Arginine and Caries Prevention: A Systematic Review

Ástvaldsdóttir, Álfheiur
Naimi-Akbar, Aron
Davidson, Thomas
Brolund, Agneta
Lintamo, Laura
Granath, Anna Attergren
Tranæus, Sofia
Östlund, Pernilla

^aDepartment of Dental Medicine, Karolinska Institutet, and ^bDepartment of Oral and Maxillofacial Surgery, Karolinska University Hospital, Huddinge, ^cDivision of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, Linköping, ^dSwedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, and ^eHealth Technology Assessment - Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden

Received January 28, 2016 Accepted after revision: March 16, 2016 Published online: July 12, 2016

Caries Research 50(4):p 383-393, September 2016. | DOI: 10.1159/000446249

Abstract

Objectives:

To evaluate the available evidence that the use of arginine-containing dental care products prevents the development of new caries lesions and the progression of existing lesions.

Search Methods:

We performed a systematic literature search of databases including PubMed, the Cochrane Library and EMBASE.

Selection Criteria:

We selected randomized controlled trials of treatment with arginine in fluoride-containing dental products measuring dental caries incidence or progression in children, adults and elderly subjects.

Data Collection and Analysis:

Two review authors independently assessed trials for risk of bias and evaluated overall study quality using the GRADE classification.

Main Results:

Due to conflicts of interest and weak transferability to Swedish conditions, no conclusions can be drawn from studies on the effects of arginine-fluoride toothpaste in children. Arginine-containing toothpaste costs about 40% more than basic fluoride toothpaste; to determine whether it is more cost-effective, the higher cost must be considered in relation to any additional caries-preventive effect. The literature review also disclosed some questionable research ethics: in several of the studies, the children in the control group used non-fluoride toothpaste. Toothpaste without fluoride is not as effective against dental caries as the standard treatment - fluoride toothpaste - which has a well-documented effect. This contravenes the fundamental principles of research ethics.

Conclusion:

At present there is insufficient evidence in support of a caries-preventive effect for the inclusion of arginine in toothpastes. More rigorous studies, and studies which are less dependent on commercial interests, are required.