Fluoride toothpaste has been proven to help prevent tooth decay. The level of fluoride concentration that is effective for this purpose is 1000 ppm (parts per million), so that’s what most toothpaste with the ADA symbol of approval use. Although toothpastes often deviate from their stated fluoride levels, a fluoride toothpaste should generally contain this minimum amount of fluoride.
However, would a higher concentration of fluoride do a better job of protecting against cavities? A new review suggests that it might.
A Large Review of Toothpaste Effectiveness
This new review was conducted and published by the Cochrane Review. The Cochrane Review is commonly considered the top standard for evidence-based medicine because they conduct in-depth, thorough reviews that look skeptically at all treatments. The reviews not only report on what the studies say, but on how well the studies were conducted, and what that says about how well we can trust their conclusions.
In this case, researchers looked for studies published between 1955 and 2014 looking at toothpaste with fluoride. After evaluating over 7000 studies, they found 96 studies that met their inclusion criteria, studies that included nearly 70,000 individuals. Some of the studies looked at primary teeth for children, others looked at adult teeth of children, and still others looked at both primary and adult teeth. Some of the studies also looked at the impact of fluoride toothpaste on adult teeth in adults.
The review confirmed that, yes, fluoride toothpastes did prevent more tooth decay than nonfluoride toothpastes. Not a surprise, but a good thing to have evaluated.
However, the study also looked at how well different concentrations of toothpaste did at reducing decay. They found that using a toothpaste with 1450 to 1500 ppm of fluoride worked better to reduce cavities than brushing with toothpaste that has 1000 to 1250 ppm.
Researchers asserted that the benefits of using toothpaste at a minimum of 1000 ppm fluoride were well-established. But they also said that the evidence for using stronger concentrations of fluoride were less well-supported. In fact, using toothpaste with just 550 ppm fluoride was statistically indistinguishable from toothpaste with 1055 ppm fluoride in some studies. However, 1450 ppm toothpaste was significantly better than 440 ppm toothpaste. And even higher concentrations showed some likelihood of being even better, but the evidence for these comparisons got weaker. The strength of individual comparisons depended on the studies where they were done, so while they could say that it seemed higher concentrations might be better, the level of certainty was only moderate.
Comprehensive Prevention
Of course, regular brushing with fluoride toothpaste is only one part of a good oral hygiene regimen. If you are looking to truly maintain your best oral health, you will also want to floss and make regular dental appointments.
Flossing helps clean between teeth to prevent cavities on the surfaces where the teeth are closest together.
Regular dental checkups give us an opportunity to provide a professional cleaning, additional tooth treatments, and an examination to look for decay. In a professional cleaning, we remove hardened plaque deposits (called tartar) that you can’t remove with brushing. And we can supply additional fluoride treatments to strengthen teeth and polish teeth to keep plaque from sticking.
At a checkup, we can make sure that your at-home prevention routine is doing its job. If so, then no additional treatment is necessary. We might also recommend changes to your hygiene routine (including a higher concentration of fluoride in your toothpaste). And if there are any problems with your teeth, we can use tooth-coloured fillings to fix them–the sooner the better.
To round out your preventive dentistry routine with professional cleanings in the Sydney area, please call (02) 9686 7375 today for an appointment with a dentist at My Hills Dentist in Baulkham Hills.
