Background: As a low-cost and easily operated treatment, the use of professionally applied topical fluoride was\napproved for preventing dental caries and remineralising early enamel caries or white spot lesions. It is also used to\narrest dentine caries. The aim of this study is to investigate the clinical efficacy of professional fluoride therapy in\nremineralising and arresting caries in children.\nMethod: A systematic search of publications from 1948 to 2014 was conducted using four databases: PubMed,\nCochrane Library, ISI Web of Science and Embase. The key words used were (fluoride) AND (remineralisation OR\nremineralization OR arresting) AND (children caries OR early childhood caries). The title and abstract of initially\nidentified publications were screened. Clinical trials about home-use fluorides, laboratory studies, case reports,\nreviews, non-English articles and irrelevant studies were excluded. The full texts of the remaining papers were\nretrieved. Manual screening was conducted on the bibliographies of the remaining papers to identify relevant\narticles.\nResults: A total of 2177 papers were found, and 17 randomised clinical trials were included in this review. Ten\nstudies investigated the remineralising effect on early enamel caries using silicon tetrafluoride, fluoride gel, silver\ndiamine fluoride or sodium fluoride. Seven studies reported an arresting effect on dentine caries using silver\ndiamine fluoride or nano-silver fluoride. Meta-analysis was performed on four papers using 5 % sodium fluoride\nvarnish to remineralise early enamel caries, and the overall percentage of remineralised enamel caries was 63.6 %\n(95 % CI: 36.0 % - 91.2 %; p < 0.001). Meta-analysis was also performed on five papers using 38 % silver diamine\nfluoride to arrest dentine caries and the overall proportion of arrested dentine caries was 65.9 % (95 % CI: 41.2 % -\n90.7 %; p < 0.001).\nConclusion: Professionally applied 5 % sodium fluoride varnish can remineralise early enamel caries and 38 % silver\ndiamine fluoride is effective in arresting dentine caries.
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