Caries-preventive Effect Research Articles

Evaluation of the Fluoride Releasing and Recharging Abilities of Various Fissure Sealants.

To evaluate the fluoride release from different fissure sealants sold mainly in non-Western countries via a curve-fitting method, and to investigate the ability of these materials to be recharged with fluoride. Four different fissure sealants which the manufacturers claim to release F- were tested; glass-ionomer cement Argecem (AC), the composite resins Fisskhim (FK), Fissulight (FL), Helioseal F (HF). Helioseal (HS), a composite resin not declared to release F, was used as a negative control. Of each material, 10 disks 8.0 mm in diameter and 1.8 mm thick were produced. For fluoride measurements, a fluoride-ion specific electrode was used. On day 21, the specimens were recharged with fluoride by immersion in toothpaste slurry. Fluoride release was evaluated and statistically compared by fitting an exponential curve through the cumulative release values and statistically comparing curve parameters (t½, AUC and plateau value) among each other as well as before and after recharging. Two materials (AC and HF) released a considerable amount of F- in the first 3 weeks after sample production. Furthermore, the increase of F- release after F- recharge was statistically significant (p < 0.05) for the materials AC, FL and HF, but not for FK and HS. Fluoride release of Fisskhim and Fissulight was negligible, while Helioseal F and Argecem noticeably released fluoride and thus can enhance the caries preventive effect of fissure sealants. Comparing release curve parameters simplifies statistical procedures.

Retention rates and caries-preventive effects of two different sealant materials: a randomised clinical trial.

The aim of this study was to compare the caries-preventive effect and the retention rates of sealants prepared with a new modified and a high-viscosity glass-ionomer cement (GIC) in recently erupted first permanent molars. MATERIALS AND METHODS: Fifty-six children (224 teeth) were included in a split-mouth randomised clinical trial. All children had their four first permanent molars sealed with either Clinpro XT Varnish (CXT) or Fuji IX GP FAST (FJ). FJ sealants were placed according to the ART protocol. Retention rates and caries-preventive effect of both materials were assessed clinically after 24months, and survival curves were created according to the Kaplan-Meier method. For sealant retention rates, analyses were performed according to both the traditional method and modified sealant retention categorisation. FJ sealants were retained longer in comparison to CXT sealants (p < 0.05), regardless of the categorisation used. In relation to the caries-preventive effect, no statistically significant differences were observed between materials (p = 0.99). Sealants prepared with the high-viscosity GIC according to the ART protocol survived longer than those prepared with the modified GIC, but both materials were equally effective in preventing cavitated dentine lesions over 24months. We concluded that GIC-based sealants are effective in preventing dentine caries lesions.

Microbiological Changes and Caries-Preventive Effect of an Innovative Varnish Containing Chlorhexidine in Orthodontic Patients

The aim of this study was to investigate the effects of Cervitec Plus® on the level of mutans streptococcus (SM) and lactobacillus (LB) colonies and the development of white spot lesions (WSLs) in patients with fixed orthodontic appliances. Informed consent was obtained from 32 volunteers (age 16.5 ± 2.75 years). At baseline, levels of the bacterial colonies were determined in saliva and plaque using a chairside test (CRT Bacteria, Ivoclar-Vivadent, Schaan, Liechtenstein), and the number of WSLs was registered. After placing the fixed appliance, Cervitec Plus® or placebo varnishes (Ivoclar-Vivadent, Schaan, Liechtenstein) were applied monthly around the brackets and tubes, randomly in the right or left (test and placebo) quadrants of the same dental arch. SM and LB colonies in saliva and the SM colonies in plaque were determined on 11–21, 13–23, 15–25, and 16–26 teeth monthly over a 6-month period. At the sixth month, the number of new WSLs was determined. By the end of the study, compared with baseline, the ratio of saliva samples belonging to the low-risk category was significantly higher (p ≤ 0.01) from the 2nd month regarding the SM (76 vs. 52%) and LB (69 vs. 52%); reduction of SM in plaque was significantly greater on the test than placebo sides (6.69 ± 1.71 and 4.45 ± 1.60, respectively; p ≤ 0.01). The mean number of new WSLs was significantly lower in the test (0.06 ± 1.60) than in the placebo quadrants (1.13 ± 1.50, p ≤ 0.01). Conclusion: Monthly use of Cervitec Plus® could result in a significant improvement in oral health of orthodontic patients.

Caries-Preventive Effect of NaF, NaF plus TCP, NaF plus CPP-ACP, and SDF Varnishes on Sound Dentin and Artificial Dentin Caries in vitro

The aim of this study was to compare the caries-preventive effect of different fluoride varnishes on sound dentin as well as on artificial dentin caries-like lesions. Bovine dentin specimens (n = 220) with one sound surface (ST) and one artificial caries lesion (DT) were prepared and randomly allocated to 11 groups. The interventions before pH cycling were as follows: application of a varnish containing NaF (22,600 ppm F^-; Duraphat [NaF₀/NaF₁]), NaF plus tricalcium phosphate (22,600 ppm F^-; Clinpro White Varnish Mint [TCP₀/TCP₁]), NaF plus casein phosphopeptide-stabilized amorphous calcium phosphate complexes (CPP-ACP; 22,600 ppm F^-; MI Varnish [CPP₀/CPP₁]), or silver diamine fluoride (SDF; 35,400 ppm F^-; Cariestop 30% [SDF₀/SDF₁]) and no intervention (N_NB/N₀/N₁). During pH cycling (14 days, 6 × 120 min demineralization/day) half of the specimens in each group were brushed (10 s; 2 times/day) with either fluoride-free (“0”; e.g., TCP₀) or 1,100 ppm F^- (“1”; e.g., TCP₁) dentifrice slurry. In another subgroup, the specimens were pH cycled but not brushed (N_NB). Differences in integrated mineral loss (ΔΔZ), lesion depth (ΔLD), and colorimetric values (ΔΔE) were calculated between the values after initial demineralization and those after pH cycling, using transversal microradiography and photographic images. After pH cycling, no discoloration could be observed. Furthermore, N_NB, N₀, and N₁ showed significantly increased ΔZ_DT/LD_DT and ΔZ_ST/LD_ST values, indicating further demineralization. In contrast, CPP₀, CPP₁, SDF₀, and SDF₁ showed significantly decreased ΔZ_DT/LD_DT values, indicating remineralization (p ≤ 0.004; paired t test). CPP₀, CPP₁, SDF₀, and SDF₁ showed significantly higher changes in ΔΔZ_DT/ΔLD_DT and ΔΔZ_ST/ΔLD_ST than N_NB, N₀, and N₁ (p < 0.001; Bonferroni post hoc test). In conclusion, under the conditions chosen, all fluoride varnishes prevented further demineralization. However, only NaF plus CPP-ACP and SDF could remineralize artificial dentin caries-like lesions under net-demineralizing conditions, thereby indicating that NaF plus CPP-ACP and SDF may be helpful to high-caries-risk patients.

School-Based Caries Prevention, Tooth Decay, and the Community Environment

The school and community context can contribute to inequity in child oral health. Whether the school and community affect the effectiveness of school-based caries prevention is unknown. The association between the school and community environment and dental caries, as well as their moderating effects with school-based caries prevention, was assessed using multilevel mixed-effects regression. Data were derived from a 6-y prospective cohort study of children participating in a school-based caries prevention program. For the school and community, living in a dental-shortage area and the proportion of children receiving free or reduced lunch were significantly related to an increased risk of dental caries at baseline. Caries prevention was associated with a significant per-visit decrease in the risk of untreated caries, but the rate of total caries experience increased over time. Caries prevention was more effective in children who had prior dental care at baseline and in schools with a higher proportion of low socioeconomic status students. There was significant variation across schools in the baseline prevalence of dental caries and the effect of prevention over time, although effects were modest. The school and community environment have a direct impact on oral health and moderate the association between school-based caries prevention and dental caries. Knowledge Transfer Statement: School-based caries prevention can be an effective means to reduce oral health inequity by embedding dental care within schools. However, the socioeconomic makeup of schools and characteristics of the surrounding community can affect the impact of school-based care.

The effectiveness and ease of a one-step conditioning agent with conventional acid etch and priming in the placement of sealants: A 6-month follow-up

Objectives: The objective of the study was to evaluate the caries incidence of occlusal surfaces sealed using the two different techniques after 6 months and the ease of placement of sealant following the two techniques, for children and operator. Materials and Methods: Children between the age groups of 8–11 years and only mandibular molars were involved in the study; the techniques used for enamel preparation before sealant placement on the right and left side of the mandibular arch were randomized. On one side Adper™ SE plus and on the other side phosphoric acid etches together with Adper™ Single Bond 2 were used. Clinpro™ sealants were placed on both sides. The retention with these two techniques was compared after 6-month-based Color Coverage Caries system. The opinions of the children were taken on the two techniques that were used and recorded on individual questionnaires using Facial Grimace Scale and the operator by visual analog scale. Descriptive statistics carried out using SPSS (version 17.0). Results: Fifty-seven (95%) of the sixty children were available for the follow-up after 6 months. The retention of the acid-etch group was significantly superior (P = 0.00*) as was the caries preventive effect (P = 0.04*). Children felt that the placement of sealants was easier following enamel preparation with Adper™ SE Plus (P = 0.00*) and same as the operator. Conclusions: The regular acid etch with placement of sealant showed less caries occurrence on the occlusal surface after 6 months. Both the operator and children opined that acid-etch method for the placement of sealants is more comfortable.

Rationale for caries prevention in young adults based on caries resistance rates

The aim of the study was to evaluate the effectiveness of caries prevention in young adults with different caries resistance rates. Sixty-seven patients aged 18-20 with low (n=32) and high (n=35) dmft were enrolled in the study. Caries prevention efficacy was assessed by laboratory tests: enamel resistance test (ERT), clinical enamel remineralization speed test (CERST), estimation of calcium and inorganic phosphorus in oral fluid. Patients with high caries activity in addition to conventional prevention program received prophylaxis procedure with Clinpro White Varnish (3M ESPE). ERT and CERST were significantly higher in high dmft (>13) subgroup. Statistically significant difference in ERT and CERST was observed between subgroups at 3 and 6 months evaluation after prevention program.

Caries Preventive Effects of High-fluoride vs Standard-fluoride Toothpastes - A Systematic Review and Meta-analysis.

To determine the efficacy of high-fluoride toothpastes (≥ 2500 ppm) as compared to standard fluoride toothpastes (≤ 1500 ppm) in preventing dental caries. Randomised controlled trials (RCTs) and cluster-randomised trials comparing high-fluoride dentifrices (≥ 2500 ppm) with lower-concentration fluoride dentifrices (≤ 1500 ppm) with a follow-up period of at least 6 months were included. A random effects model was used to assess the mean differences in caries increment between the two types of dentifrices used. A fixed effects model was used to determine the preventive effect of high-concentration fluoride toothpastes compared with low-fluoride toothpastes. Subgroup and sensitivity analyses were conducted when results indicated heterogeneity. Statistical significance was set at p < 0.05. Eight studies met the inclusion criteria. High-fluoride toothpaste use was statistically significantly associated with lower caries increment scores (pooled mean difference: -0.52 [95% CI, -0.67, -0.37], p = 0.00001). Subgroup analysis for the included studies reflected a significant reduction in I2 values from 99% to 18%. High-fluoride toothpastes were also associated with a greater preventive effect compared with low-fluoride toothpastes (pooled odds: 52.76 [95% CI, 19.74, 141.04], p = 0.95). This meta-analysis suggests that high-fluoride toothpastes are superior to low-fluoride toothpastes in reducing caries. The results of this work when used judiciously should encourage the use of high-fluoride toothpaste, specifically among the vulnerable populations, to maximise preventive benefits.

Clinical studies on the dental caries prevention effects of the ability of Weissella cibaria CMU to adhere to the oral cavity

The purpose of this study is to investigate the effects of diet containing Weissella cibaria CMU (oraCMU) on Streptococcus mutans causing dental caries. The m-PHP index was Modified Patient Hygiene Performance Index. As a measuring method, Modified patient hygiene performance index was measured to quantify oral hygiene condition among 2 subject groups consisting of W. cibaria CMU (oraCMU), a commercial product containing W. cibaria CMU and the same commercial product but removing W. cibaria CMU as a placebo control. Each group had 25 subjects. Unstimulated saliva were collected and analyzed by real-time polymerase chain reaction (RT-PCR). The measurement of Modified patient hygiene performance index was performed every 2 weeks starting from the first day of the experiment. And to know the effects of post-diet, its measurements were continued every 2 weeks for 4 weeks of a post-diet period. Data were analyzed by One-way ANOVA was carried out for the significance test between groups. Scheff's post hoc was used to determine variance homogeneity differences between the mean values (p < 0.05).

Effect of Probiotic Lactobacillus reuteri on Salivary Cariogenic Bacterial Counts among Groups of Preschool Children in Jeddah, Saudi Arabia: A Randomized Clinical Trial

To evaluate the effect of probiotic Lactobacilli reuteri lozenges on caries-associated salivary bacterial counts (Mutans streptococci and Lactobacillus), dental plaque accumulation, and salivary buffer capacity in a group of preschool children. The study group consisted of 178 healthy children (aged 3-6 years). Children were randomly grouped: the experimental group (n = 90) received L. reuteri probiotic lozenges and the control group (n = 88) received placebo lozenges, twice daily, for 28 days. Salivary Mutans streptococci and Lactobacillus counts, and buffer capacity were assessed using chair-side caries-risk test (CRT®) kits. The Simplified Oral Hygiene index (OHI-S) was used to assess dental plaque accumulation at baseline and after 28 days. After 28 days, the experimental group had a statistically significant reduction in Mutans streptococci and lactobacilli (p = 0.000 and p = 0.020, respectively) and both groups had less plaque accumulation than at baseline. While the buffer capacity in the experimental group increased more than in the control group, it was not statistically significant (p = 0.577). Compliance was 90%, with no adverse events. Consumption of probiotic lozenges containing L. reuteri reduces caries-associated bacterial counts significantly. Probiotics consumption may have a beneficial caries-preventive effect.

Caries-Preventive Effect of Salt Fluoridation in Preschool Children in The Gambia: A Prospective, Controlled, Interventional Study

The aim of this study was to investigate the anticaries effect of fluoridated salt in a communal feeding program for preschool children. In the Gambian city of Brikama, drinking water had a low fluoride content (0.1 mg F^-/L) and young children did not use toothpaste for oral hygiene. Its 2 preschools served as clusters for the trial. Random allocation of the kindergartens was performed by one person not involved in the study, and the clinical examinations were carried out using the envelope method. Meals were prepared with fluoridated salt (250 mg F^-/kg salt) in the intervention group but not in the control group. According to the inclusion criteria (complete primary dentition and informed consent from legal guardian), 441 children aged 3-5 years were enrolled. The children were examined by calibrated persons according to WHO criteria, allowing the calculation of d₃mft scores. The primary end point was the mean difference in the incidence of caries cavities (Δd_3/4mft) after 12 months. After 12 months, the mean caries incidence per person was 1.29 d_3/4mf teeth (95% CI: 0.96; 1.62) in the test group (n = 304 children) and 3.83 d_3/4mf teeth (95% CI: 2.94; 4.72) in the control group (n = 137 children). Thus, the caries-prevented fraction was 66.3%. No signs of harm due to the intervention were observed. The use of fluoridated salt in a communal feeding program and in an environment with negligible availability of fluoride from other sources yields a considerable caries-preventive effect.

Little evidence available for arginine and caries prevention.

Data sourcesPubMed, the Cochrane Library, Centre for Reviews and Dissemination (CRD) and Embase.Data abstraction and synthesisTwo independent reviewers selected studies, abstracted data and assessed study quality using the GRADE criteria. Meta-analysis was conducted using a random effects model.Study selectionRandomised controlled trials including in situ studies.ResultsSeven studies were included, five conducted in children and two in adults. The two adult studies and one child study were considered to be at high risk of bias. The remaining four child studies were considered to be at moderate risk of bias. These four studies compared 1450ppm fluoride toothpaste with 1.5% arginine against 1450ppm fluoride toothpaste as a control. Meta-analysis of three studies showed a positive effect on caries measured using quantitative light-induced fluorescence (QLF) in favour of arginine; mean difference -4.67, (95%CI, -6.34 to -3.01). The overall GRADE assessment of this was considered to be very low.ConclusionAt present there is insufficient evidence in support of a caries-preventive effect for the inclusion of arginine in toothpastes. More rigorous studies, and studies which are less dependent on commercial interests, are required.

Economic evaluation of dental sealants: A systematic literature review.

To systematically review the literature on economic evaluations of dental sealants and examine the costs and effectiveness of caries prevention using sealants. Of 21 full-text articles examined, a total of 13 were included in this study. These studies are grouped by the type of intervention as follows: (i) sealants compared with no sealants; (ii) sealants compared with other forms of caries prevention; (iii) resin-based sealants compared with glass-ionomer sealants; (iv) different sealing strategies in primary teeth; (v) different sealing strategies in permanent teeth; and (vi) sealants based on school- or clinic-based setting of delivery. All currency is reported in constant 2010 US$. Cost-effectiveness analyses differed due to varying study designs, assumptions, sealant delivery settings, outcomes, caries risk assessment and study durations. Findings varied on the cost-effectiveness of sealants compared with other caries-preventive strategies. Under the assumption of equal caries risk, always sealing primary molars appeared to be the most effective strategy, whereas risk-based sealing was the optimal strategy with differing caries risk. Studies that assessed sealing strategies in permanent teeth reported that risk-based sealing was more cost-effective than not sealing, but they differed on the cost-effectiveness of risk-based seal compared with non-risk-based seal. Sealants delivered in school settings had mixed results on costs but were as equally effective as sealants delivered in private practices. The cost-effectiveness of sealants is dependent on the conditions of delivery. The list of cost-effectiveness ratios for each intervention can support policy makers to estimate expected returns on their investments in dental sealants.

Pit and fissure sealants for preventing dental decay in permanent teeth.

Pit and fissure sealants for preventing dental decay in permanent teeth.

The caries preventive effect of 1-year use of low-dose xylitol chewing gum. A randomized placebo-controlled clinical trial in high-caries-risk adults

ObjectivesThe caries preventive effect of long-term use (1 year) of low-dosage (2.5 g/die) of xylitol chewing gum in a high-caries-risk adult population was evaluated.Materials and methodsIn this randomized clinical trial, 179 high-caries-risk adults were assigned to two experimental groups, xylitol and polyols. Caries status, salivary mutans streptococci (MS), and plaque pH were re-evaluated after 2 years from baseline in 66 xylitol and 64 polyol subjects. Outcomes (the net caries increment for initial, moderate, and extensive caries lesions and for the caries experience) were evaluated using the nonparametric Mann–Whitney U test.ResultsThe total caries experience increment was 1.25 ± 1.26 in the xylitol group and 1.80 ± 2.33 in the polyol group (p = 0.01). Subjects treated with xylitol chewing gums had a reduction of risk rate at tooth level of 23% with respect to those treated with polyols with a number needed to treat of 55 teeth. The area under the curve at pH 5.7 was statistically significantly lower (p = 0.02) during the experimental period in the xylitol group. A decrease of the concentration of salivary MS was noted in the xylitol group (p < 0.01).ConclusionsSubjects using the low-dose xylitol chewing gum showed a significantly lower increment of initial and extensive caries lesions and overall a lower increment of caries experience.Clinical relevanceOne-year use of chewing gums provides an effective means for the prevention of caries disease.Trial registration numberNCT02310308

Regular supervised fluoride mouthrinse use by children and adolescents associated with caries reduction

Data sourcesCochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, LILACS, BBO, Proquest Dissertations and Theses, Web of Science Conference Proceedings, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform.Study selectionRandomised or quasi-randomised controlled trials where blind outcome assessment was stated or indicated, comparing fluoride mouthrinse with placebo or no treatment in children up to 16 years of age with a duration of at least 12 months.Data extraction and synthesisA least two reviewers independently selected studies, abstracted data and assessed risk of bias.ResultsThirty-seven trials involving 15,813 children and adolescents were included. Supervised rinsing in schools was tested in all trials. Twenty-eight studies were at high risk of bias, nine at unclear risk. Thirty-five trials (15,305 participants) contributed data on permanent tooth surface for meta-analysis and found a prevented fraction for D(M)FS = 27%(95%CI 23% to 30%; I2 = 42%) (moderate quality evidence). Meta-regression showed no significant association between estimates of D(M)FS with baseline caries severity, background exposure to fluorides, rinsing frequency or fluoride concentration. The pooled estimate of prevented fraction from 13 studies for D(M)FT = 23% (95%CI, 18% to 29%; I2 = 54%).There was limited information on possible adverse effects or acceptability of the treatment regimen in the included trials.ConclusionsThis review found that supervised regular use of fluoride mouthrinse by children and adolescents is associated with a large reduction in caries increment in permanent teeth. We are moderately certain of the size of the effect. Most of the evidence evaluated use of fluoride mouthrinse supervised in a school setting, but the findings may be applicable to children in other settings with supervised or unsupervised rinsing, although the size of the caries-preventive effect is less clear. Any future research on fluoride mouthrinses should focus on head-to-head comparisons between different fluoride rinse features or fluoride rinses against other preventive strategies, and should evaluate adverse effects and acceptability.

Industry sponsorship in trials on fluoride varnish or gels for caries prevention.

Fluoride is effective for caries prevention, but trials on fluoride varnish or gels are often industry-sponsored. We assessed trial design and findings in sponsored and nonsponsored trials on fluoride varnish and fluoride gels for caries prevention. Data on trials included in the most recent Cochrane Reviews on fluoride varnish and fluoride gels were extracted. Sample sizes/age/dentition, year/country of publication, follow-up, test and control, risk of bias and spin (claims of a beneficial effect that were not supported by reported data) were assessed. Studies were categorized as certainly, possibly and not sponsored, and statistically compared. Inverse-generic meta-analysis and multivariable weighted least-squares meta-regression were used to assess impact of sponsorship status on effect estimates. Based on 19 nonsponsored, 14 possibly sponsored and 11 certainly sponsored trials, sponsored studies were published significantly earlier, always had >1 test group, and had significantly lower risk of spin. Caries-preventive effects were higher in earlier trials, without indication for sponsorship bias in trials published until 1990 (there were no sponsored trials afterwards). If assessing the overall body of evidence and accounting for confounders, the caries-preventive effect was significantly associated with year of publication (β: -0.06, 95% CI: -0.10/-0.02), but not sponsorship status. Industry-sponsorship bias had limited impact on the overall evidence.

ДЕЯКІ ВЛАСТИВОСТІ ГЕКСАФТОРОСИЛІКАТІВ 3,5-ДИЗАМІЩЕНИХ ПОХІДНИХ 1,2,4-ТРИАЗОЛУ

З використанням методу фотоколориметрії проведено визначення ступеня гідролізу гексафторосилікатів 3,5-дизаміщених похідних 1,2,4-триазолу в 1×10-4 М водних розчинах їх солей. Встановлено, що ступінь гідролізу солей змінюється в межах 63,8 – 92,0 %. Знайдено розчинність їх солей у воді, яка становить ≤ 0,0002 мол. %.

The caries preventive effect on permanent teeth adjusted for number of fissure-sealed teeth and surfaces from 6-year community water fluoridation program in Geoje City

The caries preventive effect on permanent teeth adjusted for number of fissure-sealed teeth and surfaces from 6-year community water fluoridation program in Geoje City

Retention and caries-preventive effect of glass ionomer and resin-based sealants: An 18-month-randomized clinical trial

The objective of this study was to compare the retention and caries-preventive effect of glass ionomer (Fuji Triage) and resin-based (Clinpro) sealants among 6-9-year-old children. This split-mouth, randomized clinical trial covered 35 children/140 fully erupted permanent first molars. Evaluation was conducted by two independent examiners after 6, 12, and 18 months and the data were compared in relation to the children's caries risk and age groups. The Kaplan-Meier survival method and chi-square test were used for analysis. There were no statistically significant differences in the survival of partial and fully retained sealants or in the survival of caries-free pits and fissures between glass-ionomer and resin-based sealants. In terms of retention, both sealants performed better in the younger age group at the end of the study, and showed better caries prevention in moderate caries risk children. After 18 months, both sealants had comparable retention and caries-preventive effects in 6-9-year old children.