A Lifetime Approach to Preventing Caries

It used to be said dental caries was a disease of childhood and it was children alone who benefited from fluoride, this view is now outdated. While it is true that fluoride can be incorporated during tooth development, the general consensus is that the topical delivery of fluoride post eruption is critical in effective prevention of caries. This means prevention through increasing fluoride availability is required throughout life and provides benefits to all age groups.1

Dental teams asked for clear guidance on the preventive advice they should give, and the actions they should take, to ensure they are doing the best for their patients in preventing and managing caries. ‘Delivering better oral health - An evidence-based toolkit for prevention’, published by Public Health England and now in its third edition2 is intended for the whole dental team. This guidance document summarises the evidence based advice and clinical interventions dental teams can use to help prevent caries in their patients.

Colgate offers a portfolio of products supported by clinically proven efficacy. This comprehensive range includes medically licensed products for the prevention and management of caries. Colgate® Duraphat® offers a trusted range of clinically proven products to increase fluoride availability to prevent caries. This range includes professional application and patient at-home use products to help deliver an effective prevention programme meeting the needs of children, adolescents, adults and the elderly.

 

Evidence Based Caries Prevention: Home Use 
Colgate® Duraphat® 2800ppm Fluoride Toothpaste is indicated for patients giving cause for concern for developing caries who are aged 10 years or over. Colgate® Duraphat® 2800ppm fluoride toothpaste can help prevent caries developing on emerging permanent dentition with a 20% caries reduction in DMFS.3 This is especially useful for those patients who have already experienced caries during childhood, or have an increased likelihood of developing caries.

Colgate® Duraphat® 5000ppm Fluoride Toothpaste is indicated for patients giving cause for concern in developing caries who are aged 16 years and over. Clinically proven, Colgate® Duraphat® 5000ppm fluoride toothpaste prevents caries in adolescent and adult patients. Results from the Adult Dental Health Survey 2009 show over the last 30 years the proportion of adults in England without natural teeth has fallen from 28% in 1978 to only 6% 2009.4 With prevalence and severity of gingival recession increasing with age, so too does the risk of root caries. Clinical studies for Colgate® Duraphat® 5000ppm Fluoride toothpaste report a 76% reduction in root carious lesions5 benefiting patients with exposed roots, active root caries or a history of periodontal disease.

Both Colgate® Duraphat® fluoride toothpastes are available to prescribe from the dental practitioners’ formulary.

 

Evidence Based Caries Prevention: Professional Application 
There is a wealth of evidence for the effectiveness of fluoride varnish in preventing caries in both primary and permanent dentitions. The latest systematic review conclude twice-yearly applications of fluoride varnish result in a mean reduction of caries, 37% in the primary dentition and 43% in the permanent dentition.6

Colgate® Duraphat® fluoride varnish is the only fluoride varnish licensed for caries prevention and should be applied as a thin layer to all susceptible surfaces. Guidance within ‘Delivering better oral health –An evidenced based toolkit for prevention’,2 recommends two or more applications per year for caries prevention in all children aged 3 years and above. Adults also giving cause for concern should also receive twice yearly applications of fluoride varnish to prevent caries.2

Colgate® Duraphat® 2800ppm Fluoride Toothpaste, PL0049/0039, Legal Status: POM 
Colgate® Duraphat® 5000ppm Fluoride Toothpaste, PL0049/0050, Legal Status: POM 
Colgate® Duraphat® fluoride varnish, PL0049/0042, Legal Status: POM

References:
1. An Update on Fluoride and Dental Health, A. Rugg-Gunn, R. Davies, Colgate 2004. 
2. Delivering better oral health – An evidenced-based toolkit for prevention, third edition, Public Health England, June 2014. 
3. Biesbrock AR et al, (2001) Community Dent Oral Epidemiol; 29:382-389 
4. Adult Dental Health Survey 2009, The NHS Health and Social Care Information Centre, May 2011 
5. Baysan et al: Caries Res. 2001; 35:41-46 
6. Marinho VCC, et.al. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database of Systematic reviews 2013, Issue 7. Art No. CD002279.