The 2016 Cochrane UK & Ireland Symposium Health Professional winning infographic was based on a review from the Cochrane Oral Health Group, Fluoride toothpastes of different concentrations for preventing dental caries in children and adolescents.
The review found some evidence of a dose-response effect in the prevention of caries when the concentration of fluoride in toothpaste is increased. The effect becomes statistically significant above 1000 parts per million (ppm) compared with placebo, but there was no evidence of a difference in caries-preventive effect between placebo and fluoride toothpastes containing 550ppm or less.
Andrew Geddis-Regan, a Dental Core Trainee based at Liverpool University Dental Hospital, used the review as the basis of his Health Professional submission to compete for attending (including travel and accommodation) the Cochrane UK & Ireland Symposium 2016 in Birmingham. If you missed out attending, all tweets relating to the Symposium can be found here: #CochraneBham
Andrew demonstrated through his prizewinning infographic how he had used this Cochrane review to improve clinical practice in a North Yorkshire dental practice.
He and his team used the findings of the review to evaluate their current practice, implement appropriate evidence-based changes (in a pilot cohort study of 100 randomly selected patients under the age of 18), before then measuring the impact of their intervention.
They advised patients and dental practice staff to use toothpastes containing an appropriate concentration of fluoride to prevent tooth decay, and were able to demonstrate a 29% increase in patients using 1000ppm+ fluoride toothpaste within 6 months of the pilot.
Their adoption of the dose-response findings of this Cochrane review relating to patients at greatest risk was associated with a 13% increase in prescriptions of 2800ppm toothpaste to high-risk children over the age of 10. This is a tremendous accomplishment in a region that suffers a greater burden of dental caries in children than other areas in England, with the second highest prevalence in 5-year-olds in 2011-12 and highest prevalence in 12-year-olds in 2008-09 (see infographic beneath for references).
The review on which this important practice change was based is now freely available through open access from the Cochrane Library. It was published in 2010 and is currently being updated.
Review citation:
Walsh T, Worthington HV, Glenny AM, Appelbe P, Marinho VCC, Shi X. Fluoride toothpastes of different concentrations for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No.: CD007868. DOI: 10.1002/14651858.CD007868.pub2.
