Reconnecting Practicing Hygienists with the Nation's Leading Educators and Researchers.

Recommendations for Patients Who Refuse Fluoride

In September 2011, expert panelists from the American Dental Association (ADA) Council of Scientific Affairs published “Clinical Practice Guidelines: Non-Fluoride Caries Preventive Agents: Evidence-Based Clinical Recommendations.” ebd.ada.org/​ClinicalRecommendations.aspx. An update of these guidelines is anticipated to be released in 2020. The existing document provides weighted recommendations for specific nonfluoride caries prevention agents. Two agents were recognized by the panel: sucrose-free polyol and chlorhexidine thymol varnish.

Photo Credit: AlfaOlga / iStock / Getty Images Plus

Xylitol Chewing Gum

Sucrose-free polyol (xylitol only or polyol combinations) chewing gum used for 10 minutes to 20 minutes after meals reduced the incidence of coronal caries, however, the panel stated the evidence level was “weak.”

Photo Credit: Eva-Katalin / E+

Chlorhexidine Varnish

The guidelines noted there was enough evidence in support of 1:1 mixture of chlorhexidine thymol varnish applied every 3 months to reduce the incidence of root caries to rule “in favor” of providing this intervention.

Photo Credit: eestingnef / iStock / Getty Images Plus

Assessing Caries Risk

If fluoride therapies are not an option, continual assessment of caries risk is a must. Dietary/​nutritional counseling as well as sugar and carbohydrate reduction strategies are strongly encouraged to promote both oral and overall systemic health. Sealants are also highly recommended for pit and fissure caries prevention. Drinking water frequently is imperative for patients presenting with medication induced-xerostomia, which significantly increases caries risk.

Photo Credit: Kateryna Kotsiuba / iStock / Getty Images Plus

Looking Ahead

Professionally applied topical fluorides continue to be the gold standard in caries prevention. Per the ADA, nonfluoride agents should be used solely as adjuncts to an established caries prevention plan. Thank you for helping your patients achieve optimal health with customization for their holistic preferences. Please stay tuned for the upcoming ADA report on nonfluoride caries preventive agents for future updates on this topic.

Photo Credit: digitalskillet / iStock / Getty Images Plus
This information is from the article What Can I Recommend to Patients Who Abstain From Fluoride? By Erin Relich, RDH, BSDH, MSA. To read the article, click here.

Leave A Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.

This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish. Accept Read More

Privacy & Cookies Policy