Highlighted review: Slow-release fluoride devices for the control of dental decay

Lee-Yee Chong, Jan E Clarkson, Lorna Dobbyn-Ross, Smriti Bhakta

Plain language summary: Slow-release fluoride devices for the control of dental decay

Review question
We conducted this review to assess the effects of different types of slow-release fluoride devices on preventing, stopping, or reversing the progression of tooth decay on all surface types of deciduous ('baby') and permanent teeth.

Tooth decay is not distributed evenly among the population, with certain groups being at greater risk of developing tooth decay than others. For example, research in Scotland has shown that 50% of tooth decay occurs in 11% of 5-year-old children and only 6% of 14-year-old children. In light of this uneven distribution, it is often suggested that these small percentages of children may be offered targeted-caries preventive measures to great potential effect, in a cost effective manner. One such preventive measure is the use of slow-release fluoride devices (e.g. slow-dissolving fluoride-releasing glass beads).

Study characteristics
Authors from Cochrane Oral Health carried out this review of existing studies and the evidence is current up to 23 January 2018. We searched scientific databases for clinical trials in children or adults treated with slow-release fluoride devices compared with another type of fluoride treatment (e.g. toothpaste, mouthrinse, gel, or varnish), placebo (a pretend treatment), or no treatment (usual care). Treatments had to be used and monitored for a minimum of 1 year.

Key results
We found one study that randomised 174 children to either slow-dissolving, fluoride-releasing glass beads or placebo beads. The setting was an inner city school in an area served with low-fluoride water. Only 48% of children retained the beads and were available for analysis.

There is insufficient evidence to determine whether slow-release fluoride devices (such as glass beads) help reduce dental decay. Retention of the beads is a problem.

Quality of the evidence
The evidence relating caries increment, side effects and retention was considered to be very low quality.

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Citation: Chong LY, Clarkson JE, Dobbyn-Ross L, Bhakta S. Slow-release fluoride devices for the control of dental decay. Cochrane Database of Systematic Reviews 2018, Issue 3. Art. No.: CD005101. DOI: 10.1002/14651858.CD005101.pub4.