The Effect of Fluoride Mouthrinse on Demineralization During Orthodontic Treatment.

Objectives: This systematic review examines the effectiveness of fluoride mouthrinses in preventing white spot lesions in orthodontic patients.
Methods: Scopus, Embase, Medline and Web of Science databases were searched according to specific inclusion and exclusion criteria. Randomised controlled trials and controlled clinical trials were selected that examined the efficacy of fluoride mouthrinses in preventing demineralisation compared to a placebo or dentrifice in patients undergoing orthodontic therapy. Data extraction and quality assessment was performed independently by two authors, with a third author consulted when needed.
Results: A total of six studies were included in the review. Five of them showed a high risk of bias relating to methodological insufficiencies. One study was classified as having a low risk of bias. Three studies used a control of no mouthrinse or placebo, while three studies compared fluoride mouthrinses to regular brushing alone. Pooling of results was not possible due to heterogeneity in study designs. Four studies reported a decreased formation of white spot lesions in the group using fluoride mouthrinses daily, while one study reported no statistical significance and another reported that high frequency brushing with highly potent fluoride dentrifice showed lesser white spot lesion formation.
Conclusions: Based on the limited evidence available, fluoride mouthrinses appear to reduce the occurrence of white spot lesions in patients undergoing orthodontic treatment. Further well-designed trials adhering to reporting guidelines and using objective measures are necessary before outlining universal guidelines for best practice.