Evidence of Effectiveness of Current Therapies to Prevent and Treat Early Childhood Caries.

PURPOSE The purpose of this paper was to systematically review the quality of evidence related to self-applied and professionally applied fluorides, antimicrobial agents, fissure sealants, temporary restorations, and restorative care for the prevention and management of early childhood caries (ECC). METHODS Relevant papers were selected after an electronic search for literature published in English between 2000 and April 2014. From 877 reports, 33 were included for full review. The quality of evidence was expressed according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. RESULTS There was moderate and limited quality of evidence in support of fluoride toothpaste and fluoride varnish for ECC prevention, while the evidence for fluoride tablets/drops was insufficient. The support for the use of silver diamine fluoride, xylitol, chlorhexidine varnish/gel, povidone iodine, probiotic bacteria, and remineralizing agents (casein phosphopeptide-amorphous calcium phosphate) was insufficient. There was also insufficient quality of evidence for the use of sealants, temporary restorations, and traditional restorative care to reduce incidence of ECC. CONCLUSION The results reinforce the need for high quality clinical research and point out the knowledge gaps to be addressed in future studies.