Theresa Cleary, Enas M Rostom, Reyes Enciso, Roseann Mulligan
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引用次数: 0
Abstract
Introduction: To evaluate the efficacy of dental varnishes/gels in the prevention/management of dental caries in older adults.
Methods: Cochrane, PubMed, Web of Science and EMBASE were searched through March 2024 for randomized controlled trials (RCT) including patients aged ≥ 60 years (or average age ≥ 60 years) utilizing varnish or gel interventions. Outcomes included caries incidence and lesion progression or reversal.
Results: Of 112 abstracts reviewed, 10 RCTs (unclear or high risk of bias) were included. One study showed 1% chlorhexidine (CHX)-1% thymol varnish applied 7 times over 12 months significantly reduced carious/filled surfaces versus placebo (p < 0.001) and improved active lesions (RR = 2.00, p = 0.018). Monthly 5% sodium fluoride (NaF) varnish with professional brushing significantly improved outcomes versus standard fluoride toothpaste and oral hygiene instructions [OHI] (RR = 1.63, p = 0.002). When professional cleaning and OHI were provided quarterly, adding varnishes (1% CHX-1% thymol or 5% NaF) showed no significant additional benefit. Evidence quality was low to moderate due to heterogeneity and bias.
Conclusion: Quarterly professional cleaning with OHI was as efficacious as adding either the 1% CHX-1% thymol or 5% NaF varnishes. Applying dental varnishes in the office every 3 months could be a more practical option for the delivery of preventive modalities to older adults who could have cognitive or physical limitations that negatively impact the frequency of daily or weekly use at home of toothpaste or rinses. Future research should evaluate cost-effectiveness and adherence to preventive protocols across different patient functional and behavioural abilities and care settings.
期刊介绍：
The ultimate aim of Gerodontology is to improve the quality of life and oral health of older people. The boundaries of most conventional dental specialties must be repeatedly crossed to provide optimal dental care for older people. In addition, management of other health problems impacts on dental care and clinicians need knowledge in these numerous overlapping areas. Bringing together these diverse topics within one journal serves clinicians who are seeking to read and to publish papers across a broad spectrum of specialties. This journal provides the juxtaposition of papers from traditional specialties but which share this patient-centred interest, providing a synergy that serves progress in the subject of gerodontology.
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