowziya M. Ali Dedicated to my family (My husband, my children, my parents, my sisters and brothers.) ACKNOWLEDGEMENTS Many people deserve thanks for help while this extremely challenging task was being done. Special gratitude goes to the head of the Paediatric Dentistry Department, Professor Monty Duggal, for his continued encouragement, guidance and his generosity in offering his long experience and knowledge during my PhD study. Many thanks go to Prof. Jack Toumba for his help and support, Dr Simon Strafford for offering his previous laboratory technical experience and guidance during the initial stages of the work which contributed considerably to this thesis. I gratefully value the comments and the scientific guidance involvement of The Head of Clinical Management trial / (Dentistry)/Clinical Trial Research / University of Leeds, Dr Catherine Fernandez, for her valued comments and scientific guided involvements during the clinical trial work. I sincerely appreciate the help and the assistance of the clinical trial study coordinator, Gillian Dukanovic, for her helpful well-organised involvement in clinical trial and Ashna Chavda for her assistance and helpful pleasant character.
    [Show full text]
  • The Role of Varnish Fluoride in Preventing Tooth Decay in Young Children
    ISSN: 2574-1241 Volume 5- Issue 4: 2018 DOI: 10.26717/BJSTR.2018.10.001996 Mohammad Karimi. Biomed J Sci & Tech Res Short Communication Open Access The Role of Varnish Fluoride in Preventing Tooth Decay in Young Children Mohammad Karimi DMD, BS* Department of Pediatric, Sepideh Dental Clinic, Iran Received: Published: *Corresponding: October author: 26, 2018;Mohammad Karimi DMD,: November BS, Department 02, 2018 of Pediatric, Sepideh Dental Clinic, Iran Introduction a new lesion in the teeth, but it is important to stop or at least to Dental caries is one of the most common diseases that occur slow down the progression of primary caries lesions on the tooth among the segments of society with any race, gender, age and surface. social status. Fewer people can be found in the community without decayed or restored teeth. For many years, dental science has Complications of Fluoride Loss shown the effect of fluoride as a preventative agent of dental caries. a)b) HavingTooth Decay gum disease Perhaps the greatest contribution to improving the dental health of deterrent to decay. Some decayed permanent teeth can be caused children around the world is the discovery and use of fluoride as a c) Tooth loss by initial injuries, just when the enamel has not yet been completely d) Cancer of the mouth and throat rigid. Since oral dentistry is difficult and challenging for minors, e) Feeling pain in the face and mouth solution. Varnish Fluoride is the newest therapeutic treatment for using Varnish fluoride can be a more effortlessly and effective f) Oral ulcers and infections gel with a hearty aroma greatly increases the strength of the tooth the prevention of tooth decay in different ages.
    [Show full text]
  • Fluorides in Dental Tissues: Caries Prevention and Fluorosis
    Central JSM Dentistry Review Article *Corresponding author Michel Goldberg, Department of Oral Biology, Faculty of Fundamental and Biomedical Sciences, Paris Cité Fluorides in Dental Tissues: Caries University, France, Tel: 33-6-62676709; Email: mgoldod@ gmail.com Submitted: 08 Januacy 2020 Prevention and Fluorosis Accepted: 05 February 2020 Michel Goldberg* Published: 07 February 2020 Department of Oral Biology, Paris Cité University, France ISSN: 2333-7133 Copyright Abstract © 2020 Goldberg M Cariostatic effects of fluorides play important role is caries prevention, both administrated OPEN ACCESS systemically and/or topically. Tunnels located inside apatite crystals are acting as ions exchangers favoring diffusion pathways and substitution of ions such as fluorides inside the crystal Keywords lattice. Fluorides increase the solubility of the mineral components and the remineralization • Fluoride process. Systemic fluoride decreases the number and severity of the carious lesions. At low • Prevention doses, white spots appear resulting from enamel hypomineralization. Pittings forming horizontal • Community water lines, groves and altered enamel surfaces merging into large pigmented defects (from brown • Salt to black) contribute to enamel pathologies (hypoplasia, and enamel staining). The needs for • Varnishes fluoride consumption have been carefully identified. The effects of topical applications have • Toothpastes been evaluated according to the age of the patient, the frequency of ingestion, and the mode • Fluorosis of absorption (community water fluoridation, tablets and salt fluoridation, fluoride-containing tooth pastes, mouth rinses, varnishes, silver diamine fluoride, and remineralization agents). The decision concerning the fluoride levels and how they are administered should be balanced between the risk of developing caries and dental fluorosis. INTRODUCTION [ Systemic vs. topical fluoride administration (2,6%) water (for a total of 3.6%), and organic components 0.4- Systemic 0.6 % , including proteins and lipids 1-5].
    [Show full text]
  • Fluorine and Fluorides
    This report contains the collective views of an international group of experts and does not necessarily represent the decisions or the stated policy of the United Nations Environment Pro- gramme, the International Labour Organisa- tion, or the World Health Organization Environmental Health Criteria 36 FLUORINE AND FLUORIDES Published under the joint sponsorship of the United Nations Environment Programme, the International Labour Organisation, and the World Health Orgaiization- World Health Organization 77, Geneva, 1984 The International Programme on Chemical Safety (IPCS) is a joint venture of the United Nations Environment Programme, the Interna- tional Labour Organisation, and the World Health Organization. The main objective of the IPCS is to carry out and disseminate evaluations of the effects of chemicals on human health and the quality of the environment. Supporting activities include the development of epidemiological, experi- mental laboratory, and risk-assessment methods that could produce inter- nationally comparable results, and the development of manpower in the field of toxicology. Other activities carried out by IPCS include the devel- opment of know-how for coping with chemical accidents, coordination of laboratory testing and epidemiological studies, and promotion of research on the mechanisms of the biological action of chemicals. ISBN 92 4 154096 6 ©World Health Organization 1984 Publications of the World Health Organization enjoy copyright protec- tion in accordance with the provisions of Protocol 2 of the Universal Copy- right Convention. For rights of reproduction or translation of WHO publica- tions, in part or in toto, application should be made to the Office of Publica- tions, World Health Organization, Geneva, Switzerland. The World Health Organization welcomes such applications.
    [Show full text]
  • Fluoride Varnishes for Preventing Occlusal Dental Caries: a Review
    dentistry journal Review Fluoride Varnishes for Preventing Occlusal Dental Caries: A Review Alaa Baik 1, Najlaa Alamoudi 2,*, Azza El-Housseiny 3 and Amani Altuwirqi 2 1 Pediatric Dentistry Department, King Abdulaziz University Dental Hospital, Jeddah 21589, Saudi Arabia; [email protected] 2 Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia; [email protected] 3 Pediatric Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria 21526, Egypt; [email protected] * Correspondence: [email protected] or [email protected]; Tel.: +966-21-640-1000 (ext. 20388) Abstract: Dental caries are most likely to occur on occlusal surfaces from the early eruptive stages of the tooth. In children, about 80% to 90% of dental caries are occlusal caries. Different preventive modalities are used to prevent occlusal caries. One of the methods used for occlusal caries prevention is fluoride varnish. A vast number of clinical trials have evaluated several types of sealant material and fluoride varnish to assess their ability to prevent occlusal caries in both primary and permanent dentition. The purpose of the current study was to provide an updated overview of the development, composition, mechanism of action, application, and safety of fluoride varnish, as well as its effect on occlusal caries prevention. This review of recently published studies on fluoride varnish and its effect on occlusal caries prevention shows that in children at moderate to high risk of caries, fluoride varnishes prevent occlusal caries. Both resin-based fissure sealants and fluoride varnish are effective for occlusal caries prevention for first-permanent molars. However, it was not possible to identify which one has the best effect.
    [Show full text]