Caries Prevention by Professional Fluoride Gel Application on Enamel and Dentinal Lesions in Low-Caries Children

In a double-blind randomized controlled clinical trial, the caries-reducing effect of semi-annually applied fluoride gel in a low-caries child population initially aged 4.5–6.5 years (n = 773) has been investigated. Secondary analyses of the data were performed to study the caries reduction including non-cavitated lesions. The treatment effect of fluoride gel was calculated as preventive fraction (PF). When enamel lesions were included in DFS count (D 2 grade), the PF was 22% as compared to 26% counting dentinal lesions. The PFs showed that the mean effect of professionally applied fluoride gel was highest (71%) for D 3 S in the permanent dentition and lowest for d 3 s in the primary dentition (5%). The PFs for approximal and buccal and lingual surfaces of the permanent dentition significantly decreased from 80 to 25% and from 60 to 37% when enamel lesions (D 2 S) were included. With the exception of the buccal and lingual surfaces, in the primary dentition the PFs varied slightly when enamel lesions were included. Inclusion of non-cavitated lesions in the treatment effect statistics did not change the former conclusion that the treatment effect of fluoride gel application on dental caries reduction in a low-caries child population was considered not clinically relevant.