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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 1

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Comparison 1 Fluoride varnish versus placebo varnish, Outcome 1 Number of participants with new DWLs.
Figuras y tablas -
Analysis 1.1

Comparison 1 Fluoride varnish versus placebo varnish, Outcome 1 Number of participants with new DWLs.

Comparison 2 Amine fluoride/stannous fluoride toothpaste/mouthrinse combination versus sodium fluoride toothpaste/mouthrinse combination, Outcome 1 White spot index.
Figuras y tablas -
Analysis 2.1

Comparison 2 Amine fluoride/stannous fluoride toothpaste/mouthrinse combination versus sodium fluoride toothpaste/mouthrinse combination, Outcome 1 White spot index.

Comparison 2 Amine fluoride/stannous fluoride toothpaste/mouthrinse combination versus sodium fluoride toothpaste/mouthrinse combination, Outcome 2 Visible plaque index.
Figuras y tablas -
Analysis 2.2

Comparison 2 Amine fluoride/stannous fluoride toothpaste/mouthrinse combination versus sodium fluoride toothpaste/mouthrinse combination, Outcome 2 Visible plaque index.

Comparison 2 Amine fluoride/stannous fluoride toothpaste/mouthrinse combination versus sodium fluoride toothpaste/mouthrinse combination, Outcome 3 Gingival bleeding index.
Figuras y tablas -
Analysis 2.3

Comparison 2 Amine fluoride/stannous fluoride toothpaste/mouthrinse combination versus sodium fluoride toothpaste/mouthrinse combination, Outcome 3 Gingival bleeding index.

Comparison 3 Intraoral fluoride‐releasing glass bead device versus mouthrinse‐only control, Outcome 1 Number of participants with new DWLs.
Figuras y tablas -
Analysis 3.1

Comparison 3 Intraoral fluoride‐releasing glass bead device versus mouthrinse‐only control, Outcome 1 Number of participants with new DWLs.

Summary of findings for the main comparison. Fluoride varnish versus placebo varnish

Fluoride varnish versus placebo varnish for the prevention of demineralised white lesions on teeth during fixed brace treatment

Patient or population: Participants undergoing orthodontic treatment with fixed appliances
Settings: Orthodontic practice
Intervention: Fluoride varnish

Comparison: Placebo varnish

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Placebo varnish

Fluoride varnish

Number of patients with new demineralised white lesions

Study population

RR 0.31
(0.21 to 0.44)

253
(1 study)

⊕⊕⊕⊝
moderate1

640 per 1000

198 per 1000
(134 to 282)

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; RR: risk ratio.

GRADE Working Group grades of evidence.
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 A single study with 253 participants evaluated this outcome. Risk of bias was assessed as low. However, this finding should be interpreted with caution until the study has been replicated.

Figuras y tablas -
Summary of findings for the main comparison. Fluoride varnish versus placebo varnish
Comparison 1. Fluoride varnish versus placebo varnish

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Number of participants with new DWLs Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

Figuras y tablas -
Comparison 1. Fluoride varnish versus placebo varnish
Comparison 2. Amine fluoride/stannous fluoride toothpaste/mouthrinse combination versus sodium fluoride toothpaste/mouthrinse combination

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 White spot index Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Visible plaque index Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Gingival bleeding index Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

Figuras y tablas -
Comparison 2. Amine fluoride/stannous fluoride toothpaste/mouthrinse combination versus sodium fluoride toothpaste/mouthrinse combination
Comparison 3. Intraoral fluoride‐releasing glass bead device versus mouthrinse‐only control

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Number of participants with new DWLs Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 Fluoride‐releasing intraoral device versus fluoride mouthrinse

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 3. Intraoral fluoride‐releasing glass bead device versus mouthrinse‐only control