Dental caries has moved from a disease confined to childhood to one prevalent in adults, with the incidence of new carious lesions in adults now being as high as that in children and root caries now affecting 29 per cent of those aged 65 and over.
Increasing fluoride availability continues to be the cornerstone of caries-preventive strategies since the introduction of water fluoridation schemes over five decades ago. Various modes of fluoride delivery have evolved, each with its own recommended concentration, frequency of use, and dosage schedule. The use of topically applied high strength fluorides has also increased. Cochrane Systematic Reviews have concluded that Fluoride toothpastes reduce caries in the primary and permanent dentitions by up to 37 per cent and 24 per cent respectively, Fluoride Varnish (22,600 ppm / F) reduces caries by 33% in the primary dentition and 46 per cent in the permanent dentition, and fluoride mouthwash also reduces caries in the permanent dentition by 26 per cent.
Dental professionals recommending fluoride therapies, such as a fluoride rinsing programme in addition to the regular use of fluoride toothpaste, can be reassured about the resulting increased caries protection. A systematic review comparing a combination of topical fluorides concluded that a fluoride rinse when used in combination with fluoride toothpaste, reduced caries by a further 10 per cent compared to the use of fluoride toothpaste alone. This additional benefit provides dental professionals with the rationale to recommend a combination approach to help protect their higher risk caries patients, including adults with active caries, exposed roots or reduced salivary flow.
Ideally, Colgate Duraphat daily mouthwash should be used at a different time from toothbrushing in order to maintain the concentration of fluoride in plaque throughout the day.