Purpose: To review in a systematic approach the effectiveness of specific fluoride treatments on the root caries activity in adults. Materials and Methods: An electronic search of the National Library of Medicine, Washington DC (Medline-PubMed), and the specialist trials register of the Cochrane Oral Health Group up to and including April 2005 was performed using specific search terms to identify randomised controlled trials, controlled clinical trials and longitudinal studies of at least 3 months duration, which investigated the effect of specific fluoride treatments with regard to root caries activity and/or incidence in healthy adults. Comparisons were made against the root caries status before the initiation of the additional fluoride application regimen and between groups in controlled studies. The papers were screened independently by two reviewers (MH and SP). Results: Out of 348 titles and abstracts, six papers fulfilled the selection criteria and were processed for data extraction. The highest level of evidence was presented in the two papers using a double-blind controlled randomised clinical trial (Wallace et al, 1993; Baysan et al, 2001). Both these studies indicate that the increased application of fluoride in the form of a high concentration dentifrice or additional mouthwash had a positive effect on the root caries incidence/severity. Conclusion: Additional fluoride appears to be a preventive and therapeutic treatment for root caries. Keywords: fluoride, root caries activity, root caries incidence, systematic review