A clinical study of the anti–caries effect of 1.23% and 0.4% APF fluoride gel on primary dentition: One year follow–up

Karam Jazrawi,Layla Makani,Tarik Khamrco

doi:10.33899/rden.2006.45478

Abstract

Aims: To determine the efficacy of acidulated phosphate fluoride (APF) gel in reducing caries increment in a group of pre–school children in Mosul City, and to compare between the anti–caries effect of two different concentrations (full strength–1.23% and half strength–0.4%) after one year of bi–annual application of the gel. Materials and Methods: The sample consisted of 363 kindergarten children [192 (52.89%) males and 171 (47.11%) females] aged 4 years –at the initial examination– from 10 randomly selected kindergartens in Mosul City Center. The sample was divided into two experimental groups and one control group. Children in the first group received bi–annual application of full strength (1.23%) APF gel; those in the second group received bi–annual application of half strength (0.4%) APF gel, whereas those in the third group did not receive any fluoride treatment. Dental examinations were done according to WHO criteria using dmft and dmfs indices: One before fluoride application and the other after one year. Results: A significant reduction in dental caries increment of the two experimental groups compared with the control group regarding dmft and dmfs indices. The percentage of caries reduction regarding dmft and dmfs indices were 97.25% and 101.15% for the first group, and 95.94% and 85.33% for the second group, respectively. However, the differences between the two concentrations were statistically not significant, although children in the first group who received the full strength fluoride application revealed slightly better reduction in caries increment than those in the second group who received the half strength fluoride application. Therefore, to decrease the risk of ingesting a highly concentrated fluoride gel, the use of the lower concentration APF gel is recommended. Conclusion: The use of such a program involving professional APF gel application for pre–school children is advised especially for those with evidence of dental caries.

Highlights

Despite great improvements in the oral health of populations across the world, problems still persist
412 children were included in the trial and 363 of them remained by the end of the study, which represents a loss of 11.89%
The topical fluoride applications were conducted on deciduous teeth without prior professional cleaning, since in vivo studies have demonstrated that fluoride uptake and caries inhibition are not reduced if teeth remained uncleaned.[33,34,35,36] the improvement in cost regarding the elimination of this step as well as the decrease in chair–side time for each treatment is making the single step procedure for application of fluoride more suitable for public health programs as well as those programs conducted at kindergartens

Summary

Introduction

Despite great improvements in the oral health of populations across the world, problems still persist. This is so among underprivileged groups in both developed and developing communities.[1] According to the WHO report,(2) dental caries remains a major public health problem in most industrialized countries, affecting 60–90% of school children and the vast majority of adults. It is the most prevalent oral disease in several Asian and Latin American countries. A primary tooth with a restoration is still at risk for additional attacks of dental caries and to inflammation of its supporting tissues.[1, 2]

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Conclusion