A systematic review of selected caries prevention and management methods

A systematic review of the periodic scientific literature was undertaken to determine the strength of the evidence for the efficacy of professional ca ries preventive methods applied to high risk individuals, and the efficacy of professionally applied methods to arrest or reverse non-cavitated cariou s lesions. An initial search identified 1435 articles, of which 27 were eve ntually included in the review. Among the 22 studies addressing the prevent ion of carious lesions in caries-active or high risk individuals, the stren gth of the evidence was judged to be fair for fluoride varnishes and insuff icient for all other methods. Among the seven studies addressing the manage ment of non-cavitated carious lesions, the strength of the evidence for eff icacy was judged to be insufficient for all methods. The results do not ind icate that the preventive and management methods reviewed are not efficacio us; rather, they demonstrate that not enough is known to determine the effi cacy of the methods. Suggestions for strengthening the limited evidence bas e involve the following: i) increasing the number of studies that examine p revention among high risk individuals and non-surgical management of non-ca vitated lesions, ii) including a wider variety of subject ages, iii) target ing aspects of the efficacy questions not yet addressed, iv) strengthening research methods employed mi the studies, and v) reporting methods and outc omes more completely.