Guidelines and Recommendations

Experts in Conservative dentistry will publish summaries on different topics to help clinicians and teachers to recognize actual concepts throughout Europe. It is the aim of the EFCD to gather the information available in the European literature and to condense it to a practical document for teaching purposes or clinical practice.

Education of Conservative Dentistry


Consensus report of the EFCD: erosive tooth wear-diagnosis and management

T.S. Carvalho, P. Colon, C. Ganss, M.C. Huysmans, A. Lussi, N. Schlueter, G. Schmalz, R.P. Shellis, A.B. Tveit, A. Wiegand

Clinical Oral Investigations 2015; 19: 1557-1561

PDF available


Guidelines for the use of fluorides - EFCD
(Professor Jan Ekstrand, March 2009)

To be successful in the use of fluoride in caries treatment and prevention the fluoride program must be based on the knowledge of optimal safety and evidence based efficacy.

Based on recent literature reviews (ref 1, 2 and 3) the following statements  can be made on the efficacy of various fluoride products and programs. The results  from these reviews are based on studies judged as having high-grade to moderate-grade evidence  and were  based on approximately 1000 articles. The results revealed that a large number of clinical studies had  ”insufficient  scientific evidence”.  It is important to emphasize that “insufficient evidence” does not indicate that the method or program had no clinical effect. However, if the scientific documentation shows that a method has no effect; its use should be questioned.  Based on the reviews  the following conclusion can currently be made:

Fluoride intake at intervals throughout the day is an important factor in limiting the prevalence and severity of dental caries in erupted teeth and, therefore, the widespread use of water fluoridation and fluoridated  toothpaste has provided effective in caries prevention. Fluoride toothpaste dominates the toothpaste market and the fluoride concentration in the paste range from 250 to 2500 PPM (0.025 – 0.25 % F ). Scientific evidence shows that F toothpaste has a strong preventive dose dependent effect both in children and adults, that is, 0.15 % F has better effect than 0.10 % F toothpaste. 

In the literature there is limited evidence that mouth rinsing with fluoride daily, weekly, or once every two weeks has any significant effect in children and adolescents beyond that achieved by the daily use of F toothpaste.  There are some studies that suggest that daily mouth rinsing with fluoride prevents root caries in older people.

The preventive effect  of   fluoride supplements or tablets on primary teeth or permanent teeth cannot be scientifically assessed, nor can the preventive effect of adding fluoride to milk or salt.

Fluoride Varnish has shown to give a preventive effect on caries when the treatment is performed  two times a year in children and adolescents in combination with the daily use of fluoride toothpaste.

1. Marinho VCC, Higgins JPT, Logan S, Sheiham A. Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews 2003, Issue 1. Art. No.: CD002278. DOI: 10.1002/14651858.CD002278
2. Marinho VCC, Higgins JPT, Sheiham A, Logan S. Combinations of topical fluoride (toothpastes, mouthrinses, gels, varnishes) versus single topical fluoride for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD002781. DOI: 10.1002/14651858.CD002781.pub2
3. Prevention of Dental Caries: A Systematic Review; The Swedish Council on Technology Assessment in Health Care. ISBN 991-87890-81-X report no : 161, 2002