NMDA Journal Spring 2020

nmdental.org 23 The Recommendations for Primary Teeth The Recommendations for Permanent Teeth On all cavitated lesions: • 38% SDF Solution On all cavitated lesions: • 38% SDF Solution On occlusal noncavitated lesions: • Sealants plus 5% NaF varnish • Sealants alone On occlusal noncavitated lesions: • Sealants plus 5% NaF varnish • Sealants alone If you can't do this: • 5% NaF varnish • 1.23% APF gel • Resin infiltration plus 5% NaF varnish • 0.2% NaF mouth rinse If you need to try something else: • 5% NaF varnish • 1.23% APF gel • 0.2% NaF mouth rinse On approximal nocavinated lesions: • Sealants alone • 5% NaF varnish • Resin infiltration • Or both together On approximal nocavinated lesions: • Sealants alone • 5% NaF varnish • Resin infiltration • Or both together On facial or lingual lesions: • 1.23 APF gel • 5% NaF varnish On facial or lingual lesions: • 1.23 APF gel • 5% NaF varnish On root surfaces that are cavitated and noncavitated: • 5,000 ppm fluoride (1.1% NaF) toothpaste or gel If you need to try something else: • 5% NaF varnish • 38% SDF solution plus potassium iodide • 38% SDF solution alone • 1.23% APF gel • 1% chlorhexidine plus 1% thymol varnish every 3–6 months), or 5% NaF varnish (application every 3–6 months. (Moderate- to low-certainty evidence, conditional recommendation.) • To arrest or reverse noncavitated carious lesions on coronal surfaces of primary and permanent teeth, the expert panel suggests clinicians do not use 10% CPP-ACP if other fluoride interventions, sealants or resin infiltration is accessible (Low- certainty evidence, conditional recommendation.) Question 3 To arrest or reverse noncavitated root carious lesions on primary or permanent teeth, should we recommend NaF, stannous fluo- ride, polyols, chlorhexidine, calcium phosphate, amorphous cal- cium phosphate (ACP), casein phosphopeptide (CCP) –ACP, nano-hydroxyapatite, tricalcium phosphate, or prebiotics with or without 1.5% arginine, probiotics, SDF, silver nitrate, lasers, resin infiltration, sealants, sodium bicarbonate, calcium hydroxide, or carbamide peroxide? • To arrest or reverse noncavitated and cavitated carious lesions on root surfaces of permanent teeth, the expert panel suggests clinicians prioritize the use of 5,000 ppm fluoride (1.1% NaF) toothpaste or gel (at least once per day) over 5% NaF varnish (application every 3–6 months ), 38% SDF plus potassium iodide solution (annual application), 38% SDF solution (annual application, or 1% chlorhexidine plus 1% thymol varnish (application every 3–6 months). (Low-certainty evidence, conditional recommendation.)