Overview
Fluoride mouth rinses (FMR) are neutral water solutions containing between 0.05% (230 ppm) and 0.2% (900 ppm) sodium fluoride, with or without flavour. They are traditionally applied in school-based programmes but currently also recommended by dental professionals for home use. The fluoride ions interact with the tooth structures and the oral biofilm to prevent caries.
Use and Application
10 mL of the solution is “swished” around the teeth for 1 minute 1-2 times per day. The solution should be spat out and not swallowed. Avoid eating and tooth brushing for 60 minutes. The lower concentration (0.05%) is intended for children between 6 and 12 years, the higher (0.2%) for caries-active subjects above 12 years. Children younger than the age of 6 should not use fluoride mouth rinses as they lack the ability to spit out effectively.
Effectiveness
In supervised fluoride mouth rinsing programs among children and adolescents, the caries preventive effect is 27% in comparison with placebo [1]. Some clinical trials have shown that the caries preventive effect of FMR equals that of professional fluoride applications. Fluoride mouth rinses seem better than placebo in arresting root caries in dry mouth elderly.
Safety
Fluoride mouth rinses are safe to use [2].
Cost Effectiveness
The cost-effectiveness of FMR, particularly in supervised school settings, is specifically favourable in communities with low fluoride exposure and low socio-economic status. The cost-effectiveness compared with other preventive strategies for children is however sparsely investigated.
Recommendations
FMR is a home-use option for high risk and caries active subjects over 6 years of age. In particular, daily rinses are suitable for patients undergoing orthodontic treatment and for compliant dry mouth patients and those with irregular, non-daily tooth brushing with fluoride toothpaste.
Key Further Reading
1. Fluoride mouth rinses for preventing dental caries in children and adolescents.
Marinho VC, Chong LY, Worthington HV, Walsh T. Fluoride mouth rinses for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2016;7:CD002284.
2. Fluoride and Oral Health.
O’Mullane DM, Baez RJ, Jones S, Lennon MA, Petersen PE, Rugg-Gunn AJ, Whelton H, Whitford GM. Fluoride and Oral Health. Community Dent Health. 2016;33:69-99.
Guidance Document
ACFF Members can download the download the full reference document for Fluoride Mouth Rinse.