Supervised regular use of fluoride mouthwash by children and adolescents is associated with a large reduction in tooth decay in permanent teeth
Tooth decay is a health problem worldwide, affecting the vast majority of adults and children. Repair and replacement of decayed teeth is costly in terms of time and money, and is a major drain on the resources of healthcare systems. Preventing tooth decay in children and adolescents is regarded as a priority for dental services and is considered more cost-effective than treatment. Use of fluoride, a mineral that prevents tooth decay, is widespread. As well as occurring naturally, fluoride is added to the water supply in some areas, and is used in most toothpastes and in other products that are available to varying degrees worldwide. As an extra preventive measure, fluoride can be applied directly to teeth as mouthrinses, lozenges, varnishes, and gels.
Fluoride mouthrinse has frequently been used under supervision in school-based programmes to prevent tooth decay. Supervised (depending on the age of the child) or unsupervised fluoride mouthrinse needs to be used regularly to have an effect. Recommended procedure involves rinsing the mouth one to two minutes per day with a less concentrated solution containing fluoride, or once a week or once every two weeks with a more concentrated solution. Because of the risk of swallowing too much fluoride, fluoride mouthrinses are not recommended for children younger than six years of age.
A team of Cochrane authors based in the United Kingdom worked with Cochrane Oral Health to investigate how effective and safe the use of fluoride mouthrinse are for preventing tooth decay in children and adolescents compared with placebo (a mouthrinse without the active ingredient fluoride) or no treatment. The team included 37 randomized controlled trials with 15,813 children from age six to 14. The evidence was rated to be of moderate quality.
The review found that supervised regular use of fluoride mouthrinse by children and adolescents is associated with a large reduction in caries increment in permanent teeth. Most of the evidence evaluated use of fluoride mouthrinse supervised in a school setting, but the findings may be applicable to children in other settings with supervised or unsupervised rinsing, although the size of the preventive effect is less clear. Very little evidence is available to assess adverse effects.
- Read the full Cochrane Review
- Visit the Cochrane Oral Health Website
- Read the Plain Language Summary
- Listen to the podcast
- ‘Rinse and repeat: fluoride mouthrinses can prevent tooth decay in children’: blog post on Evidently Cochrane
- ‘Supervised use of fluoride mouthrinse results in large reductions in decay in children’s permanent teeth’: blog post on Cochrane Oral Health Editorial base blog
- 'Fluoride mouthrinse: regular supervised use reduces tooth decay in children': blog post on The Dental Elf