Effectiveness of mouth rinses on caries prevention and arrest: an umbrella review.

OBJECTIVES

Among various fluoride delivery methods, such as toothpaste, varnishes, and water fluoridation, mouthrinses have gained attention for their versatility, ease of use, and potential to complement other preventive strategies. The aim was to evaluate the effectiveness of mouthrinses in preventing and arresting caries by synthesizing data from existing systematic reviews.

METHODS

Five electronic databases, named PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science and Scopus, were searched to identify systematic reviews that assessed the effect of mouthrinses containing chemical, herbal, or natural agents in comparison to standard oral care, placebo, water, or saline in the development or arrest of crown or root caries. Eligible reviews were selected, and data were extracted and assessed for bias.

RESULTS

Three systematic reviews with meta-analysis and four without were included, with a total of eighty-three initial studies (moderate overlap). Supervised regular use of fluoride mouthrinse can reduce coronal and root caries initiation and progression in permanent teeth for an observational period of 6 months to 4 years. The only significant effect was in favor of the fluoride mouthrinse for crown caries at 36 months and root caries at 48 months follow-up time.

CONCLUSIONS

Mouthrinses effectively reduce the occurrence of crown caries in moderate- and high-risk patients, as well as root caries in older adults. However, their anticaries benefit in populations with additional fluoride exposure remains uncertain.

CLINICAL SIGNIFICANCE: Given the great variability in the design, inclusion criteria set and conduct of the eligible systematic reviews, it is impossible to reach specific conclusions concerning the efficacy of any single product. However, it seems that fluoride mouthrinses are effective in preventing and/or arresting dental caries in moderate and high caries risk patients and may reduce initiation of root caries in older individuals.