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Funnel Plot of D(M)FS PFs according to standard errors of the studies included in the meta‐analysis
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Figure 1

Funnel Plot of D(M)FS PFs according to standard errors of the studies included in the meta‐analysis

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Comparison 1 Topical fluoride versus placebo/no‐treatment, Outcome 1 D(M)FS increment (PF) ‐ nearest to 3 years (133 trials).
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Analysis 1.1

Comparison 1 Topical fluoride versus placebo/no‐treatment, Outcome 1 D(M)FS increment (PF) ‐ nearest to 3 years (133 trials).

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Comparison 1 Topical fluoride versus placebo/no‐treatment, Outcome 2 D(M)FT increment (PF) ‐ nearest to 3 years (79 trials).
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Analysis 1.2

Comparison 1 Topical fluoride versus placebo/no‐treatment, Outcome 2 D(M)FT increment (PF) ‐ nearest to 3 years (79 trials).

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Comparison 1 Topical fluoride versus placebo/no‐treatment, Outcome 3 d(e)fs increment (PF) ‐ nearest to 3 years (5 trials).
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Analysis 1.3

Comparison 1 Topical fluoride versus placebo/no‐treatment, Outcome 3 d(e)fs increment (PF) ‐ nearest to 3 years (5 trials).

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Comparison 1 Topical fluoride versus placebo/no‐treatment, Outcome 4 Developing one or more new caries (12 trials).
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Analysis 1.4

Comparison 1 Topical fluoride versus placebo/no‐treatment, Outcome 4 Developing one or more new caries (12 trials).

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Comparison 1 Topical fluoride versus placebo/no‐treatment, Outcome 5 Unacceptability of treatment as measured by leaving study early (10 trials).
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Analysis 1.5

Comparison 1 Topical fluoride versus placebo/no‐treatment, Outcome 5 Unacceptability of treatment as measured by leaving study early (10 trials).

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Table 1. Random‐effects metaregression analyses of prevented fractions: D(M)FS

Characteristic

Number of studies

Slope estimate

95% CI

Slope interpretation

P‐value

F Gel vs F Varnish (indirect comparison)

29

‐15%

(‐28% to ‐1.6%)

PF lower among Fluoride Gel trials

0.03

F Mouthrinse vs F Varnish (indirect comparison)

41

‐14%

(‐27% to ‐0.5%)

PF lower among Fluoride Mouthrinse trials

0.04

F Toothpaste vs F Varnish (indirect comparison)

77

‐14%

(‐27% to ‐0.6%)

PF lower among Fluoride Toothpaste trials

0.04

Control group

133

14%

(5% to 23%)

Higher PF for no‐treatment compared with placebo

0.002

Mean baseline caries

126

0.7%

(0.2% to 1.2%)

Increase in PF per unit increase in mean baseline caries

0.004

Fluoridated water

116

2.9%

(‐3.3% to 9.1%)

Higher PF in presence of water fluoridation

0.4

Background fluorides

115

‐1.5%

(‐6.7% to 3.7%)

Lower PF in presence of any background fluoride

0.6

Operator vs unsupervised (indirect comparison)

76

‐3.4%

(‐18% to 11%)

PF lower among operator applied TFT

0.7

Self applied supervised vs unsupervised (indirect comparison)

111

11%

(3.7% to 17%)

PF higher among self applied supervised TFT

0.002

Mode of use

133

13%

(0.12% to 27%)

PF higher among self applied (supervised plus unsupervised) TFT

0.5

Intensity (frequency x concentration)

128 (excludes Di Maggio 1980)

2.5%

(1% to 3.9%)

Increase in PF equivalent to doubling from 100 to 200 applications and increasing by 1000 ppmF

0.001

Frequency of application

131 (excludes Di Maggio 1980)

3%

(0.4% to 5.7%)

Increase in PF per 100 extra applications/year

0.03

Fluoride concentration

129

‐0.3%

(‐1.4% to 0.9%)

Decrease in PF per 1000 ppm F

0.6

Method of application

133

‐3.8%

(‐21% to 14%)

Lower PF for tray or paint compared with brush or rinse

0.7

Allocation concealment

133

2.6%

(‐5% to 10%)

Higher PF with poorly concealed allocation

0.6

Blind outcome assessment

133

1.4%

(‐8.7% to 12%)

Higher PF with blind outcome assessment not clearly stated

0.8

Double‐blinding

133

4.9%

(‐8.7% to 18%)

Higher PF with lack of double‐blinding

0.5

Drop out

128

1.7%

(‐0.2% to 3.5%)

Increase in PF per 10 drop outs

0.08

Language of publication

132 (excludes Di Maggio 1980)

5.9%

(‐3.1% to 15%)

Higher PF with publications only in languages other than English

0.2

Length of follow up

133

‐0.04%

(‐3.9% to 3.8%)

Decrease in PF per extra year of follow up

0.98

APF vs AmF (indirect comparison)

26

‐3.9%

(‐22% to 14%)

PF lower among APF trials

0.67

NaF vs AmF (indirect comparison)

48

‐7.6%

(‐20% to 5%)

PF lower among NaF trials

0.25

SMFP vs AmF (indirect comparison)

29

‐8%

(‐20% to 4%)

PF lower among SMFP trials

0.19

SnF2 vs AmF (indirect comparison)

28

‐9.8%

(‐22% to 2%)

PF lower among SnF2 trials

0.11
Figuras y tablas -
Table 1. Random‐effects metaregression analyses of prevented fractions: D(M)FS
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Comparison 1. Topical fluoride versus placebo/no‐treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 D(M)FS increment (PF) ‐ nearest to 3 years (133 trials) Show forest plot

133

65179

Prevented Fraction (Random, 95% CI)

0.26 [0.23, 0.29]

1.1 Fluoride toothpaste versus placebo

70

41796

Prevented Fraction (Random, 95% CI)

0.24 [0.21, 0.28]

1.2 Fluoride gel versus placebo

13

4142

Prevented Fraction (Random, 95% CI)

0.21 [0.14, 0.28]

1.3 Fluoride varnish versus placebo

3

1654

Prevented Fraction (Random, 95% CI)

0.40 [0.09, 0.72]

1.4 Fluoride mouthrinse versus placebo

30

13324

Prevented Fraction (Random, 95% CI)

0.26 [0.22, 0.29]

1.5 Fluoride gel versus no‐treatment

9

2677

Prevented Fraction (Random, 95% CI)

0.38 [0.23, 0.53]

1.6 Fluoride varnish versus no‐treatment

4

624

Prevented Fraction (Random, 95% CI)

0.52 [0.35, 0.69]

1.7 Fluoride mouthrinse versus no‐treatment

4

962

Prevented Fraction (Random, 95% CI)

0.33 [0.27, 0.40]

2 D(M)FT increment (PF) ‐ nearest to 3 years (79 trials) Show forest plot

79

41391

Prevented Fraction (Random, 95% CI)

0.26 [0.21, 0.30]

2.1 Fluoride toothpaste versus placebo

53

32186

Prevented Fraction (Random, 95% CI)

0.23 [0.19, 0.28]

2.2 Fluoride gel versus placebo

4

1525

Prevented Fraction (Random, 95% CI)

0.18 [0.09, 0.27]

2.3 Fluoride varnish versus placebo

2

978

Prevented Fraction (Random, 95% CI)

0.49 [0.02, 0.96]

2.4 Fluoride mouthrinse versus placebo

13

4920

Prevented Fraction (Random, 95% CI)

0.24 [0.18, 0.30]

2.5 Fluoride gel versus no‐treatment

6

1673

Prevented Fraction (Random, 95% CI)

0.43 [0.29, 0.57]

2.6 Fluoride varnish versus no‐treatment

1

109

Prevented Fraction (Random, 95% CI)

0.6 [0.36, 0.84]

3 d(e)fs increment (PF) ‐ nearest to 3 years (5 trials) Show forest plot

5

1685

Prevented Fraction (Random, 95% CI)

0.33 [0.22, 0.44]

3.1 Fluoride gel versus placebo

2

578

Prevented Fraction (Random, 95% CI)

0.26 [‐0.11, 0.63]

3.2 Fluoride varnish versus placebo

1

676

Prevented Fraction (Random, 95% CI)

0.2 [0.02, 0.38]

3.3 Fluoride varnish versus no‐treatment

2

431

Prevented Fraction (Random, 95% CI)

0.41 [0.26, 0.55]

4 Developing one or more new caries (12 trials) Show forest plot

13

5297

Risk Ratio (M‐H, Random, 95% CI)

0.88 [0.82, 0.95]

5 Unacceptability of treatment as measured by leaving study early (10 trials) Show forest plot

10

2897

Risk Ratio (M‐H, Random, 95% CI)

1.20 [0.85, 1.70]
Figuras y tablas -
Comparison 1. Topical fluoride versus placebo/no‐treatment
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