***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract A clinical trial was conducted in a non-fluori date d water , high-caries community in which school children ( average age = 13.04yr ) were r and omly assigned to one of four groups subjected to two different fluoride procedures . Clinical and radiographic examinations were conducted at baseline , 12 , 24 and 36 months . After 12 months , there was a small but significant rinse effect and a small gel effect which fell short of significance . The effects were additive , and subjects who received both forms of fluoride treatment experienced a 19 per cent reduction in decayed + filled ( DF ) surface increment . The pattern of incremental findings at the end of 24 months was similar to that at 12 months . Both gel and rinse effects were significant and of similar size ; subjects receiving both treatments experienced a 31 per cent reduction in DF surface increment . The incremental findings after 24–36 months 2 yr and 1 yr were similar . The effects were reduced relative to those seen at 24 months ; the gel effect was still statistically significant , but the rinse effect was not . Possible mechanisms underlying the treatment effects include deposition of CaF 2 and fluorapatite , and suppression of microbial flora UNLABELLED The piped water of Kuopio , Finl and , was fluori date d in 1959 . Owing to strong opposition by different civic groups , water fluoridation was stopped at the end of 1992 . OBJECTIVES The aim of this study was to examine the consequences of the discontinuation on dental health . METHODS In 1992 and 1995 , independent r and om sample s of all children aged 6 , 9 , 12 and 15 years were drawn from Kuopio and Jyväskylä , a nearby low fluoride town whose distribution of demographic and socio-economic characteristics was fairly similar to Kuopio 's . The total number of subjects examined was 550 in 1992 and 1198 in 1995 . Caries was registered clinical ly and radiographically by the same two calibrated dentists in both towns . RESULTS In 1992 , the mean DMFS values were lower in the fluori date d town for the two older age groups , the percentage differences for 12- and 15-year-olds being 37 % and 29 % , respectively . For the two younger age groups no meaningful differences could be found . In 1995 , the only difference with possible clinical significance was found in the 15-year-olds in favor of the fluori date d town ( 18 % ) . In 1995 , a decline in caries was seen in the two older age groups in the nonfluori date d town . In spite of discontinued water fluoridation , no indication of an increasing trend of caries could be found in Kuopio . The mean numbers of fluoride varnish and sealant applications decreased sharply in both towns between 1992 and 1995 . In spite of that caries declined . CONCLUSIONS These findings suggest that the decline of caries has little to do with professional preventive measures performed in dental clinics Many dental research ers have been expressing the response to treatment with anticariogenic agents  in terms of per cent reduction of caries incidence . Although they have found it desirable from time to time to calculate confidence limits and certain probabilities associated with true per cent reduction in caries incidence , they have not done so because they did not have access to any analytical tool for this purpose . Procedures for calculating confidence intervals associated with a single mean or difference between two means from normal distributions are commonly discussed in statistical texts , but a procedure for calculating a confidence interval associated with the ratio of two means from non-normal distributions with unequal variances is rarely considered . It is the purpose of this paper to make available to the research ers such a procedure . The procedure is based on asymptotic theory , which has application in our problems , since clinical comparisons of control and experimental regimens produce large sets of data The clinical effects of different preventive regimens provided for young people in their early and middle teens were studied during a 2-year period . The regimens studied during the 1st year of the trial were professional tooth-cleaning plus fluoride mouth-rinsing every 3rd week versus fluoride varnish treatment every 6 months . During the 2nd year , the preventive measures were given in accordance with the estimated needs of each individual . The results were related to the individuals ' previous experience with dental prevention to determine whether this had a significant influence . The results showed that fairly good or excellent effects on the individuals ' oral hygiene and gingival status were readily achieved and maintained with a professional tooth-cleaning plus fluoride mouth-rinsing regimen . The study failed to demonstrate any superior caries-preventive effect of the fluoride varnish treatments . Subsequent individualized prevention produced similar average end results in all groups . Differences in the results in accordance with the individuals ' previous experience with dental prevention indicate a superior and prolonged influence on dental health of professional  tooth-cleaning plus fluoride mouth-rinsing in comparison with a fluoride-based program alone 251 9 - 12-yr-old children completed a 3-yr , double-blind , clinical trial of two caries preventive fluoride programs . Caries increments and progression patterns were compared in two groups of children who rinsed every fortnight with a 0.2 % NaF solution or received biannual topical applications with a fluoride varnish ( Fluor-Protector ) . Clinical ly recorded mean DFS increments were 3.3 + /- 0.2 ( SE ) in the rinse group and 3.5 + /- 0.2 in the varnish group . In both groups nearly half of these increments were recorded in the occlusal surfaces of second molars . The mean incremental DFS recorded radiographically on approximal surfaces of posterior teeth were 1.1 + /- 0.2 and 1.5 + /- 0.2 in the rinse and varnish group , respectively . None of the inter-group differences were statistically significant ( P greater than 0.05 ) . Detailed analyses of the radiographic scores revealed a similar and extremely slow caries progression in the two study groups and they strengthened the conclusion of equal clinical efficacy of the two treatments . None of the fluoride programs had been able to change preestablished patterns of caries development among the children In a nonfluori date d community of Finl and , where fortnightly fluoride rinsing with 0.2 % sodium fluoride has been used for nearly two decades , a total of 313 children 7 - 8 yr old were recruited and r and omly divided into two groups . 206 children completed the 3-yr trial . The control group ( n = 94 ) participated in the rinsing program which included supervised toothbrushings , while the test group ( n = 112 ) received a new fluoride toothpaste tube ( 0.15 % F ) for home use every second month . Annual dental recordings , treatment plannings and the treatment itself were all carried out by one clinician . At the end of the study the number of caries-free children of the toothpaste group was lower ( P < 0.01 ) and the caries increment higher ( P < 0.05 ) than that of the mouthrinse group . Out of the mean of four dental visits per child and year some 1.5 were prophylactic by nature . No differences were found between the number of treatment visits , time or prophylactic care of the two groups . Unsupervised use of fluoride toothpaste may not be a sufficient substitute for the school-based fortnightly fluoride rinses and supervised toothbrushings in caries prevention of children with erupting permanent teeth 376 three-year old children were divided into four experimental groups and exposed to different combinations of preventive programs for a period of two years . All the groups were given the same basic prophylactic information . Additionally Group I received fluoride tablets ( FLUDENT ) for daily sucking twice a day plus a placebo dentifrice free of fluoride . Group II was given a fluoride dentifrice containing 0.025 % F , ( ACTA ) . Group III was given a placebo dentifrice plus fluoride varnish ( Duraphat ) twice a year . Group IV a fluoride dentifrice containing 0.025 % F ( ACTA ) plus fluoride varnish ( Duraphat ) twice a year . No statistically significant difference in caries increment during the two experimental years was found between the groups . A tendency to lower caries increment was found in Group IV , i.e. in the children using the low fluoride dentifrice and treated twice a year with fluoride varnish 751 14- and 15-year old children completed a 3-year , double-blind , caries preventive program . The effects of daily , supervised toothbrushing with an 0.76 % sodium monofluorophosphate dentifrice , rinsing with a 0.05 % sodium fluoride mouthrinse , and the combined effects of the two treatments were investigated . Both the dentifrice and mouthrinse reduced the incidence of dental caries , but their combined use at the same time had no greater effect than either used alone The study groups using a dentifrice and mouthrinse both containing fluorides , a dentifrice containing stannous fluoride and a mouthrinse containing sodium fluoride , or a mouthrinse containing sodium fluoride with a placebo dentifrice had a 20.7 % to 29.0 % lower DMF increment than the control group after 30 months . These differences were significant . The study groups using a dentifrice containing amine fluorides and a placebo mouthrinse , a mouthrinse containing amine fluorides and a placebo dentifrice , or a dentifrice containing stannous fluoride and a placebo mouthrinse had a 13.6 % to 22.4 % lower DMF increment than the control group . These differences were not statistically significant . There was no significant difference in effectiveness against caries between the use of the organic or inorganic fluoride products The purpose of this study was to evaluate the separate effect of fluoride dentifrice , fluoride mouthrinsing and fluoride varnish on approximal dental caries . All 252 13 - 14-yr-old children at an elementary school were selected at r and om and divided among four groups for a 3-yr longitudinal study . Group 1 received a fluoride dentifrice for home care and a fluoride mouthrinse once a week . Group 2 received a fluoride dentifrice for home care and a placebo mouthrinse once a week . Group 3 received a fluoride dentifrice for home care and a fluoride varnish once every 3 months . Group 4 received a placebo dentifrice for home care and a fluoride rinse once a week . Fluoride rinsing did not give any additional effect compared with placebo-rinsing when a fluoride dentifrice was used for home care . Fluoride varnish gave a significant caries reduction compared with fluoride rinsing A study to test the efficacy of two amine fluoride products in reducing the extent of  plaque and the  degree of gingivitis  was conducted with 6th- grade school children in Pensacola , Florida . The treatment regimens consisted of a daily supervised mouthrinse at school and the ad libitum home use of a dentifrice . Examinations were conducted at 12-week and 20-week intervals after the treatment had begun . There was no recognizable difference between the plaque and gingival reductions achieved with the use of the amine fluoride dentifrice or mouthrinse when compared either with their inorganic counterparts or with placebo treatment The aim of this study was to assess the caries incidence and plaque accumulation in schoolchildren at caries risk , after brushing the teeth fortnightly with gels containing 0 , 0.4 % F , 1.25 % F as amine fluoride ( AmF ) or the common amine fluoride toothpaste containing 0.125 % F. The study was conducted double blind over an 18-month period , and after 6 months discontinuation of brushing . Only the group that brushed with the 1.25 % AmF gel showed a significant decrease in caries development compared to the group that brushed with the 0.125 % AmF toothpaste . During the 6-month discontinuation period , the incidence of caries increased in all groups ; the differences in caries development between all groups were not significant . Plaque indices were significantly lower in the AmF-treated groups . The highest fluoride concentration in the gel reduced the development of caries to zero , probably due to increased fluoride levels in the oral milieu of caries risk children . In order to maintain a positive effect of fluoride over an extended time period , caries-prone subjects should continue an initiated fluoride programme This report describes a clinical study carried out to compare the  cariesinhibiting effect of the unsupervised home use of a sodium-monofluorophosphate-calcium-carbonate-based toothpaste formulation The aim of this trial was to compare the caries-preventive effect of sodium fluoride varnish and acidulated phosphate fluoride ( APF ) gel .  A total of 254 children aged 12 - 13 years with high past caries experience were r and omly divided into two groups . The participants received semi-annual applications of either fluoride varnish or APF gel for 3 years . During the study , the mean ( + /- SD ) total DMFS increments of the varnish and gel groups were 6.8 + /- 5.6 and 7.7 + /- 6.4 , respectively , when initial caries was included , and 3.1 + /- 3.7 and 3.6 + /- 4.6 when initial caries was excluded . The difference was most evident on the approximal surfaces ( varnish : 1.4 + /- 2.4 ; gel : 1.9 + /- 3.1 ) . However , this difference was not statistically significant . Although larger studies are needed for firm conclusions about the comparative effect of the two fluoride measures , the results suggest that fluoride varnish is as effective as fluoride gel at least in preventing approximal caries . Taking into account the shorter treatment time , using fluoride varnish for professional applications seems justified 
    Output:
    
REVIEW ER 'S CONCLUSIONS Fluoride toothpastes in comparison to mouthrinses or gels appear to have a similar degree of effectiveness for the prevention of dental caries in children .
There is no clear suggestion that fluoride varnish is more effective than mouthrinses and the evidence for the comparative effectiveness of fluoride varnishes and gels , and mouthrinses and gels is inconclusive .
Acceptance is likely to be greater for fluoride toothpaste