***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: Since there is no consensus on the anticaries effectiveness of low-fluoride ( F ) dentifrice , this r and omized clinical trial evaluated its effect in children at different caries activity status . One hundred and twenty 2- to 4-year-old children , half with and half without active caries lesions , were r and omly divided into 2 groups which used 500- or 1,100-µg F/g ( NaF ) dentifrices during 1 year  . Caries progression or regression were evaluated as the number of lesions becoming active/cavities or inactive , respectively . The anticaries effect of the low-F dentifrice was similar to the conventional F dentifrice when used by caries-inactive children . However , in children with active caries lesions the low-F dentifrice was less effective than the 1,100-µg F/g dentifrice in controlling the progression of lesions . The data suggest that the child caries activity may be taken into account to recommend a low-F dentifrice BACKGROUND The authors investigated the associations between enamel fluorosis , caries and early fluoride use among Norwegian children who received fluoride supplementation under a protocol similar to the current U.S. protocol . METHODS Two examiners whose techniques were calibrated examined r and omly selected middle-school-aged children living in Bergen , Norway-where the water supply contains less than 0.10 milligrams of fluoride per liter-for both enamel fluorosis and caries by using the Fluorosis Risk Index and modified National Institute of Dental and Craniofacial Research criteria . The authors ascertained past fluoride exposure via a follow-up question naire mailed to parents . RESULTS The question naire had an 88 percent response rate and 87 percent reliability . Adjusted analyses revealed a strong association between regular supplementation ( given in the form of lozenges ) and mild to moderate enamel fluorosis ( odds ratio [ OR ] , 6.85 ; P < .05 ) , as well as fluorosis of lesser severity ( OR , 3.07 ; P < .05 ) . No children who had exclusively used only a pea-sized amount of toothpaste ( 0.1 percent fluoride ) had mild to moderate fluorosis . The authors found a 40 percent reduction in caries risk associated with early use of pea-sized amounts of fluori date d toothpaste and a 46 percent reduction associated with regular use of fluoride supplement lozenges . CONCLUSIONS These findings suggest that both risk of fluorosis development and caries-preventive benefit are associated with regular use of fluoride supplements , and caries prevention was associated with early use of a pea-sized amount of toothpaste . CLINICAL IMPLICATION S These findings underscore the need for clinicians to consider thoroughly- and discuss with a child 's parent or guardian-both the benefit and the potential risk of fluorosis development associated with preventive fluoride agents before introducing them . Clinicians also should emphasize the proper use of such agents PURPOSE To describe oral health status and to evaluate the effectiveness of a caries prevention programme in preschool children . MATERIAL S AND METHODS A sample of 1656 3- to 7-year-old children were examined in kindergartens in 2002 , and 411 3-year-old children were then selected to participate in the prevention programme . The test group A ( n = 156 ) , group B ( n = 118 ) , and the control group ( n = 137 ) were defined for the study . For test group A , supervised toothbrushing was prescribed and for test group B , fluoride gel applications were used . For the control group , children did not undergo any of the aforementioned procedures . Dental caries was assessed according to the World Health Organization ( WHO ) criteria , and oral hygiene according to the Greene-Vermillion simplified oral hygiene index . Preventive programmes were based on oral hygiene instructions , supervised daily toothbrushing , and fluoride gel applications . The relationship between oral hygiene and severity of dental caries was determined by using Fisher 's test . RESULTS The prevalence of dental caries varied between 39.7 % and 90.8 % , and the decayed , missing , and filled teeth ( dmf-t ) varied between 1.3 + /- 0.16 and 5.0 + /- 0.24 . Oral hygiene was satisfactory in 43.2 % of children . During the 3 years of the programme , a significant difference was found between the test and the control groups . The reduction in test group A was 45.4 % and in test group B was 60.1 % . CONCLUSIONS The prevalence and severity of dental caries among the examined children increased with age , and was lower in both the test groups compared with the control group . The professional fluoride applications and proper oral hygiene showed the most effective results in caries prevention OBJECTIVE To assess the impact of a programme regularly supplying free fluoride toothpaste to children on the prevalence and severity of fluorosis and other developmental defects of enamel . DESIGN R and omised , controlled , parallel three-group clinical trial . Two groups received toothpaste containing either 440 or 1450 ppm F ; the third group received no intervention .  Children were supplied with  toothpaste  and advice on its use from the age of 12 months until they were 5 - 6 years old . The participants were a sub sample of those involved in a study that considered the caries benefits of providing free fluoride toothpaste . They were eligible if they completed the main study , lived in four of the nine districts involved and attended schools with 6 or more eligible participants . SETTING Children from the north west of Engl and consuming drinking water containing less than 0.1 ppm F were examined in primary schools . PARTICIPANTS 3731 children completed the main study . Of the 1833 children in the four selected districts , 927 were from schools with six or more participants . METHOD Digital images encompassing the upper and lower anterior sextants were taken of each child when they were 8 - 9 years old . MAIN OUTCOME MEASURES Developmental defects of enamel and dental fluorosis ( TF index ) were recorded on upper central incisors from wet and dry images . RESULTS A total of 703 children were included in the data analysis . In the 1450 ppm F ( n=218 ) , 440 ppm F ( n = 226 ) and control ( n = 259 ) groups the prevalence of dental fluorosis ( TF > 0 ) was 17 % , 15 % and 12 % for the wet ( p > 0.05 ) and 26 % , 24 % and 25 % for the dry ( p > 0.05 ) photographs respectively . The prevalence of TF scores 2 or 3 ( highest score ) was 5 % , 4 % and 2 % and for the wet ( p > 0.05 ) and 7 % , 4 % and 5 % for the dry ( p > 0.05 ) photographs respectively . All subjects identified with TF score 3 were found in the group using the 1450 ppm F toothpaste ( 3 wet and 4 dry ) and there were statistically significant differences between the three groups for both wet ( p = 0.03 ) and dry photographs ( p < 0.01 ) . However , the pairwise comparisons between the groups failed to attain statistical significance . The highest prevalence and severity of demarcated opacities was seen in the control group and for the wet photographs the difference between the three groups attained statistical significance ( p = 0.04 ) . For both the wet and dry photographs the prevalence of any enamel defects ( including fluorosis ) and large demarcated or TF score 3 was similar for the three groups ( p > 0.05 ) . CONCLUSION Previously it has been reported that only the provision of 1450 ppm F toothpaste provides anticaries benefits in a programme of this type . This benefit is accompanied by a slight increase in prevalence of TF score 3 but not the overall prevalence of developmental defects of enamel . Careful targeting and implementation of a programme of this type is required to maximise benefits and minimise risks of fluoride exposure Abstract s on this page have been chosen and edited by Dr Trevor Watts Abstract A low-fluoride dentifrice gave measurable benefit only in the most deprived groups , but a high-fluoride dentifrice improved health in less deprived groups as well OBJECTIVE To assess the impact of regularly supplying free fluoride toothpaste regularly to children , initially aged 12 months , and living in deprived areas of the north west of Engl and on the level of caries in the deciduous dentition at 5 - 6 years of age . A further aim was to compare the effectiveness of a programme using a toothpaste containing 440 ppmF ( Colgate 0 - 6 Gel ) with one containing 1,450 ppmF ( Colgate Great Regular Flavour ) in reducing caries . DESIGN R and omised controlled parallel group clinical trial . Clinical data were collected from test and control groups when the children were 5 - 6 years old . SETTING A programme of posting toothpaste with dental health messages to the homes of children initially aged 12 months . Clinical examinations took place in primary schools . PARTICIPANTS 7,422 children born in 3-month birth cohorts living in high caries areas in nine health districts in north west Engl and . Within each district children were r and omly assigned to test or control groups . INTERVENTIONS Toothpaste , containing either 440 ppmF or 1450 ppmF , and dental health literature posted at three monthly intervals to children in test groups until they were aged 5 - 6 years . MAIN OUTCOME MEASURES The dmft index , missing teeth and the prevalence of caries experience . RESULTS An analysis of 3,731 children who were examined and remained in the programme showed the mean dmft to be 2.15 for the group who had received 1,450 ppmF toothpaste and 2.49 for the 440 ppmF group . The mean dmft for the control group was 2.57 . This 16 % reduction between the 1,450 ppmF and control group was statistically significant ( P<0.05 ) . The difference between the 440 ppmF group and control was not significant . Further analyses to estimate the population effect of the programme also confirmed this relationship . CONCLUSION This study demonstrates that a programme distributing free toothpaste containing 1,450 ppmF provides a significant clinical benefit for high caries risk children living in deprived , non-fluori date d districts OBJECTIVE The objective of this two-year comparative investigation was to assess the anticaries efficacy of three dentifrices commercially available in China . Two products contained the stated active agent sodium monofluorophosphate ( SMFP ) at a concentration of 1.14 % ; one was calcium carbonate-based , the second was silica-based . The third dentifrice tested contained no fluoride and was calcium carbonate-based . METHODS Prior to the start of this double-blind , parallel-group study , all aspects of the study were review ed and approved by the human review committee of the West China College of Stomatology , Sichuan University . All parents signed the approved consent form before the initial evaluations . A total of 1200 qualifying children living in the Chengdu , China area entered the study , and 998 children completed all aspects of the study . Subjects were r and omly assigned to use one of the three dentifrices : 328 participants used the non-fluoride calcium carbonate-based dentifrice ;  341 participants used the  1.14 % SMFP silica-based dentifrice ;  and 329 participants used the 1.14 % SMFP calcium carbonate-based dentifrice . Participants were instructed to brush their teeth with their assigned dentifrice twice daily . Brushing instructions were reinforced . RESULTS At the baseline examination , the mean dfs ( decayed and filled tooth surfaces ) scores of the non-fluoride dentifrice group ( 3.60 + /- 6.07),the 1.14 % SMFP silica-based dentifrice group ( 3.53 + /- 5.62 ) , and the 1.14 % SMFP calcium carbonate-based dentifrice group ( 3.54 + /- 5.34 ) were not statistically different ( p > 0.05 ) . After one year , the mean dfs increment of the non-fluoride dentifrice group was 2.19 + /- 4.12 , 1.69 + /- 3.12 for the 1.14 % for the SMFP silica-based dentifrice group , and 1.53 + /- 3.09 for the 1.14 % SMFP calcium carbonate-based dentifrice group ; after two years , the mean dfs increments were 4.73 + /- 5.17 , 2.98 + /- 4.42 , and 2.75 + /- 4.33 , respectively . Both the 1.14 % SMFP calcium carbonate-based and the 1.14 % SMFP silica-based dentifrices provided significantly more caries reduction than the non-fluoride silica-based dentifrice after one year ( -30 % and -23 % ) and two years ( -42 % and -37 % ) of product use . The 1.14 % SMFP calcium carbonate-based dentifrice was not significantly different from the 1.14 % SMFP silica-based dentifrice after one and two years of use . CONCLUSION The results of this clinical study indicate that the 1.14 % SMFP calcium carbonate-based and the 1.14 % SMFP silica-based dentifrices are effective against tooth decay compared to brushing with a non-fluoride toothpaste In 
    Output:
    
Limited scientific evidence demonstrates that for children younger than 6 years , fluoride toothpaste use is effective in caries control .
Ingesting pea-sized amounts or more can lead to mild fluorosis .