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Is there a relationship between personal oral hygiene and dental caries in the absence of fluoride?


Dr. Philippe Pierre Hujoel sat with me to talk about a systematic review he recently co authored. Theories on dental caries are proliferant and some of them refute the evidence that fluoride might play a role in preventing cavities and dental caries. The systematic review that we are sharing with you today asks a very pertinent question: does personal oral hygiene really matter, if we took out fluoride from the toothpaste that patients use to brush their teeth? You can access the full article through our resource section below. 

Dr. Philippe Hujoel is Professor of Oral Health Sciences and Adjunct Professor of Epidemiology and Periodontics in the Dept of Epidemiology at the University of Washington in Seattle.

We would like to hear from you and know your thoughts and questions about this topic. If you wish to reach us, it’s quite easy: email us at oasisdiscussions@cda-adc.ca or call our toll-free number 1-855-716-2747.

Until next time!

Chiraz Guessaier, CDA Oasis Manager 


  • The goal is to conduct a systematic review of randomised trials assessing the association between personal oral hygiene and dental caries in the absence of the confounding effects of fluoride.
  • Dental caries continues to affect close to 100% of the global population. There is a century-old conflict on whether dental caries is caused by poor oral hygiene or poorly formed teeth (ie, teeth with dental defects). Resolving this conflict is of significant public health importance as these two hypotheses on dental caries aetiology can lead to different prevention strategies.
  • A systematic search for randomised trials was conducted using predefined criteria in 3 databases. The impact of personal oral hygiene interventions on coronal dental caries incidence was evaluated using random- effects models. 
  • Personal oral hygiene in the absence of fluorides has failed to show a benefit in terms of reducing the incidence of dental caries.

Read/download the transcript of the interview (PDF)


Hujoel PP, Hujoel MLA, Kotsakis GA. Personal oral hygiene and dental caries: A systematic review of randomised controlled trials. Gerodontology. 2018 May 15. doi: 10.1111/ger.12331. [Epub ahead of print]

Additional Resource

The conversation continues on whether or not dental hygiene products could prevent dental caries. The question is raised whether professional organisations, with a dependence on advertising revenues, can become complicit in amplifying advertised health claims which are inconsistent with the principles of evidence‐based medicine. Here’s an interesting read on the topic:

Hujoel PP, Hujoel. Historical perspectives on advertising and the meme that personal oral hygiene prevents dental caries. Gerodontology, 2018 April 11. DOI: 10.1111/ger.12374.

Oasis Moment (1.44″)

Full Conversation (14.25″)


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