The systematic review was commissioned by the Australian National Health and Medical Research Council (NHMRC) to evaluate the scientific literature relating to the health effects of fluoride and fluoridation. The systematic review's research questions relate to the caries-reducing benefits and associated potential health risks of providing fluoride systemically (via addition to water, milk and salt) and the use of topical fluoride agents, such as toothpaste, gel, varnish and mouthrinse. Although the review summarises the recent evidence, it does not constitute health policy or clinical practice recommendations. A literature search was undertaken using the Medline and Embase databases (via www.embase.com
 ). In addition, the Cochrane Systematic Review and Clinical Trial databases were searched to help identify additional systematic reviews and original studies. Because of the availability of recent systematic reviews, searches were limited to publications from 1996 onwards . The search was conducted in December 2006 and limited to English-language publications. Based on types of intervention (individual or population) and the outcomes assessed (efficacy or safety), the hierarchy of study types considered most relevant for answering each of the clinical questions defined in this review was chosen (Table 1). The levels of evidence used by NHMRC for intervention and aetiological studies are summarised in Table 2.
 Screening of eligible studies was conducted by three reviewers. Data were extracted for all of the included systematic reviews and individual studies using standardised data-extraction forms. This included information about the study design, NHMRC level of evidence, population, intervention, comparator, outcome definitions and results. Information relating to potential biases and study quality were also extracted. Where appropriate, study results were pooled using standard meta-analysis techniques. In total, 5418 nonduplicate citations were identified. After applying the inclusion and exclusion criteria, 408 citations were considered potentially eligible for inclusion in the review. After the review of the full papers of potentially eligible articles, 77 citations were included in the review. The summary of findings was presented in the context of the research questions (Table 3).
 Fluoridation of drinking water remains the most effective and socially equitable means of achieving community-wide exposure to the caries prevention effects of fluoride. It is recommended (see also www.nhmrc.gov.au/news/media/rel07/_files/fluoride_flyer.pdf
 ) that water be fluoridated in the target range of 0.6–1.1 mg/l, depending on the climate, to balance reduction of dental caries and occurrence of dental fluorosis.n particular with reference to care in hospital for those following stroke.

/pdf/a-systematic-review-of-the-efficacy-and-safety-of-l84tk2wkvy.pdf

A systematic review of the efficacy and safety of fluoridation

BACKGROUND: The need for improved oral hygiene routines in individuals with disabilities has been documented in many reports. The aim of this study was to evaluate whether visual pedagogy is a suit ...

Teaching oral hygiene to children with autism.

Aim To describe the occurrence of dental caries at the person, tooth and tooth surface level from childhood to early mid-life. Background No studies have reported on age and caries experience in a population-based sample through the first half of life. Methods Prospective cohort study of a complete birth cohort (n = 1,037) born in 1972/73 in Dunedin, New Zealand. Dental examinations were conducted at ages 5, 9, 15, 18, 26, 32 and 38, and participation rates remained high. Surface-level caries data were collected at each age (WHO basic methods). Statistical analyses and graphing of data were undertaken using Intercooled Stata Version 10. Results Data are presented on dental caries experience in the permanent dentition at ages 9, 15, 18, 26, 32 and 38. Percentile curves are charted and reported for person-level caries experience. Data are also presented on the number of decayed teeth and tooth surfaces, (including root surfaces at age 38), as a function of the number of teeth and surfaces present, respectively. Across the cohort, the number of tooth surfaces affected by dental caries increased by approximately 0.8 surfaces per year (on average), while the percentage of at-risk tooth surfaces affected by caries increased by approximately 0.5% per year, with negligible variation in that rate throughout the observation period. Conclusion These unique data show clearly that dental caries continues as a disease of adulthood, remaining important beyond childhood and adolescence and that rates of dental caries over time remain relatively constant.

/pdf/permanent-dentition-caries-through-the-first-half-of-life-41omaue9iz.pdf

Permanent dentition caries through the first half of life

The aim of this study is to assess whether the dental caries experience is higher in children with an autistic disorder (AD) than in normal children. Three schools for autistic children and three standard elementary schools in Istanbul, Turkey, were included in a cross-sectional study. Subjects were orally examined. Socio-demographic information and data about their oral care habits were obtained from their parents from records. Sixty-two children with AD and 301 children without AD were examined. Their ages varied between 6 and 12 years. Children with AD compared to those without AD had lower experience of caries. Logistic regression analysis of DMFT showed that the dental status was positively affected in younger children (OR = 15.57; 95% CI 7.62, 31.80), children from families with high income (OR = 5.42; 95% CI 2.31, 12.75), children brushing teeth regularly (OR = 2.01, 95% CI 1.10, 3.68), children consuming less sugar (OR = 5.01; 95% CI 2.57, 9.76) and in those with AD (OR=3.99; 95% CI 1.56, 10.19). Children with AD had better caries status than children without AD at younger ages.

Do autistic children have higher levels of caries? A cross-sectional study in Turkish children.

Attention deficit hyperactivity disorder (ADHD) is a common developmental disorder. This study tested the hypothesis that children with ADHD exhibit a higher caries prevalence and poorer oral health behavior than children in a control group. Twenty-one children with ADHD and a control group of 79 children, all aged 13 yr, underwent a clinical dental examination and completed two questionnaires on dietary habits and dental hygiene habits. Differences between the groups regarding decayed, missed, or filled surfaces, decayed surfaces, initial caries lesions, and gingival inflammation were non-significant. Forty-eight percent in the ADHD group brushed their teeth every evening compared with 82% in the control group. The corresponding frequencies for brushing the teeth every morning were 48% and 75%. Children with ADHD were 1.74 times more likely to eat or drink more than five times a day than children in the control group. In conclusion, at age 13, children with ADHD do not exhibit a statistically significantly higher caries prevalence but do have poorer oral health behavior than children in a control group. The intervals between dental examinations of children with ADHD should be shorter than for other children to prevent a higher caries incidence in adolescence because of their oral health behavior.

Dental caries and oral health behavior in children with attention deficit hyperactivity disorder

Experience in practice has suggested that children with attention-deficit hyperactivity disorder (ADHD) tend to have higher numbers of diseased, missing and filled teeth (DMFT score) than children wit

Is Attention-Deficit Hyperactivity Disorder a Risk Factor for Dental Caries?

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Is Attention-Deficit Hyperactivity Disorder a Risk Factor for Dental Caries?