Analyzing the Effectiveness of Different Delivery Methods for Remineralization Agents in Pediatric Dental Health: A Systematic Review.

Abstract

Pediatric dental health is critically impacted by enamel demineralization and early-stage caries, with remineralization therapies playing a vital role in preventing progression. This systematic review evaluates the effectiveness of various delivery methods for remineralization agents in pediatric patients aged 3-15 years, focusing on varnishes, gels, foams, and sprays. Studies were included if they were randomized controlled trials (RCTs), cohort studies, or case-control studies involving pediatric patients with early-stage caries or enamel demineralization, while studies with non-pediatric populations, unrelated treatments, or significant methodological flaws were excluded. A comprehensive search across PubMed, Cochrane, Google Scholar, and Web of Science using keywords like "pediatric," "fluoride varnish," "CPP-ACP," and "enamel remineralization" identified 10 RCTs with 743 participants from countries such as Germany, Italy, Turkey, China, Thailand, Iran, and Brazil. Data extraction followed a standardized protocol, and quality was assessed using the Cochrane Risk of Bias 2 tool. Results showed that fluoride varnishes were the most effective delivery method for high-risk caries populations due to their prolonged retention and sustained fluoride release, while sprays and foams emerged as promising alternatives for behaviorally challenging patients because of their ease of application and better compliance. Gels demonstrated mixed results, indicating that their efficacy might depend on application frequency and patient adherence. The findings also underscore the importance of cultural and regional factors in the acceptance of certain treatment methods. Additionally, long-term studies are needed to evaluate the sustained effects of sprays and foams in pediatric populations. This review highlights the critical role of delivery methods in the success of remineralization therapies, emphasizing that fluoride varnishes remain the gold standard, while sprays and foams are viable alternatives for specific patient needs. Tailoring treatments to individual patient requirements is essential for optimizing outcomes in pediatric dental health, particularly in addressing diverse patient behaviors and treatment environments.