Fluoride Concentration In Saliva Research Articles

Dose-response relationship between toothpaste soluble fluoride absorbed in the gastrointestinal tract and saliva fluoride secretion

Aim: This study aimed to evaluate if there is a dose-response relationship between toothpaste chemically soluble fluoride absorbed in the gastrointestinal tract and fluoride secreted by saliva, giving support to the use of saliva as surrogate for plasma fluoride. Methods: A 4-phase single blind study was conducted, in which 10 participants were subjected in each phase to one of the assigned treatment groups: group I: fresh sample of a Na2FPO3/CaCO3-based toothpaste with 1,334 μg F/g of total soluble fluoride (TSF) and groups II–IV: aged samples of this toothpaste presenting TSF concentrations of 1,128, 808, and 687 μg F/g, respectively. In all phases, the participants ingested an amount of toothpaste equivalent to 70.0 μg F/Kg body weight, as total fluoride (TF). Saliva and blood samples were collected before (baseline) and up to 180 min after toothpaste ingestion as indicator of fluoride bioavailability. F concentration in saliva and blood plasma was determined with a fluoride ion-specific electrode. The areas under the curve (AUC) of F concentration versus time (AUC = ng F/mL × min) and the peaks of fluoride concentration (Cmax) in saliva and plasma were calculated. Results: A significant correlation between mg of TSF ingested and the AUC (r=0.47; p<0.01), and Cmax (r=0.59; p<0.01) in saliva was found; for TF, the correlation was not significant (p>0.05). In addition, the correlations between plasma and saliva fluoride concentrations were statistically significant for AUC (r=0.55; p<0.01) as for Cmax (r=0.68; p<0.01). Conclusion: The findings support that saliva can be used as a systemic biomarker of bioavailable fluoride present in Na2FPO3/ CaCO3-based toothpaste.

Bio-Tribocorrosion of Titanium Dental Implants and Its Toxicological Implications: A Scoping Review.

Bio-tribocorrosion is a phenomenon that combines the essentials of tribology (friction, wear, and lubrication) and corrosion with microbiological processes. Lately, it has gained attention in implant dentistry because dental implants are exposed to wear, friction, and biofilm formation in the corrosive oral environment. They may degrade upon exposure to various microbial, biochemical, and electrochemical factors in the oral cavity. The mechanical movement of the implant components produces friction and wear that facilitates the release of metal ions, promoting adverse oro-systemic reactions. This review describes the bio-tribocorrosion of the titanium (Ti) dental implants in the oral cavity and its toxicological implications. The original research related to the bio-tribo or tribocorrosion of the dental implants was searched in electronic databases like Medline (Pubmed), Embase, Scopus, and Web of Science. About 34 studies included in the review showed that factors like the type of Ti, oral biofilm, acidic pH, fluorides, and micromovements during mastication promote bio-tribocorrosion of the Ti dental implants. Among the various grades of Ti, grade V, i.e., Ti6Al4V alloy, is most susceptible to tribocorrosion. Oral pathogens like Streptococcus mutans and Porphyromonas gingivalis produce acids and lipopolysaccharides (LPS) that cause pitting corrosion and degrade the TiO2. The low pH and high fluoride concentration in saliva hinder passive film formation and promote metal corrosion. The released metal ions promote inflammatory reactions and bone destruction in the surrounding tissues resulting in peri-implantitis, allergies, and hyper-sensitivity reactions. However, further validation of the role of bio-tribocorrosion on the durability of the Ti dental implants and Ti toxicity is warranted through clinical trials.

Comparative Evaluation of Salivary Fluoride Concentration after Topical Application of Silver Diamine Fluoride and Sodium Fluoride: A Randomized Controlled Trial.

BackgroundThe topical fluoride acts on the tooth in many ways and their most important action is inhibition of demineralization and enhancement of enamel remineralization.AimThe purpose of this clinical trial was to assess the fluoride concentration in saliva before and after 38% silver diamine fluoride (SDF) and 5% sodium fluoride (NaF) application on enamel and duration of its availability at different time intervals.MethodologyA randomized clinical trial was conducted among 40 healthy children aged between 6 and 12 years. The participants were then randomly allocated into two different groups in which the first group (group I) was given 30% SDF and the second group (group II) were topically applied with 5% NaF solution. The fluoride concentration was measured in the salivary samples, which were collected at three time intervals, that is, at baseline (S1), 2 hours (S2), and 24 hours (S3) after application. Analysis of variance (ANOVA) test was used for evaluation and independent paired t-test was conducted for comparison between groups.ResultsWhen using an ANOVA with repeated measures with a Greenhouse–Geisser correction, the mean scores of fluoride concentration were statistically significantly different at different time intervals for both NaF (F = 20.854, p < 0.0005) and SDF (F = 22.746, p < 0.0005).ConclusionThe present trial concluded that topical fluoride application increases fluoride bioavailability in saliva thereby increasing tooth remineralization. A steep rise in fluoride concentration was observed shortly post-SDF application at 2 hours and 24 hours time interval emerging a need for further research into the field of fluoridation with SDF.How to cite this articleJabin Z, Nasim I, Priya V V, et al. Comparative Evaluation of Salivary Fluoride Concentration after Topical Application of Silver Diamine Fluoride and Sodium Fluoride: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2022;15(3):371-375.

Evaluation of Oral Hygiene Status, Salivary Fluoride Concentration and Microbial Level in Thalassemic and Hemophilic Patients

Objective: This study aimed to evaluate oral hygiene status, salivary fluoride concentration, and Streptococcus mutans and Lactobacillus levels in saliva of thalassemic, hemophilic and individuals without any other systemic disorders.Materials and Methods: A total 162 individuals (44 healthy individuals, 86 thalassemic and 32 hemophilic patients) were selected, and randomly (n=30 in each group), the patients were allocated to Group A: individuals without any systemic condition, Group B: thalassemic patients, and Group C: hemophilic patients. Detailed case history, DMFT/DMFS, and OHI-S index were recorded. An aliquot of 5 ml of saliva was collected from each patient to determine the salivary fluoride concentration and predominant microbial colony in saliva. The data were analyzed by chi-square test of independence and nonparametric Kruskal-Wallis H test.Results: The mean debris and calculus index among groups A, B, and C was 0.55 ± 0.43, 0.61 ± 0.46, 0.46 ± 0.47 and 0.33 ± 0.48, 0.18 ± 0.34, and 0.15 ± 0.34, respectively. The DMFT score for group A was high (1.93 ± 1.86, 1.67 ± 1.92) compared to groups B (0.40 ± 0.77, 0.67 ± 1.37) and C (0.47 ± 0.68, 0.30 ± 0.54). The fluoride concentrations among three groups (A, B, and C) were 0.06 ± 0.07, 0.12 ± 0.13, and 0.12 ± 0.13 ppm respectively. The number of colony-forming units was highest in the healthy individual&gt;hemophilic&gt;thalassemic and presence of predominant microorganisms showed insignificant association among the groups (p=0.323).Conclusion: Compared to healthy individuals, thalassemic and hemophilic patients had better oral hygiene.

Salivary retention of silver diamine fluoride.

The topically applied fluorides are efficacious in both prevention against caries attack and inhibition of virulent bacteria. The purpose of this clinical trial was to assess the fluoride concentration in saliva before and after 38% SDF, 5% NaF and 1.23% ApF gel application on enamel and duration of its availability at different time intervals. The present randomized clinical trial was conducted among 60 healthy children aged between 6-12 years where at baseline the participants were instructed to spit for 2 min in sterile containers and the first saliva sample (S1) was taken. The participants were then randomly allocated into 3 different groups in which 38% Silver diamine fluoride, 5% Sodium fluoride and 1.23% ApF gel were applied respectively. The second saliva sample (S2) was collected after 5 min and patients were called after 1 hour for third saliva sample collection. The fluoride concentration was measured in the salivary samples. ANOVA test was used for evaluation and chi square t test was conducted for comparison of 3 groups. The fluoride concentration is comparatively slightly higher for the group receiving SDF than NaF and ApF at baseline, 5 min and 1 hour time interval but is not statistically significant. The mean scores of Fluoride concentration of the three groups were statistically significant at 5 min (F=63.556, p<0.0005) and 1 hour time interval (F=17.577, p<0.0005). Slightly increased salivary fluoride retention was observed post SDF application at 5min and 1 hour time interval when compared to Na F and ApF gel application. The present trial also concluded that topical fluoride application increases fluoride bioavailability in saliva thereby increasing tooth remineralization.

Salivary fluoride concentration following toothbrushing with and without rinsing: a randomised controlled trial

BackgroundCaries prevalence has declined significantly since the introduction of fluoridated toothpaste. There have been several developments regarding specific active fluoride ingredients but not enough evidence to support one over the other. The purpose of this double-blind randomized controlled trial was to compare salivary fluoride concentrations of different fluoride formulations in the form of toothpaste with and without post-brushing water rinsing in adults.MethodsThe study included 120 participants who were randomly assigned to one of 12 groups (10 participants/group). The toothpaste formulas investigated included (1) fluoride-free (0 ppmF); (2) sodium fluoride (1450 ppmF); (3) sodium monofluorophosphate (1450 ppmF); (4) sodium fluoride and monofluorophosphate combined (1450 ppmF); (5) stannous fluoride and sodium fluoride combined (1450 ppmF); and (6) amine fluoride (1400 ppmF). Block randomisation was used to assign each participant to one of the 12 groups. Participants brushed with 1.0 g of one of the six different toothpaste formulations either with or without post-brushing water rinsing. Saliva was collected at six different times (baseline and at 1, 15, 30, 60, and 90 min/s post-brushing). Samples were analysed using a fluoride ion-specific sensitive electrode connected to an ion analyser.ResultsThe demographic characteristics of the participants were not significantly different among the groups (P > 0.05). Time, toothpaste formulation, and post-brushing rinsing routines had significant effects on saliva fluoride retention (P < 0.05). Amine fluoride-containing toothpaste was the only formula that showed statistically significantly higher concentrations of salivary fluoride at 90 min in both the rinsing and non-rinsing groups. Sodium monofluorophosphate toothpaste did not result in a significant difference compared to the control group at any time point, in both rinsing and non-rinsing groups.ConclusionsBased on the results from this study, no rinsing after toothbrushing in adults can be recommended when sodium monofluorophosphate containing toothpaste formula is used. It also concludes that amine fluoride resulted in a significantly higher saliva fluoride concentration at 90 min in both the rinsing and non-rinsing groups compared to other fluoride toothpaste formulations.Registry: Protocol Registration and Results System (ClinicalTrials.gov).Clinical trial registration number: NCT02740803 (15/04/2016).

Salivary Fluoride Bioavailability after Brushing with Brazilian Red Propolis Dentifrice: A Clinical Study.

Introduction Fluoride plays an important role in the control of dental caries, and currently new dentifrices are being associated with natural products. Objective This study aimed to evaluate the availability of fluoride in saliva samples after using a dentifrice incorporated with Brazilian red propolis (BRP, INPI Patent no. BR1020170110974) and to compare it to a conventional fluoridated dentifrice in healthy participants. Methods This study was conducted implementing a double-blind, randomized, controlled, and crossover design. Saliva samples of participants were collected at the following time points: 0 at baseline and 5, 15, 30, 45, and 60 minutes after brushing with each dentifrice. Salivary fluoride concentrations showed no statistically significant difference when comparing the two treatments (p > 0.05). All available fluoride concentrations in saliva decreased after one hour, with no significant difference between BRP and conventional fluoridated dentifrice treatment samples (p > 0.05). Results The results showed that there was no difference between the analyzed fluoride concentrations 1 hour after brushing with the different dentifrices. Conclusions The results of this study suggest that the propolis incorporated in the dentifrice did not interfere with the kinetics and bioavailability of the fluoride ion in saliva samples, enabling its integration with the pharmaceutical formula and thereby promoting its anti-inflammatory and antimicrobial benefits without compromising the anticaries activity of the formulation.

Comparison of the Fluoride Release of Silver Diamine Fluoride, Fluoride Varnish, Acidulated Phosphate Fluoride Gel on Extracted Teeth over Various Time Intervals in Artificial Saliva

Silver Diamine Fluoride (SDF) has been documented to effectively arrest dental caries and reduce dental hypersensitivity. SDF promotes remineralization and harden the carious lesion. SDF increases fluoride concentration in saliva and increase the bioavailability of fluoride in saliva. After SDF application, fluoride ion promotes remineralization and silver ion is available for antimicrobial action.&#x0D; Aim: The study aims to determine and compare the amount of fluoride released from various fluoride releasing materials in artificial saliva after 24 hours, 7th day and 14th day of the study.&#x0D; Materials and Methods: 96 premolars free of any caries, fractures, or any other defects were sterilized in 10% formalin for 2 weeks. Then they were rinsed in tap water to remove any fixative from its surface and then stored in deionised distilled water for a period of 30 days prior to testing. Tooth samples were divided into four groups- Group 1: 38% SDF, Group 2: 1.23% APF gel, Group 3: Fluoride varnish and Group 4: Control. All the teeth specimens were blot dried and subjected to their respective material. Fluoride release was analysed using a Fluoride ion-selective electrode after 24 hours, 7days and 14 days of suspension in artificial saliva.&#x0D; Results: Mann-Whitney U Test for inter-group comparison was used for statistical evaluation. 24 Hours fluoride release: The maximum amount of fluoride was released from Fluoride Varnish followed by SDF then APF Gel and least by artificial saliva alone (control) (p&lt;0.001). 7th Day fluoride release: The maximum amount of fluoride was released from SDF followed by Fluoride Varnish then APF Gel and least by artificial saliva alone (control) (p&lt;0.001). 14th Day fluoride release: The maximum amount of fluoride was released from Fluoride Varnish followed by SDF then APF Gel and least by artificial saliva alone (control) (p&lt;0.001).

Effect of Different Toothbrushing Routines on Interproximal Fluoride Concentration

This study aimed to evaluate the effect of different toothbrushing routines and different kinds of toothpaste on the interproximal fluoride concentration after toothbrushing and its clinical relevance to the recommendations given to patients regarding the process of toothbrushing. Eight adults participated a total of 8 times in order to test different toothbrushing routines with different amounts of toothpaste (1 or 2 cm), durations (1 or 2 min) and amounts of water after toothbrushing (10 or 20 mL). An additional 8 adults participated 6 times in total to test different forms of toothpaste administration (paste, gel and foam) with different amounts of water after toothbrushing (no rinsing or 10 mL). Interdental saliva samples were collected from proximal sites 25/26 and 46/45 using small paper points, before and up to 60 min after toothbrushing. The fluoride concentration was measured by an ion-specific electrode. The area under the curve, saliva fluoride concentration versus time, was calculated. Differences between the groups were tested by ANOVA with Tukey’s multiple comparisons test. An increase in fluoride concentration of 47.2% was observed when the amount of toothpaste increased from 1 to 2 cm (p < 0.01), 26.8% when increasing the duration from 1 to 2 min (p < 0.01) and 41.2% when reducing the amount of water rinsing from 20 to 10 mL (p < 0.01). The paste and gel resulted in higher fluoride concentration (p < 0.01) compared with foam. These findings suggest that the amount of toothpaste, the duration and the amount of water have a significant effect on fluoride concentration after toothbrushing. Furthermore, despite the lower amount of fluoride, the gel gives almost the same fluoride concentration after toothbrushing as the toothpaste. The results confirm the importance of giving clear advice to patients regarding the process of toothbrushing.

Amount of Dentifrice and Fluoride Concentration Influence Salivary Fluoride Concentrations and Fluoride Intake by Toddlers

The present study evaluated fluoride (F) concentrations in saliva of toddlers after brushing with dentifrices containing different F concentrations, applied in different quantities, and estimated F intake from toothbrushing. The study comprised a double-blind, crossover protocol, in which toddlers (n = 18, 2–3 years old) were randomly assigned into six groups, according to possible combinations of dentifrices (0/550/1,100 ppm F, as NaF) and amounts (rice grain, pea size, and transverse technique). Volunteers used a F-free dentifrice during 1 week. On the 7th day, saliva samples were collected before (baseline), and at 5/15/30/60 min after toothbrushing. All dentifrice expectorated after brushing was collected. F concentrations (saliva and expectorate) were determined with an ion-specific electrode. Data were submitted to ANOVA or Kruskal-Wallis test, followed by Fisher’s LSD or Student-Newman-Keuls’ tests (p <0.05). Brushing with 550 ppm F dentifrice (pea size or transversal technique) increased the area under the curve (AUC) at similar levels compared to 1,100 ppm F (rice grain). The highest AUC and salivary F at 5 min after brushing were achieved by 1,100 ppm F (pea size), followed by 550 ppm F (transversal technique). Regarding F intake, the highest values were observed for 550 ppm F (transversal technique), followed by 1,100 ppm F (pea size). It is possible to conclude that the amount of dentifrice and F concentration in the product significantly affected both salivary F concentrations and F intake during toothbrushing.

Chemically Soluble Fluoride in Na2FPO3/CaCO3-Based Toothpaste as an Indicator of Fluoride Bioavailability in Saliva during and after Toothbrushing

The relationship between the concentration of chemically soluble fluoride found in toothpaste and that present in saliva, during and after brushing, was evaluated as an indicator of potentially bioavailable fluoride in toothpaste. Ten adult participants brushed their teeth with the assigned toothpastes: group I: fresh sample of a fluoride toothpaste: Na₂FPO₃/CaCO₃, 1,378 µg F/g of total soluble fluoride (TSF); groups II–IV: aged samples of toothpaste presenting TSF concentrations of 1,160, 900, and 597 µg F/g, respectively; group V: non-F placebo toothpaste. The volunteers brushed their teeth for 1 min with 0.7 g of the toothpaste, all toothbrushing residues (TR) produced were collected, the mouth was rinsed with water, and saliva samples were collected up to 120 min. Total fluoride (TF) and TSF concentrations were determined in TR and in saliva samples using a fluoride ion-selective electrode. TSF concentration (µg F/mL) in TR was determined as an indicator of fluoride bioavailability during toothbrushing and the areas under curves of saliva fluoride concentration versus time (area under the curve, AUC = µg F/mL × min) were calculated as an indicator of fluoride bioavailability after toothbrushing. A significant correlation was found between the TSF concentrations in the toothpastes and the variables TR (r = 0.850; p = 0.0001) and AUC (r = 0.445; p = 0.004). For TF no significant correlation was found for TR (r = –0.099; p = 0.542) and AUC (r = –0.018; p = 0.912). The findings suggest that TSF concentration chemically found in Na₂FPO₃/CaCO₃-based toothpaste could estimate how much fluoride would be bioavailable in saliva when the teeth are brushed.

Biomarkers for the Assessment of Fluoride Exposure in Children

Due to practical difficulties in quantifying fluoride exposure, the ability of various biomarkers to predict exposure has been investigated previously. However, the results are inadequate for validation of their application and usefulness. This study aimed to investigate the association between contemporary/recent biomarkers of fluoride exposure and total daily fluoride intake (TDFI) of children with large differences in fluoride exposure through drinking water. TDFI was assessed in 61 healthy 4- to 5-year-old children who provided at least 1 biomarker sample; 32 lived in a low-fluoride area (0.04 mg F/L) and 29 lived in a high-fluoride area (3.05 mg F/L). Validated questionnaires were administered to evaluate fluoride intake from diets (including water) and toothpaste ingestion. Daily urinary fluoride excretion (UFE) and fluoride concentrations in plasma, fasting whole saliva, hair, and nails (toenails/fingernails) were evaluated and related to total fluoride exposure. TDFI, UFE, and fluoride concentrations of biomarkers were statistically significantly higher in the high-fluoride area than in the low-fluoride area. There was a strong statistically significant positive correlation between TDFI and UFE (ρ = 0.756, p < 0.001); plasma fluoride concentration (ρ = 0.770, p < 0.001); and toenail fluoride concentration (ρ = 0.604, p < 0.001). The statistically significant positive correlation between TDFI and fingernail fluoride concentration (ρ = 470, p < 0.001) as well as between TDFI and fasting whole saliva fluoride concentration (ρ = 0.453, p = 0.001) was moderate, whereas it was weak between TDFI and hair fluoride concentration (ρ = 0.306, p = 0.027). In conclusion, the current study confirmed the suitability of 24-h urine samples for estimating fluoride exposure in children. The strong correlations between TDFI and fluoride in plasma and toenails also suggest these biomarkers may be considered for health risk assessments of fluoride in children who are susceptible to development of dental fluorosis.

Fluoride in Saliva and Oral Mucosa after Brushing with 1,450 or 5,000 ppm Fluoride Toothpaste

The aim was to measure and compare fluoride concentrations in oral mucosa and saliva following a single brushing with either 1,450 or 5,000 ppm fluoride toothpaste. Fourteen healthy participants provided saliva and oral mucosa samples in the morning before tooth brushing. Then participants brushed their teeth with 1,450 ppm fluoride toothpaste, and saliva and mucosa samples were collected after 1, 2, 4, and 6 h. The experiment was repeated 3–7 days later with 5,000 ppm fluoride toothpaste. All samples were analyzed for fluoride using an ion-selective electrode adapted for microanalysis. Pre-brushing fluoride concentrations were higher in mucosa (mean_1,450 0.26 ppm and mean_5,000 0.20 ppm) than in saliva (mean_1,450 0.08 ppm and mean_5,000 0.07 ppm). The mean fluoride concentrations increased in both mucosa and saliva following a single brushing with both 1,450 ppm (mean_{muc1,450 (1 h)} 1.15 ppm, mean_{sal1,450 (1 h)} 0.33 ppm) and 5,000 ppm fluoride toothpaste (mean_{muc5,000 (1 h)} 3.21 ppm and mean_{sal5,000 (1 h)} 0.90 ppm). At 6 h, the fluoride concentrations had returned to pre-brushing levels. Across the 6-h sampling period the fluoride concentration in saliva was statistically significantly 1.4 times higher following brushing with 5,000 ppm compared with 1,450 ppm fluoride toothpaste. For mucosa, this ratio was only 1.1 and not statistically significant. In conclusion, the fluoride level in oral buccal mucosa is higher than in saliva and follows the same fluoride clearance pattern as in saliva. Over the initial 6-h period following a single tooth brushing, the ratio of the fluoride concentration in mucosa to that in saliva is independent of the fluoride concentrations in the toothpastes used.

Fluoride Concentration in Saliva following Professional Topical Application of 2% Sodium Fluoride Solution.

Background:Topical fluoride application in moderate and high-risk individuals and in those living in low-fluoride communities has been a common practice by dental professionals.Objectives:The objective of this study was to assess fluoride concentration available in saliva after a professional 2% sodium fluoride solution application (9000 ppm), and the duration of its availability to have an evidence-based practice for application.Materials and Methods:Two percent sodium fluoride application was carried out in 45 participants residing in a boarding school. The participants were non tea drinkers and nonfluoride users. Water fluoride of the area ranged from 0.34 ppm to 0.38 ppm. Whole mixed saliva samples were collected at baseline and various time intervals postapplication of 2% sodium fluoride solution. Fluoride in saliva was estimated using the fluoride combination electrode (Orion model 94–09, 96–09) coupled to an ionanalyzer.Results:IBM SPSS statistics version 23.0 was used for the analysis. Normality of the data was assessed using the Kolmogorov–Smirnov test and box plot, and it was found to be nonnormal. Wilcoxon signed-rank test was used to compare all time intervals with baseline, and statistically significant differences were observed (P = 0.0001). Salivary fluoride according to this study showed a biphasic clearance pattern with a peak at 15 min and a rapid fall in 60 min followed by a slow, consistent decline over a 20-h period. The fluoride concentration in saliva remained elevated above baseline from 0.03 ppm to 0.076 ppm even 3 months after application.Conclusion:Findings of this study show that, in this population, the frequency of application should be between 2 and 3 months (four applications per year).

Caries experience and elementary composition of mixed saliva in adult patients with dental fluorosis

Caries experience assessment in adult patients with dental fluorosis living in endemic area and in the region with normal fluoride concentration in drinking water; assessment of correlation between DMFT index and elementary composition of mixed saliva in adult patients with dental fluorosis. Two groups of patients took part in the clinical study. Group 1 involved 33 persons with dental fluorosis living in endemic area. In group 2 there were 31 persons with dental fluorosis living in region with normal fluoride concentration in drinking water. DMFT index was calculated. Enamel resistance to acids and remineralizing activity of saliva were tested. Electron probe X-ray microanalysis (EPXMA) was used to detect elementary composition of mixed saliva. The mean DMFT value was 3.97±0.31 in group 1 and 4.65±0.41 in group 2, which was 15% higher. In both groups high enamel resistance to acids was observed, but remineralizing activity of saliva was significantly better in group 1. The mean fluoride concentration in mixed saliva was 42% higher in group 1 comparing to group 2 (0.108±0.003 mass%, and 0.063±0.0002 mass%, respectively). Adult patients with dental fluorosis living in endemic area are more caries resistant comparing to those living in region with normal fluoride concentration in drinking water. It's associated with elevated fluoride concentration in mixed saliva due to permanent fluoride consumption with drinking water.

Persica Chewing Gum Effects on Saliva Fluoride Concentration and Flow Rate: A Triple-Blind Randomized Clinical Trial.

Context:Dental caries is a prevalent disease worldwide. Salvadora persica or Miswak could be a source of fluoride and has caries preventive effects.Aims:The aim of this study was to compare saliva fluoride concentration and flow rate after using Persica and sodium fluoride chewing gums.Settings and Design:In a triple-blind crossover randomized trial, 44 healthy volunteers (21–25 year old) were recruited according to the inclusion criteria and were randomly allocated into two groups (22 each).Participants and Methods:This study was performed within two sets of trial with a 10-day washout period. Participants (subjects) were followed a running period and matched for trial confounders. Saliva samples were collected under controlled conditions at similar time (11 am) within baseline, 5, 10, 20, and 45 min intervals preceded by 5-min chewing of Persica or sodium fluoride chewing gum. Saliva samples were analyzed for fluoride ion using hexamethyldisiloxane diffusion method.Statistical Analysis Used:Saliva flow rate (ml/min) and mean fluoride concentration (ppm) during different time periods in two types of gum were compared using ANOVA-repeated measures (P < 0.05).Results:The difference in total means of stimulated saliva flow rates between two Persica and sodium fluoride gum intervention groups was statistically significant (P = 0.048); however, difference of fluoride concentrations was not statistically significant (P = 0.244).Conclusions:Chewing Persica containing gum released fluoride ions in saliva and increased saliva flow rate comparable with sodium fluoride chewing gum use as a gold standard.

Anticariogenic efficacy of a saliva biomimetic in head-and-neck cancer patients undergoing radiotherapy.

The aim of this study was to investigate the effect of treatment with the saliva biomimetic, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and SnF2 /NaF compared with SnF2 /NaF alone on coronal surface caries progression in head-and-neck cancer patients undergoing radiotherapy. Twenty-four participants were randomized into two groups. Both groups used 0.4% SnF2 gel and a 0.32% NaF toothpaste; the test group also applied a crème containing 10% CPP-ACP three times daily while the control group used an identical crème without CPP-ACP (placebo). Resting saliva flow rate and saliva fluoride concentrations were determined. Caries status was assessed using ICDASII at baseline and 12-weeks postradiotherapy. Data were statistically analysed using a linear mixed effects model. Both groups showed significantly reduced resting saliva flow rate (P < 0.001) postradiotherapy. There were no significant differences in flow rates and fluoride concentration between groups. The CPP-ACP group exhibited a significant (P < 0.05) 51% reduction in coronal surface caries progression compared with the placebo group. Resting salivary flow rate was significantly reduced in head-and-neck cancer patients following radiotherapy and use of CPP-ACP with SnF2 /NaF significantly lowered caries progression compared with SnF2 /NaF alone.

Effect of silver diamine fluoride application on fluoride concentration in saliva

Silver diaminefluoride can increase fluoride concentration in saliva, facilitate remineralization, and increase the bioavailability of fluoride in saliva. The purpose of this study was to analyze the difference in fluoride concentration in saliva before and after silver diaminefluoride application on enamel. Stimulated saliva of four subjects was collected, and the concentration of fluoride was measured. The results showed that there were significant differences in the fluoride concentration (p<0.05) before, immediately after, and one hour after silver diaminefluoride application on enamel. It can be concluded that fluoride concentration reached its peak immediately after silver diamine fluoride application on enamel and that it had returned to the baseline one hour after application.

Fluoride-Releasing Effect of a Modified Resin Denture Containing S-PRG Fillers on Salivary Fluoride Retention: A Randomized Clinical Study

This study aimed to evaluate the clinical effect of a resin denture base containing 20wt% surface prereacted glass ionomer (S-PRG) fillers on saliva fluoride concentrations as a surrogate evaluation of caries control. The study was a double-blind randomized clinical trial with a total of 110 participants aged 35–60 years who wore a removable partial resin denture for 1.5 years. Subjects were randomly assigned to receive a partial resin denture fabricated either with or without 20wt% S-PRG fillers (n = 55 per group). After 14 days of wearing the dentures, 5,000 ppm fluoride gel was applied nightly on both sides of the denture before storing it in a denture box overnight every night for 1.5 years. The salivary fluoride concentration was measured at baseline, on days 1, 14, and 15, and at 3 months and 1.5 years of wearing the denture. A significant increase in salivary fluoride concentration in the S-PRG denture group was observed from baseline to day 1, followed by a significant decrease to an approximate baseline level. After recharge with 5,000 ppm fluoride gel, salivary fluoride increased markedly on day 15 and remained elevated at month 3 through to 1.5 years. The resin denture base containing 20wt% S-PRG fillers demonstrated an initial fluoride release that increased saliva fluoride concentrations, but the fluoride release from within the material was short lived. The long-term effect of sustained fluoride release from the denture when combined with a regular fluoride recharge regimen may be beneficial for caries prevention.

Fluoride Increase in Saliva and Dental Biofilm due to a Meal Prepared with Fluoridated Water or Salt: A Crossover Clinical Study

Knowledge about fluoride delivery to oral fluids from foods cooked with fluoridated water and salt is scarce, and no study has evaluated fluoride concentrations in saliva or biofilm during meal consumption. In this randomized double-blind crossover study, 12 volunteers ingested meals (rice, beans, meat, and legumes) prepared with nonfluoridated water and salt (control group), fluoridated water (0.70 mg F/L; water group), and fluoridated salt (183.7 mg F/kg; salt group). Whole saliva was collected before meal ingestion, during mastication, and up to 2 h after meal ingestion. Dental biofilm was collected before and immediately after meal ingestion. Fluoride concentrations in saliva and dental biofilm were determined by an ion-specific electrode. The mean (±standard deviation; n = 4) fluoride concentrations in meals prepared for the control, water, and salt groups were 0.039 ± 0.01, 0.43 ± 0.04, and 1.71 ± 0.32 μg F/g, respectively. The three groups had significantly different fluoride concentrations in saliva collected during mastication (p < 0.0001) and after meal ingestion (p < 0.04; salt > water > control). The fluoride concentration in saliva returned to baseline 30 min after meal ingestion in the water group but remained high for up to 2 h in the salt group (p = 0.002). The fluoride concentration in biofilm fluid differed only between the salt and control groups (p = 0.008). The mastication of foods cooked with fluoridated water and salt increases fluoride concentrations in oral fluids and may contribute to the local effect of these community-based fluoride interventions on caries control.