A critical review of the relative anticaries efficacy of sodium fluoride and sodium monofluorophosphate dentifrices.

While there is broad consensus in the research community that fluoride dentifrices provide important anticaries benefits, debate still remains as to the most efficient form of fluoride used in toothpastes. Recently, the authors of this paper collaborated as part of a scientific advisory group whose objective was to comprehensively review all clinical information available comparing the anticaries efficacy of the two agents most widely used in fluoridated toothpastes, sodium fluoride (NaF) and sodium monofluorophosphate (SMFP). This review included a detailed analysis of each published study pertinent to the question, a comprehensive meta-analysis of all available clinical findings, and an epidemiological assessment of how anticaries benefits of dentifrices may be anticipated to propagate with time. Overall, the use of meta-analysis of head-to-head clinical comparisons between the two fluoride-active systems was found to be the most valid means for comparing the relative efficacy of NaF and SMFP dentifrices. Results of this analysis demonstrated that NaF was significantly more effective than SMFP in preventing caries (p < 0.01). While the numerical difference in efficacy between NaF and SMFP measured between 5 and 10% (total DMFS) over a 2- to 3-year clinical period, this could be expected, on theoretical grounds, to propagate to substantially larger differences (e.g. 10-20%) over 10-20 years. Hence, the difference in efficacy between these two actives was judged to be clinically important as well as statistically significant. Based upon these findings the authors recommend that NaF be used as the active system in fluoridated dentifrices whenever practically feasible. However, the authors caution that this recommendation pertains to the formulation of NaF in highly compatible abrasive systems, which must be demonstrated by critical evaluation of ionic fluoride within formulations for stability, availability and bioavailability. One additional recommendation emanating from this review is that important improvements must be made in the design, execution and reporting of future caries clinical trials in order to bring these important methods up to scientifically acceptable standards.

Predicting the "Wits" appraisal from the ANB angle.

The ANB and "Wits" values of fifty patients were correlated to see how accurately one can predict the "Wits" value, given the ANB measurement. There is no correlation between these two values when the "Wits" measurement is negative. In our study, when the positive ANB measurement was less than 4 degrees, the "Wits" values could be either positive or negative. When the ANB angle was between 4 and 8 degrees, all "Wits" values were positive. When both the "Wits values were positive and the ANB values ranged between 1 and 8 degrees, we could predict the "Wits" measurement with a 38 percent accuracy. If the ANB range was narrowed to 4 to 8 degrees, all "Wits" values were positive and we could predict them 28 percent of the time. Both these figures are statistically significant but clinically irrelevant. Further studies are needed to determine the exact nature of these interrelationships.