Stannous fluoride 0.4% dental gel sugar free

ObjectiveTo systematically identify and evaluate clinical trials assessing the caries-preventive efficacy of fluoride-free active ingredients in toothpaste formulations.DataRandomized clinical trials analyzing the caries preventive effect of fluoride-free active ingredients in toothpastes.SourcesA PRISMA-related systematic review of MEDLINE and Embase was conducted. Inclusion criteria were human in vivo clinical trials on toothpastes, fluoride-free interventions, and caries-focused outcomes; exclusion criteria were in vitro or animal studies, non-toothpaste products, fluoride-only products, and non-English publications. The review followed the PICO framework: Population - participants of all ages with primary, mixed, or permanent dentition; Intervention - use of a toothpaste with a non-fluoride active ingredient; Comparison - a fluoride-containing toothpaste as control; Outcome - a measurable oral health effect based on in vivo caries estimation.Study selectionFifteen clinical trials met the inclusion criteria. Eleven used fluoride-free, non-therapeutic abrasive toothpastes as placebo controls. Three trials evaluated the caries-preventing efficacy of fluoride-free hydroxyapatite toothpastes across children, adolescents, and adults; one trial evaluated the caries-preventive efficacy of fluoride-free arginine toothpaste in children.ConclusionCaries prevention relies on reducing sugar intake and thorough daily oral care, with toothpaste, containing evolving combinations of remineralizing agents, antibacterials, and abrasives, playing a central role. With growing global interest in fluoride-free options, this literature review shows that clinically proven fluoride alternatives are already in use.Clinical significanceThis review provides evidence-based guidance for dentists when recommending fluoride-free toothpastes to patients.

Abstract licence: CC BY-NC

ObjectivesTo update the evidence on the comparative effectiveness of self-applied dentifrices for the treatment of dentin hypersensitivity (DH) using systematic review and network meta-analysis methodology.Materials and methodsRandomized controlled trials evaluating self-applied dentifrices in adults with a diagnosis of DH were identified through literature searching of OvidSP versions of Medline, EMBASE and the Cochrane Library from November 2022-July 2025, supplemented by records obtained in a previous review and manual citation searching. Outcomes were assessed using validated measures including evaporative cold, tactile and thermal cold stimuli. Random-effects frequentist network meta-analyses were conducted for outcomes measured at 2 weeks. Risk of bias was assessed using the RoB 2 and certainty of evidence evaluated using the CINeMA framework.ResultsNinety-three studies (9548 participants) were included, with 47 studies (4636 participants) contributing to the network meta-analyses. In consolidating findings across different outcome measurements we found stannous fluoride and arginine-based dentifrices consistently demonstrated the most clinically meaningful reductions in DH symptoms compared with a benchmark fluoride dentifrice across evaporative cold (Stannous Schiff MD -0.85 (95% CI -1.08; -0.62), high confidence rating; Arginine MD -0.78 (95% CI -1.02, -0.54), low confidence rating) and tactile (Stannous Yeaple MD 14.87 (95% CI 10.24, 19.50), moderate confidence rating; Arginine MD 9.78 (95% CI 4.69, 14.86), low confidence rating) outcomes. High-certainty evidence supported stannous fluoride for evaporative cold outcomes, while arginine demonstrated comparable effect sizes with lower certainty. Other formulations showed small to moderate effects with generally low certainty when compared with a benchmark fluoride dentifrice at 2 weeks.ConclusionsStannous fluoride and arginine dentifrices should be considered first-line self-care options for DH.Clinical relevanceClinicians can recommend the use of stannous fluoride or arginine dentifrices as first-line treatment for DH, with choice guided by patient preference, tolerability and availability rather than expectation of superior efficacy.

Abstract licence: CC BY