An alternative to the controversy surrounding the implementation of water fluoridation (WF) for caries prevention is salt fluoridation (SF). The aim of this systematic review was to assess the caries preventative effect of SF in the primary dentition in children. There were two objectives: (1) To compare the caries preventive effects of SF versus no exposure in 6 year-old children (2) To compare SF versus other community based interventions (water or milk fluoridation) for caries prevention in the primary dentition. Methods: The search strategy covered 9 English electronic databases. For inclusion, papers had to report on the caries preventative effect of groups (with controls) that were exposed to SF in the form of mean dmft or dft scores with standard deviations. Differences in exposed and non-exposed groups were computed on the basis of weighted mean differences (WMDs) with 95% confidence intervals (CIs). Results: For 6 year-olds, only one study from and one from were included. The French study reported on dft scores among 6 year olds between 1987 and 1991 (4 years exposure). The dft score was significantly reduced from 3.48 (pre- SF) to 2.48 (post –SF; p <0.001), implying a -1.01 reduction (95% CI -1.26 to -0.76) in mean dft score between pre- and post-exposure. In Hungary, the dmft scores for 6 year-olds between pre-and post exposure (1966-1974) was reduced from 4.18 to 2.43 (-1.75 reduction [95% CI: -2.76 to -0.74]). There were no studies that compared dmft scores when SF and WF were implemented in different groups. Conclusion: For the 2 included studies, there were significant caries preventive effects as measured by improvements in dmft or dft scores. However, these findings cannot be considered as conclusive due to the limited number of included studies in this review.
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