High Fluoride Concentration Toothpastes for Children and Adolescents

The purpose of this review is to present the available evidence to support the use of dentifrices with high (>1,500 ppm) concentrations of fluoride to help in the prevention and treatment of caries in high-risk children and adolescents. Recent evidence from high-quality systematic reviews supports the dose-response relationship between caries prevention and fluoride levels, and there is good evidence from randomised clinical trials to support the use of high fluoride dentifrices. Such products are typically prescribed oral pharmaceuticals that require thorough risk assessment by the clinician and restricting use in those less than 6 years old to cases where the risk of severe morbidity caused by caries is greater than that of aesthetically objectionable fluorosis and which should mitigate the risk of fluorosis. Further research is required on the use of population- or community-based interventions using such products and currently, the evidence for dentifrices containing more than 2,900 ppm is weaker than for those containing 2,800 ppm or less.