Fluoride toothpaste significantly reduces childhood cavities

A review of clinical trials going back more than 50 years firmly establishes that, in children, brushing with toothpaste containing fluoride results in 24 percent less cavity formation than does brushing with non-fluoridated toothpaste.

The review, one of the most definitive ever conducted on effectiveness of fluoride toothpaste, was announced recently by The Cochrane Collaboration, an independent, international, nonprofit organization.

The announcement was made at a conference sponsored by the Forsyth Center for Evidence-Based Dentistry (www.forsyth.org/ebd), in Boston.

The results were presented by William Shaw, joint co-ordinating editor of the Cochrane Oral Health Group, one of 50 review groups in The Cochrane Collaboration, which undertook the research. "In the last thirty years, the incidence of cavities in children's teeth has declined significantly in many communities--a result of both fluoridation of the water supply and of increased use of fluoridated toothpastes and other topically-applied fluoride treatments," Shaw said. "However, questions had arisen about the effectiveness and safety of fluoride toothpastes in various concentrations and in relation to the widespread availability of fluoride from other sources, such as drinking water."

Hence, The Cochrane Collaboration team embarked on the first systematic quantitative investigation ever to assess the overall effectiveness and safety of fluoride toothpastes in comparison to non-fluoride toothpastes, and to examine formally the main factors that may influence their effectiveness. In their investigation, the reviewers assessed the results of 74 studies involving more than 42,000 children under age 16. The studies had been conducted between 1950 and 2001 in the Americas, Europe and Asia.

In addition to establishing that brushing significantly reduced the formation of cavities in children, the researchers found that in children under 16:

* Brushing twice a day or more with fluoride toothpaste confers greater caries reduction than does brushing once a day or less.
* Brushing with toothpaste containing higher concentration of fluoride is associated with greater caries reduction.
* Fluoride toothpaste use may confer greater caries benefits in those with higher baseline levels of decayed, missing and filled teeth.
* Brushing with fluoride toothpaste provides additional caries reduction even if children live in areas with fluoridated water supplies.

According to Richard Niederman, DMD, Director of The Forsyth Center for Evidence-Based Dentistry: "This definitive study reinforces the need for parents to continue to protect their children from tooth decay by using fluoridated toothpaste." The Center, originally established at the Harvard School of Dental Medicine, moved to The Forsyth Institute, in 2001. Forsyth is an independent, nonprofit research institute focused on oral, craniofacial and related biomedical science.

Available data did not allow the researchers to determine differences in effectiveness of varying fluoride toothpaste formulations, or to assess the risks of possible adverse effects. The researchers did not study the effectiveness of fluoride toothpaste in adults.