Gluzman, R., Katz, R.V., Frey, B.J., McGowan, R.

Purpose
This literature review summarises the effectiveness of the seven leading root caries preventive agents and provides recommendations for use of those agents in clinical practice with older adults and vulnerable elderly.

Method
Studies were eligible if they assessed the effectiveness of fluoride, chlorhexidine, xylitol, amorphous calcium phosphate, sealants, saliva stimulators, or silver diamine fluoride to prevent/control root caries in English language articles between 1979 and 2010.

Results
In the 31 eligible studies, the most effective primary (1°) prevention agents had reductions in RC incidence ranging from 72% to nearly 200% as compared to a placebo, while for secondary (2°) prevention, the best agents demonstrated arrest rates between 67 and 80%.

Conclusion
For 1° prevention of root caries, the recommended “best choice” is a 38% silver diamine fluoride solution professionally applied annually, while for the 2° prevention of root caries, the recommended “best choice” is a 22,500ppm sodium fluoride varnish professionally applied every three months.

Special Care in Dentistry 2013; 33 (3): 133-140.