Abstract
ObjectiveThis in situ study compared the effectiveness of two toothpastes containing hydroxyapatite or 500 ppm fluoride in promoting remineralization and inhibiting caries development.Materials and methodsTwo enamel blocks (human primary teeth), one sound and one with artificially-produced caries lesion, were exposed to toothpaste containing either 10% hydroxyapatite or 500 ppm F− (amine fluoride) via intra-oral appliance worn by 30 adults in two-arm double blind randomized crossover study lasting 14 days per arm (ClinicalTrials.gov: NCT03681340). Baseline and post-test mineral loss and lesion depth (LD) were quantified using microradiography. One-sided t-test of one group mean was used for intragroup comparison (baseline vs. post-test), while two-sided t-test of two independent means was used to compare the two toothpaste groups.ResultsPairwise comparison (baseline vs. test) indicated significant (p < 0.0001) remineralization and LD reduction by either toothpaste; however, when compared against each other, there was no statistically significant difference in remineralization or LD reduction between the two toothpastes. No demineralization could be observed in sound enamel blocks exposed to either toothpaste. While F− induced lesion surface lamination, HAP produced a more homogenous lesion remineralization.Conclusions10% hydroxyapatite achieved comparable efficacy with 500 ppm F− in remineralizing initial caries and preventing demineralization. Thus the HAP toothpaste is confirmed to be equal to the fluoride toothpaste in this study.
Highlights
Preventable, dental caries continues to be one of the most prevalent chronic diseases among children in the U.S and the world, and one of the most common unmet healthcare needs of poor children.[1]
The effect of dose limitation on fluoride effectiveness may be more pronounced in children below 6 years, since the fluoride dose recommended for this group is even lower than the regulatory 1000–1500 ppm fluoride concentration in non-prescription toothpastes, and as such probably suboptimal for effective remineralization of initial lesions
One may suggest increasing the dose of fluoride since its effectiveness is dose-dependent,[7] there is a limit to fluoride dose allowed in oral care products to avoid the risk of fluorosis in children[17] and toxicity in all ages.[18,19]
Summary
This in situ study compared the effectiveness of two toothpastes containing hydroxyapatite or 500 ppm fluoride in promoting remineralization and inhibiting caries development. MATERIALS AND METHODS: Two enamel blocks (human primary teeth), one sound and one with artificially-produced caries lesion, were exposed to toothpaste containing either 10% hydroxyapatite or 500 ppm F− (amine fluoride) via intra-oral appliance worn by 30 adults in two-arm double blind randomized crossover study lasting 14 days per arm (ClinicalTrials.gov: NCT03681340). RESULTS: Pairwise comparison (baseline vs test) indicated significant (p < 0.0001) remineralization and LD reduction by either toothpaste; when compared against each other, there was no statistically significant difference in remineralization or LD reduction between the two toothpastes. CONCLUSIONS: 10% hydroxyapatite achieved comparable efficacy with 500 ppm F− in remineralizing initial caries and preventing demineralization. The HAP toothpaste is confirmed to be equal to the fluoride toothpaste in this study
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