***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: The determination of anticarious effects of topically administered fluorine compounds is usually based on short-time cross-sectional or longitudinal studies . In a comparison made for a period of more than seven years the anticarious effects of amine fluorides administered to selected groups of test subjects have been studied under controlled clinical experimental conditions The purpose of the present study was to evaluate the effect of fluoride upon the stain-inducing capacity of chlorhexidine . Ninety-one children , 13 years of age , volunteered for the experiment . Three test dentifrices were used , containing 0.1 % NaF , 0.1 % NaF + 2 % chlorhexidine , and 2 % chlorhexidine respectively . The experiment was carried out as a double-blind test , and the degree of staining was recorded after 1 and 2 years . Four methods were used for stain scoring . The results after 1 year showed that chlorhexidine  induced less stain when applied together with fluoride than when applied alone . After 2 years this difference disappeared , indicating that fluoride only retarded chlorhexidine-induced staining of teeth A double-blind , clinical trial involving 923 children and extending over 4 years was carried out on the Isle of Wight . It investigated the additional protection against dental caries result ing when Aluminum salts have demonstrated anticaries activity in a number of laboratory and animal studies . The aim of this double-blind , pilot , clinical trial was to evaluate the effect of an alum ( Al ) mouthrinse on dental caries formation both by itself and in combination with an ADA-approved sodium fluoride ( F ) dentifrice . A total of 260 caries-prone children residing in a low-F area were preselected for the study and scored independently for caries by two experienced examiners . After using gender , age , and initial DMFT(S ) scores for baseline stratification , the subjects were assigned to one of three treatment regimens : ( 1 ) placebo mouthrinse and F dentifrice , ( 2 ) Al mouthrinse and placebo dentifrice , and ( 3 ) Al mouthrinse and F dentifrice . The alum mouthrinse contained 500 ppm Al and the sodium fluoride dentifrice contained 1100 ppm F. Rinsing was supervised at school on weekdays for 30 sec/day , while the dentifrices were used ad libitum at home . Subjects were reexamined for caries and oral health after six and twelve months . Both examiners found that children who used Al mouthrinse , in conjunction with either placebo or F dentifrices , had lower caries incidence than those who used placebo mouthrinse/F dentifrice combination ; but the differences were statistically significant for only one of the examiners . No evidence of deleterious effects to the oral tissues was observed . The results of this pilot clinical trial demonstrated that daily supervised use of an alum mouthrinse inhibited caries development in decay-prone children at least as effectively as a F dentifrice A r and omized , double blind clinical trial of the caries inhibition effects of dentifrices containing respectively monofluorophosphate and amine fluoride was performed . A third control group used a toothpaste without fluoride .  A total number of 2008 schoolchildren ranging in age from 6 to 8 years and living in Strasbourg ( France ) participated in this study . After a baseline examination three groups were constructed with the block r and omization technic . The caries inhibition effects of the three dental pastes were compared after 3 years of unsupervised use . The monofluorophosphate dentifrice showed a reduction of 7.02 % for DMFT , 5.17 % for DMFS and 25.26 % for the df rate . The reduction of amine fluoride dentifrice caries was respectively 21.62 % for DMFT , 20.94 % for DMFS and 48.66 % for the df rate This study aim ed to determine whether incidence density ( ID ) calculations of caries incidence rates would provide a more sensitive means of detecting caries – preventive effects than would traditional techniques . A secondary analysis was conducted using data from a 1981 study in which three dentifrices  were compared in a double – blind r and omized clinical trial . Subjects were examined at baseline and 1 , 2 and 3 years after baseline . Three – year DMFS increments were calculated for 1,754 subjects attending the baseline and 3–year examinations . Caries ID rates then were calculated for 2,661 subjects who had at least two examinations , using each surface 's net increment ( –1 , 0 or + 1 ) as the numerator and the surface 's time at risk as the denominator . Despite theoretical advantages , the ID method did not alter the conclusions drawn using DMFS increments , apparently because ( a ) subjects lost to follow – up were similar to those completing the study , and ( b ) loss to follow – up was similar among treatment groups The effect of reducing the abrasivity of toothpaste on dental caries was observed in a 3-year clinical trial involving 1106 11 - 13-year-old Berkshire schoolchildren were divided into three groups ; Group 1 were allocated a low abrasivity paste containing 0.8 % sodium monofluorophosphate , Group 2 a paste of conventional abrasivity also containing 0.8 % sodium monofluorophosphate and Group 3 a low abrasivity non-fluoride paste . After 3 years the net DMFS increments ( clinical and radiographic scores combined ) were 4.22 in Group 1 , 4.72 in Group 2 and 6.43 in Group 3 . The differences between Groups 1 and 3 and between Groups 2 and 3 were highly significant ( P less than 0.001 ) . The mean increment in Group 1 was lower than in Group 2 but did not reach statistical significance . Reducing the abrasivity of the toothpaste had no meaningful effect on the st and ard of oral hygiene and prevalence of gingivitis as measured by the Gingival and Plaque Indices In a 3-year , 4-year and 5-year studies , the authors tested clinical ly and radiographically the caries-inhibiting efficiency of topically applied amine fluoride in defined groups ( fluoride group with Elmex fluid and Elmex tooth-paste for unsupervised dental and oral hygiene at home , placebo group and control group ) . After the fifth study year , the caries increment in the children who were 11 years of age at this time had decreased by 30.6 % ( DMF/T index ) and 32.1 % ( DMF/S index ) OBJECTIVE To examine the effect of reported toothbrushing frequency and method of rinsing after brushing on caries experience and increment . METHODS Data are presented from 2621 adolescents ( mean age 12.5 years at outset ) participating in a 3-year double-blind caries clinical trial . At baseline , examiners question ed each participant about their toothbrushing habits , and at subsequent examinations , this information was obtained using a self-administered computer-based question naire . Participants used a fluoride-containing dentifrice throughout and clinical examinations were conducted using a mirror , CPITN probe and fibre-optic transillumination . RESULTS The reported brushing frequency increased throughout the trial . Caries experience at baseline was inversely related to toothbrushing frequency with mean DMFS=9.66 , 8.12 and 7.63 respectively for < 1/day , 1/day and > 1/day brushers ( P<0.001 ) . Mean 3-year DMFS increments of 8.90 , 6.63 and 5.48 ( P<0.01 ) were observed in those reporting to brush < 1/day , 1/day or > 1/day , on not less than two of the three clinical examinations during the trial . Caries increment was also significantly related to the cl aim ed method used to rinse post-brushing . Overall frequency of brushing and rinsing method accounted for over 50 % of the explained variance in the ANOVA model used to analyse the DMFS increments . CONCLUSIONS Stated toothbrushing frequency and rinsing method after brushing were found to be strongly correlated with caries experience and caries increment . These factors should be reflected in the design of oral health education material and taken into account in the design and analysis of caries clinical trials The purpose of this double blind clinical trial was to determine the anticaries activity of a dentifrice containing 0.78 % sodium monofluorophosphate in a silica gel abrasive base compared with a placebo under conditions of supervised brushing . 1154 schoolchildren , ages 9 - 12 , were recruited in a non-fluori date d semi-rural area of northeastern Connecticut . Subjects were stratified according to school , grade and sex , and then r and omly divided into two groups . Each school day , children brushed their teeth for 1 min under supervision by project personnel . Weekend and vacation usage was ad libitum . Caries examinations and radiographic readings were performed by the same examiner ( J.R. ) . After 12 months , the 996 subjects examined showed that the group using the test dentifrice had significantly ( less than 0.05 ) lower DMFT ( 25.0 % ) and DMFS ( 19.1 % ) increments than the group using the placebo . After 24 months the 876 subjects examined showed that the test group continued to have significantly lower DMFT ( 24.5 % ) and DMFS ( 24.7 % ) increments than the placebo group . Surface protection after 24 months ranged from 22.1 % for occlusal to 37.1 % for interproximal surfaces The relationship between oral hygiene and dental caries incidence in 11-year-old children . A 3-year R and om tests made in school children of the Ludwigsburg district showed that after 3 years of uncontrolled use , the number of new DMF surfaces is smaller in children using Na2PO3F toothpaste and regularly cleaning their teeth than in the corresponding placebo groups . The caries-inhibiting effect was statistically significant ( significance level p=0.05 % ) . The increase in caries impact in school children regularly but insufficiently cleaning their teeth was also significant in the placebo groups AN important part of research in clinical dentistry /~ is to measure the effect of agents used in the prevention of dental caries .  This is achieved by the use of the controlled clinical trial . In conducting a clinical trial of a caries preventive agent , the investigator wishes to make an unbiased assessment of its effect on the greatest number of individuals possible , within the limitations of available re sources . It is of primary importance to be able to measure this effect in numerical terms . This enables a comparison to be made between the new agent and established procedures , and gives an indication of the reduction in clinical treatment loads which might result from its use in a public health programme , and ultimately the cost benefit which might be expected . The investigator tries to assess therefore , by how much dental decay will be reduced by the agent , in comparison with the amount which would be likely to occur if it were not used . The measurement of the agent ’s effect is achieved by selecting a test and a control group of subjects . If the test group receives the agent , and the control group receives either nothing at all , or preferably , an inactive substitute , it will be possible , over the course of time , to compare the differences between the groups in the amount of decay which is observed . The amount of dental decay which occurs during the trial represents the ’ caries increment ’ over the period , and must be determined separately for each group . Caries increment is usually measured by the DMF Index , which is basically a count of the number of teeth in the mouth which are decayed , plus the number A 3-year clinical trial was carried out in France just after fluoride toothpaste was allowed to be sold on the mass market . The aim was to assess the caries preventive effect of a toothpaste containing the maximum fluoride level permitted by the EEC ( 1.2 % SMFP ) . The trial started with 1318 10 - 12-yr-old children from a wide socioeconomic background in a typical French community . Test toothpaste was given to 659 children whereas the remaining 659 children obtained the same toothpaste without the fluoride additive . The brushing was unsupervised and performed by the children at home . Dental caries was assessed by clinical and radiographic examinations . 1061 children completed the trial . An interview carried out at the final examination identified a group of 116 uncooperative children ( less than five brushings a week on average ) who were not included in the statistical analysis . The following mean reductions were found : 26 % for DMFT , 27 % for DMFS , and 39 % for DMFSU . The DMFS index for approximal , buccal-lingual and occlusal surfaces showed caries reductions of 32 % , 25 % , and 22 % , respectively . The trial demonstrated a highly significant effectiveness of the 1.2 % SMFP toothpaste in a French population Prior to the start of the present investigation , 578 children in the 10–12 year age-group in Ballerup-Malov municipality ( a suburban area near Copenhagen ) had participated in a 30-months investigation of the caries-inhibiting effect of a dentifrice containing sodium monofluorophosphate . At the end of this 30-month study , a group of 172 children , selected at r and om , were examined for incidence of plaque and gingivitis . At this point the supervised toothbrushing at school ceased , as did the supplying of dentifrice to the families . One year later ( i.e. 42 months after the start of the basic experiment ) , the children were re-examined . The results of the investigation led to the following conclusions : 1 . The incidence of plaque and gingivitis was identical in the fluoride group and the control group at both first and second examination . This suggests that using a dentifrice containing sodium monofluorophosphate - up to three times a day - for 30 months does not increase the incidence of plaque or gingivitis in children . 2 . At the time of the second examination (  
    Output:
    
The effect of  fluoride toothpaste increased with higher baseline levels of D(M)FS , higher fluoride concentration , higher frequency of use , and supervised brushing , but was not influenced by exposure to water fluoridation .
There is little information concerning the deciduous dentition or adverse effects ( fluorosis ) .
REVIEW ER 'S CONCLUSIONS Supported by more than half a century of research , the benefits of fluoride toothpastes are firmly established .
Taken together , the trials are of relatively high quality , and provide clear evidence that fluoride toothpastes are efficacious in preventing caries