Topical fluoride for preventing dental caries in children and adolescents.

The use of topically applied fluoride has been widely researched as a means to reduce the risk of dental caries in conjunction with other treatment modalities (mechanical oral hygiene, dietary control, antimicrobial intervention, pit and fissure sealants). There is overwhelming evidence that reports not only the significance and importance of the use of fluoride as a caries-preventive agent, but also how safe fluoride application is when used appropriately, particularly in higher risk individuals and populations. This paper reviews the caries-protective benefits of topical fluoride application in children and adolescents, with an emphasis on the clinical efficacy and safety of the vehicles by which fluoride is topically delivered. Fluoride toothpaste represents today the most cost-effective fluoride-delivery system in the oral cavity and its use should be the centerpiece in all caries-preventive strategies. On the other hand, mouthrinses, gels and varnishes currently represent adjuncts to toothpaste use and should be targeted towards individuals and groups at high risk of caries.

Prevalence and socio-behavioral determinants of dental caries in Sicilian schoolchildren.

BACKGROUND: Epidemiological data revealed a marked decline in dental caries prevalence in schoolchildren of Western industrialized countries. In Italy this decline is not well documented, particularly for schoolchildren living in southern Italy. This study investigated the prevalence of caries in schoolchildren in the city of Palermo, Sicily, and assessed the relationship between socio-behavioral determinants and caries. MATERIAL/METHODS: A sample of 511 schoolchildren, 153 aged 5 (29.94%) and 358 aged 12 (70.06%), was selected using the cluster sampling technique from a stratified population. The World Health Organization caries diagnostic criteria for Decayed, Missing and Filled Teeth and Surfaces for both permanent (DMFT/DMFS) and primary (dmft/dmfs) dentition was used. A questionnaire to assess oral health behaviors and socio-economic factors was completed by the parents. A logistic regression model was estimated, with DMFT/dmft index properly dichotomized as the dependent variable, and oral hygiene, dietary habits, dentist visit attendance, mother's employment status and level of education as explanatory variables. Two separate analyses were made for 5- and 12-year-old subjects. RESULTS: The overall prevalence of dental caries was 38.56% in 5-year-olds and 44.97% in 12-year-olds. In the case of the 5-year-olds, maternal educational level was a protective factor for caries, while in the case of the subjects aged 12, frequent snack consumption was significantly associated with caries. CONCLUSIONS: The prevalence of caries in Sicilian schoolchildren was quite high and appears to be related to socio-behavioral determinants (socio-economic background of mothers and frequency of cariogenic snack consumption).

Community water fluoridation and caries prevention: a critical review.

The aim of this paper was to critically review the current role of community water fluoridation in preventing dental caries. Original articles and reviews published in English language from January 2001 to June 2006 were selected through MEDLINE database. Other sources were taken from the references of the selected papers. For the past 50 years community water fluoridation has been considered the milestone of caries prevention and as one of the major public health measures of the 20th century. However, it is now accepted that the primary cariostatic action of fluoride occurs after tooth eruption. Moreover, the caries reduction directly attributable to water fluoridation have declined in the last decades as the use of topical fluoride had become more widespread, whereas enamel fluorosis has been reported as an emerging problem in fluoridated areas. Several studies conducted in fluoridated and nonfluoridated communities suggested that this method of delivering fluoride may be unnecessary for caries prevention, particularly in the industrialized countries where the caries level has became low. Although water fluoridation may still be a relevant public health measure in poor and disadvantaged populations, the use of topical fluoride offers an optimal opportunity to prevent caries among people living in both industrialized and developing countries.