Comparing the Effectiveness of Topical Fluoride and Povidone Iodine with Topical Fluoride Alone for the Prevention of Dental Caries among Children: A Systematic Review and Meta-analysis

• Published in: International journal of clinical pediatric dentistry Vol. 13; no. 5; pp. 559 - 565
• Main Authors: Gupta, Arpit, Nishant, Sharda, Shweta, Kumar, Amit, Goyal, Ashima, Gauba, Krishan
• Format: Journal Article
• Language: English
• Published: India Jaypee Brothers Medical Publishers 01.09.2020
• Subjects: Review; Dental caries; Povidone-iodine; Topical fluorides; Mutans Streptococci; Systematic review; Lactobacillus; Meta-analysis
• ISSN: 0974-7052; 0975-1904
• DOI: 10.5005/jp-journals-10005-1844

Combined use of povidone iodine (PI) along with topical fluorides (TF) has been suggested as a promising strategy to reduce dental caries incidence and cariogenic bacterial load. However, the available literature presents mixed evidence regarding its effectiveness as compared to TF application alone. 'TF + PI' vs TF alone in the prevention of dental caries among 1-12-year-old children assessed through caries increment and mean and counts. Five databases (Cochrane Central Register of Controlled Trials, EBSCOhost, PubMed/Medline, Scopus, and Web of Science) were searched for relevant literature. Out of 72 studies that were screened, 7 eligible studies were included out of which 4 studies were subjected to meta-analysis. The generic inverse variance test was used to assess the primary outcome reported as mean ± SD/events occurred (caries incidence), whereas for mean post-intervention colony count, inverse variance function was used. The Cochrane's Collaboration tool and Modified Downs and Black scoring criteria were used to evaluate the quality of the included articles. Heterogeneity across the studies was assessed using the statistic. Statistical significance was set at < 0.05. Overall, for primary and permanent dentition combined, the dental caries incidence was found to be significantly lower in the 'TF + PI' combined therapy group as compared to TF alone [SMD -0.4 (-0.78 to -0.03), = 0.04]. The two groups showed no significant difference with respect to post-intervention count [SMD -0.1 (-0.57 to +0.37), = 0.69]. No study was found that compared post-intervention count between the two groups. Based on the pooled analysis from the limited literature available, there is a very low quality of evidence that 'TF + PI' combined therapy is more effective in the prevention of new caries lesions among 1-12-year-old children as compared to TF use alone. Future clinical trials with robust methodologies are recommended to generate conclusive evidence. PI application might exert an added benefit with TF in preventing the occurrence of new carious lesions among 1-12-year-old children. Gupta A, Nishant, Sharda S, Comparing the Effectiveness of Topical Fluoride and Povidone Iodine with Topical Fluoride Alone for the Prevention of Dental Caries among Children: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2020;13(5):559-565.