Caries Control by the Use of Fluoride and Chlorhexidine

Dental caries is one of the most prevalent chronic diseases that affect people of all ages worldwide. The primary prevention should be based on common risk factors and early lesions should be managed by a minimally invasive tissue-preserving approach. In recent years, several systematic reviews of clinical trials have reinforced strong evidence for fluoride toothpaste as the most cost-effective measure to prevent and control caries in childhood. For those at moderate and high risk however, additional preventive treatments may be indicated. The presentation will examine the evidence for an anti-caries efficacy of fluoride- and chlorhexidine-containing dental varnishes by assessing recent systematic reviews and randomized controlled trials. Only studies with clinical caries as endpoint were considered. For topical F-varnish applications 2-4 times per year, the evidence was moderately strong for a caries-inhibiting effect both in the permanent and deciduous dentitions with an estimated prevented fraction of around 30%. Although numerous studies reported that CHX-varnishes could significantly suppress the growth of mutans streptococci in plaque and saliva, its ability to prevent and control caries was unclear with conflicting findings. Limited evidence was however found that CHX-varnish treatments could be beneficial in fissures of newly erupted permanent molars. In conclusion, professionally applied topical fluoride, such as F-varnish, should be considered for patients at moderate and high risk of caries. The lack of evidence for antibacterial therapy emphasizes the need for further clinical trials of high quality.