CONTENT: Multiple databases were searched (MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Web of Science). Two reviewers independently screened sources, extracted data and assessed study quality. Results were synthesised qualitatively and quantitatively. The main outcome measure was the prevalence of dental fluorosis.
SUMMARY: Six studies of cross-sectional design were included. Two studies were scored as evidence level B (moderate) and the remaining four publications were evidence level C (poor). Meta-analysis indicated fluorosis prevalence was significantly decreased following either a reduction in the concentration of fluoride or cessation of adding fluoride to the water supply (OR:6.68; 95% CI:2.48 to 18.00).
OUTLOOK: The evidence suggests a significant decrease in the prevalence of fluorosis post cessation or reduction in the concentration of fluoride added to the water supply. However, this work demonstrates that when studies are subject to current expectations of methodological and experimental rigour, there is limited evidence with low methodological quality to determine the effect of stopping or reducing the concentration of fluoride in the water supply on dental fluorosis.
METHODS: This study involved lifelong residents aged 9- and 12-year-olds in fluoridated and nonfluoridated areas in Malaysia (n = 1155). In the fluoridated area, children aged 12 years and 9 years were exposed to 0.7 and 0.5 ppm, respectively, at the times when maxillary central incisors developed. Standardized photographs of maxillary central incisors were blind scored for fluorosis using Dean's criteria. Dental caries was examined using ICDAS-II criteria.
RESULTS: The prevalence of fluorosis (Dean's score ≥ 2) among children in the fluoridated area (35.7%, 95% CI: 31.9%-39.6%) was significantly higher (P
MATERIALS AND METHODS: Four online databases (PubMed, ScienceDirect, Scopus, and Web of Science) were searched using different MeSH terms and Boolean Operators to retrieve the articles (until June 2021), followed by a hand-search of the reference list of the included articles. All full-text, original studies in English that evaluated SDF staining and at least one SDF modification/alternative were included.
RESULTS: Among the assessed studies, nine studies explored the stain-minimization effect of potassium iodide (KI) post-application following SDF treatment. Among these, eight concluded that KI application after SDF treatment significantly reduced tooth staining, while one showed marginal staining following glass ionomer restoration of the SDF-treated dentine. Additionally, one study applied potassium fluoride (KF) and silver nitrate (AgNO3 ) concurrently to mitigate SDF-mediated staining. One study compared SDF staining with polyethylene glycol (PEG)-coated nanoparticles containing sodium fluoride (NaF), and another used nanosilver fluoride (NSF) for staining comparison with SDF.
CONCLUSIONS: Within the limitations of this study, the addition of different materials to SDF has proven to be a beneficial strategy for overcoming tooth staining associated with SDF. Future studies are warranted, particularly clinical trials, to validate these findings.
CLINICAL SIGNIFICANCE: SDF-mediated tooth staining is a serious concern that limits its clinical use. A review of various strategies to overcome this problem will help clinicians enhance its clinical use and patient acceptance.
METHODS: A cross-sectional study was conducted among school children of Grade Seven in 12 schools of Kaski district in Nepal. Schools were randomly selected from the urban and semi-urban areas in the district. Data were collected covering oral health knowledge, socio-demographic characteristics, oral health condition and practices. The factors of poor oral health condition and practices were examined using t-test, one-way ANOVA, and multiple linear regression.
RESULTS: Of the total participants (n = 669), 54.9% were females and their mean DMFT score was 1.82 (SD = 1.07). Total decayed score was higher among those who did not have knowledge that fluoride prevents decay compared to those who had knowledge about it (Being aware of fluoride prevents decay: Mean = 1.21 (SD = 1.54) versus not being aware of that: mean = 2.13 (SD = 2.13); p = 0.029). Females were more likely to have higher DMFT scores compared to males (β-coefficient = 0.43, 95% CI 0.13, 0.73, p = 0.005). In addition, higher knowledge score was negatively associated with higher DMFT score (β-coefficient = - 0.09, 95% CI - 0.20, -0.01, p = 0.047).
CONCLUSION: Being female students and those having lower level of knowledge on oral health attributed to higher DMFT index. Periodic dental check-up coupled with oral health education on regular brushing, use of fluoridated paste, tongue cleaning and care of gum diseases are recommended in schools.