Effect of a third application of toothpastes (1450 and 5000 ppm F), including a ‘massage' method on fluoride retention and pH drop in plaque

Abstract

Objective.The aim was to investigate fluoride (F) retention in plaque, saliva and pH drop in plaque using high-F toothpaste (5000 ppm F) or standard toothpaste (1450 ppm F) twice a day or 3-times a day. A method using the toothpaste as a ‘lotion' and massaging the buccal surfaces with the fingertip was also evaluated. Materials and methods.The investigation had a randomized, single-blinded, cross-over design and 16 subjects participated in six brushing regimes: (1) 5000 ppm F; twice a day, (2) 5000 ppm; 3-times/day, (3) 5000 ppm; twice a day, plus the ‘massage' method once a day, (4) 1450 ppm F; twice a day, (5) 1450 ppm; 3-times/day and (6) 1450 ppm; twice a day, plus the ‘massage' method once a day. The outcome measure was F retention in plaque, saliva and the plaque-pH change after a sucrose rinse. Results.The highest F concentration was found using high-F toothpaste (No 1–3) and differed significantly from those with 1450 ppm (No 4–6). Brushing with high-F toothpaste 3-times a day (No 2) resulted in a 3.6-times higher F saliva value compared with standard toothpaste twice a day (No 4) (p < 0.001). Increasing the frequency of application, from twice to 3-times a day, increased the F retention in plaque significantly when the two methods for application 3-times a day were pooled (p < 0.05). Brushing with 5000 and 1450 ppm toothpastes twice a day plus the ‘massage' once a day resulted in the same F concentration in saliva and plaque as brushing 3-times a day with the same paste. Conclusion.A third application of toothpaste is increasing the F retention and toothpaste as a ‘lotion' and massaging the buccal surfaces with the fingertip may be a simple and inexpensive way of delivering F a third time during the day.