Fluoride for adults

- Research needs

Multiple well designed, appropriately powered, placebo-controlled randomized trials that follow the Consolidated Standards of Reporting Trials¹⁶ (CONSORT) guidelines with standardized reporting according to age, dentition and caries risk status should be conducted in Egypt. Standard methodologies for caries and fluoride randomized controlled trials should be developed. Future trials should be registered with ClinicalTrials.gov or equivalent registries. Specific areas of research recommendations are as follows:

·   Determining of the mechanism of action and caries-preventive effects of various topical fluorides when in use at the current level of background fluoride exposure (fluoridated water and fluoride toothpaste).

·  Evaluation of fluoride in arresting or reversal of caries progression.

·       Comparative effectiveness of different fluoride strategies in high-risk populations, including: adults aged 18 through 65 years, adults older than 65 (including those living in long-term care facilities), adults who are at extremely high risk of developing caries, special needs populations (cognitive disabilities, compromised self-care abilities or physical disabilities) and populations with chronic diseases (such as Sjögren syndrome).

·  Comparative effectiveness of different strategies to manage xerostomia-induced coronal and root caries.

·  Evaluation of the effectiveness and risks of specific products in the following areas: self-applied, prescription-strength, home-use fluoride gels, toothpastes or drops; 2% professionally applied sodium fluoride gel; alternative delivery systems, such as foam; optimal application frequencies for fluoride varnish and gels; one-minute applications of APF gel; and combinations of products (home-use and professionally applied).

·  Evaluation of caries arrest and reversal using different measures.

· Effectiveness and economic benefit of using topical fluoride in caries prevention of different caries risk populations.

· Incorporation of clinical recommendations of using fluoride into practice.

➡️Monitoring and evaluating the impact of the guidelines:

· Fluoride Treatment Coverage: Percentage of patients receiving fluoride varnish or treatment during visits.

·  Caries Prevention Rate Post-Fluoride: Percentage reduction in new caries development in patients treated with fluoride over a defined period.

·       Reduction in DMFT Index Post-Fluoride: Change in Decayed, Missing, and Filled Teeth (DMFT) index in patients who received fluoride treatment.

·  Cost-Effectiveness of Fluoride Programs: Cost per case of dental caries prevented due to fluoride interventions.