Prevention of Dental Caries With Fluoride Slow-Releasing Devices in Children

In many countries the distribution of dental caries has become "bimodal", with 80% of the disease present in only 20% of the population. Consequently, there has been a shift in the emphasis for providing preventive advice from the general population to targeting those who are high "caries-risk". The mainstay of preventive measures are the judicious use of fluoride, plaque control, fissure sealants and sensible dietary advice. Originally it was thought that the incorporation of large amounts of fluoride into enamel were responsible for the reduction of enamel solubility. However, it is the activity of the fluoride ion in the oral fluid that is of most importance in reducing the solubility of the enamel rather than a high content of fluoride in enamel. This is now the most widely accepted view of the role of fluoride in the prevention of dental caries. Objective:the latest fluoride research is investigating the use of slow-release devices for the long term intra-oral provision of fluoride. Method: a double blind clinical trial over a period of 2 years involving 174 children aged 8yrs living in an inner city area of Leeds using fluoride slow-releasing glass devices. Results:this showed 67% fewer new carious teeth and 76% fewer new carious surfaces, and are therefore, effective in preventing caries in children. There were 55% fewer new occlusal fissure carious cavities showing that occlusal surfaces were also protected by the fluoride released from the devices. Conclusions:the fluoride devices release low levels of fluoride for at least two years and have great potential for use in preventing dental caries in high "caries-risk" groups and irregular dental attenders.