Fluoride-containing Toothpaste Research Articles

Clinical and laboratory evaluation of the effectiveness of children's toothpastes containing 1000 ppm fluoride

Relevance. This article presents the findings from studies evaluating the effectiveness of toothpastes containing 1000 ppm fluoride in clinical settings. The data demonstrates the cumulative benefits of these toothpastes on oral hygiene, the reduction of inflammatory oral manifestations, and their anticaries effects.Purpose. To assess the effectiveness of fluoride-containing toothpastes through laboratory tests and clinical trials.Materials and methods. The study evaluated the effectiveness of toothpastes containing 1000 ppm fluoride using the following parameters: Greene-Vermillion hygiene index, periodontal indices (PMA and SBI), enamel mineralization and resistance, presence and number of carious lesions at the white spot stage, enamel hypersensitivity, and antimicrobial activity against Streptococcus spp.Results. The analysis of hygiene indices demonstrated that the tested toothpastes were highly effective in cleaning, with a positive cumulative effect on participants' oral hygiene. The use of these toothpastes significantly reduced inflammatory manifestations, decreased gum bleeding, and improved periodontal tissue health. A reduction in the number of participants with early-stage carious lesions, as well as a decrease in the overall number of lesions, was observed. The toothpastes also enhanced enamel resistance to acid exposure, contributing to their anticaries benefits. Enamel hypersensitivity was reduced, and a dose-dependent antibacterial effect against Streptococcus mutans, Streptococcus gordonii, and Streptococcus sobrinus was observed.Conclusion. Toothpastes containing 1000 ppm fluoride demonstrated strong cleaning and refreshing effects, along with a positive cumulative impact on oral hygiene and a significant reduction in inflammation. Their anticaries benefits were confirmed, and they also reduced enamel hypersensitivity. The tested toothpastes were well-tolerated, with no reports of allergic reactions or irritation.

Knowledge and practices of Iranian students (13–16 age) regarding the use of fluoride toothpaste

IntroductionFluoride is the main factor in reducing the prevalence of caries worldwide. However, there is insufficient knowledge about whether people in different age groups are aware of the benefits of fluoride toothpaste, as well as about people’s daily oral care habits and whether they use fluoride. The purpose of this research is to investigate the knowledge and performance of Iranian students regarding the use of toothpaste containing fluoride.MethodThis study was conducted on the first- and second-year high school students of Kerman city. Questionnaires containing personal questions, general questions, and questions related to students’ knowledge and performance regarding the use of fluoride toothpaste were provided to them and then they were asked to complete and submit it. The results obtained from the survey were analyzed by T-test, Mann-Whitney test, and Chi-Square test in SPSS Version 24. The significance level in data analysis was P < 0.05.ResultsIn this research, 681 forms including 252 boys and 429 girls were examined. The average age of the participants was 14.1 ± 0.4. 91.2% declared that they use toothpaste and 77.8% of them used toothpaste containing fluoride. 521 people stated that the price of toothpaste is important in using the type of toothpaste. 621 people used regular toothbrush and 609 people evaluated their oral health as good. 621 of the participants stated that toothpaste makes the mouth healthy. The average knowledge score was 16.7 ± 2.1 out of 24, which indicates the average knowledge of students in this field.ConclusionThis study showed that students’ knowledge and performance about using fluoride-containing toothpaste is average. There was no significant relationship between performance and knowledge with age and gender. There was also a positive correlation between knowledge and performance indicating that increasing knowledge leads to an increase in behavioral changes. Also, there was a positive correlation between knowledge and performance, and a correlation coefficient of 0.731 was obtained between knowledge and performance. It shows that increasing knowledge leads to increasing behavioral changes.

Antibacterial effects of dentifrices against Streptococcus mutans in children: a comparative in vitro study.

Fluoridated dentifrices have antibacterial effects on children's teeth. On the other hand, the side effects encountered with the use of them have led researchers to look for safe alternatives. This study aimed to determine the antibacterial effect of different commercially available fluoride-free dentifrices on Streptococcus mutans (S. mutans) in comparison with different concentrations of fluoridated dentifrices. Study groups comprised of fluoride-free dentifrices, which contain Probiotic (Activated Charcoal Probiotic Dentifrice-Group P), Aloe Vera-Group AV and Salivary Proteins-Group SP. Fluoridated dentifrices containing 1450 ppm fluoride-Control Group 1 and 500 ppm fluoride-Control Group 2 served as control groups. Antibacterial activity was assessed by Minimum Inhibitory Concentrations and agar well diffusion assays on S. mutans. Biofilm inhibition assay was performed with dentifrices, which had antibacterial activities, and a negative control phosphate-buffered saline (Group PBS) on sterile hydroxyapatite discs against S. mutans. Statistical evaluation was performed. Only group AV showed an antibacterial effect on S. mutans, while control groups showed a similar antibacterial effect. The mean number of viable bacteria present in S. mutans biofilm in Control Group 1 and 2 and Group AV were statistically significantly lower than that in Group PBS, but there were no statistically significant differences between Control Groups and Group AV. Antibacterial activity of commercial dentifrices against S. mutans may be exerted by antibacterial components other than fluoride. Aloe vera-containing toothpaste showed an antibacterial effect on S. mutans, although not as much as the fluoride-containing toothpastes in the control groups. However, further in vivo and long-term studies are required.

Fluoride Concentration, Antibacterial Effect, and Cytotoxicity in Children's Toothpaste: In Vitro Study

Abstract Objectives The aim of this study is to evaluate the effect on cell viability, antibacterial activity against cariogenic bacteria, and total fluoride availability of commercially available children's toothpastes in Thailand. Materials and Methods Seven toothpaste slurries were prepared from seven commercial toothpastes for children. Total fluoride concentration was determined. The agar diffusion method was used to examine the antibacterial effect of toothpaste against Streptococcus mutans. The viability of L929 mouse fibroblasts exposed with different concentrations of each toothpaste slurry was tested by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay. Statistical Analysis One way analysis of variance (ANOVA) and Tukey's honestly significant difference (HSD) tests were used for zone inhibition analysis. Cell viability data were analyzed using Student's t-test. Results Fluoride concentration in fluoride-containing toothpastes ranged from 521.36 to 1,377.83 ppm. Two toothpastes exhibited a similar level of fluoride concentration compared between the product labels. Other toothpastes showed a difference or slight difference in fluoride concentration between the companies' information and our data. The zone of inhibition ranged from 0 to 2.08 cm. A significantly higher zone of inhibition was observed in toothpastes with sodium lauryl sulfate. The concentration of toothpaste that reduced cell viability to less than 50% of the control was 0.8, 3.1, 6.3, 6.3, 25, and 100% for Fluocaril Deli Fruity, Oral-B Junior 6 + , Kodomo Kids, CUdent Stevia, SunStar GUM, and Kindee Organic, respectively. Conclusion The examined children's toothpastes can inhibit the growth of S. mutans, which did not correlate with fluoride concentration. The antibacterial effects could be the results of other ingredients, for example, sodium lauryl sulfate.

Effects of Different Toothpastes on the Nanomechanical Properties and Chemical Composition of Resin-Modified Glass Ionomer Cement and Composite Resin Restorations.

This study evaluates the effects of different toothpastes on the nanohardness and chemical compositions of restorative materials and dental surfaces. Bovine enamel (n = 72) and dentin (n = 72) blocks were obtained and restored using RMGIC (n = 36) or CR (n = 36) to create the following surfaces: dentin adjacent to RMGIC (DRMGIC), enamel adjacent to RMGIC (ERMGIC), dentin adjacent to CR (DCR), and enamel adjacent to CR (ECR). After restoration, one hemiface of each specimen was coated with an acid-resistant varnish to facilitate the creation of control (C) and eroded (E) sides; the latter were achieved by erosion-abrasion cycles as follows: erosion with 1% citric acid: 5 days, four times for 2 min each day; 1% citric acid/abrasion, two times for 15 s, followed by immersion in a toothpaste slurry for 2 min. Toothpastes without fluoride (WF; n = 12), with sodium fluoride (NaF; n = 12), and with stannous fluoride (SnF2; n = 12) were used for RMGIC or CR. The specimens were analyzed for nanohardness (H), and chemical composition using energy-dispersive X-ray spectroscopy and Raman microscopy. The data were statistically analyzed using two-way repeated measures ANOVA and Tukey's test (α = 0.05). Lower H values were obtained with NaF for DRMGIC-C, with a statistically significant difference from the H value obtained with WF (p < 0.05). The calcium and phosphorus concentrations in DCR-E were significantly lower with WF than with the other types of toothpaste (p < 0.05). Fluoride-containing toothpastes are capable of preserving the main chemical components of the dentin adjacent to the restorative materials under erosive-abrasive conditions.

Evaluating the comparative efficacy of Bioactive glass containing Toothpaste, Amine fluoride-containing toothpaste and CPP-ACPF on remineralization of Artificial Incipient Enamel Lesion

Objectives: The purpose of this in-vitro study was to evaluate the comparative efficacy of Bioactive glass containing toothpaste (BioMin) and Amine fluoride-containing toothpaste (Amflor), and CPP-ACPF (GC Tooth mousse plus) on remineralization of artificial incipient enamel lesion and evaluated using Vickers micro-hardness test. Materials and Methods: A total of fifty freshly extracted premolar teeth were collected and decoronated at 1mm below the CEJ. An adhesive tape of size 4x4 mm is placed on the labial surface of each specimen. Following this, the specimens were mounted in acrylic resin moulds such that only the adhesive tape was exposed, and on the removal of the tape, a window of 4x4 mm is created. Then the specimens were randomly divided into five groups, among which specimens of four groups were subjected to demineralization for four days at 370c using an incubator. Group A (sound enamel), Group B (BioMin), Group C (CPP-ACPF), Group D (Amflor), Group E (demineralized lesion). The specimens of groups B,C,D were subjected to pH cycling for 10 days. Following whichmicro-hardness,all the specimens were evaluated using Vickers Micro-hardnessTest. Statistical analysis: The analysis was done using One Way ANOVA and inter-group comparison was done using a post hoc test. Results: Results showed statistically significant differences (p&lt;0.001) between groups B,C,D, and group E. Among the interventional groups even though there was no significant difference, group B( BioMin) showed higher micro-hardness values when compared to group C (CPP-ACPF) and group D(Amf). Conclusion: Under the limitation of this study, it can be concluded that Bioactive glass-based toothpaste (BioMin) is a novel technology that can be used for the remineralization of early enamel caries.

Overview of Knowledge Level and Status of Oral Hygiene in Aceh Besar State Elementary School Students

Teaching children about the importance of dental and oral hygiene from an early age is a long-term investment in their health. Parents and caregivers have an important role in guiding children to maintain regular dental and oral hygiene. Good dental care habits should be taught from an early age, including brushing teeth twice a day, using age-appropriate fluoride-containing toothpaste, flossing teeth, and visiting the dentist regularly. This study aimed to provide an overview of aspects of knowledge and status of students' dental and oral hygiene in state elementary schools in Aceh Besar, Indonesia. The descriptive observational study, where as many as 44 research subjects participated in this study. Observation of knowledge and oral health status was carried out univariately using SPSS. In conclusion, the knowledge of Aceh Besar, state elementary school students, is still relatively poor regarding oral health. The dental and oral health status of Aceh Besar state elementary school students is classified as moderate.

AWARENESS OF DENTAL CARIES PREVENTION IN INFANTS AND YOUNG CHILDREN AMONG DENTAL STUDENTS AND DENTAL INTERNS

Introduction. Promoting a commitment to dental caries prevention in young children plays a vital role in establishing healthy lifestyle habits that ward off dental diseases. The initial dental visit is as a cornerstone for fostering parental motivation in preventing dental issues and providing optimal conditions for the development of healthy eating habits, oral care practices, and the use of fluoride toothpaste. The foundation of dental knowledge, habits, and skills is laid within the family as children emulate adult behavior. Pediatric dentists, pediatricians, and primary healthcare personnel should serve as the primary and reliable sources of knowledge. As the determinants of dental caries are influenced by family-related risk factors, such as oral hygiene practices, the use of fluoride toothpaste, and sugar and carbohydrate consumption from an early age, parents bear the responsibility for creating an environment conducive to effective prevention. Dental professionals act as key information sources for oral health within the population and primary healthcare workers.&#x0D; Objective. This study aims to analyze the awareness of senior dental students and interns regarding the prevention of dental caries in infants and young children.&#x0D; Materials and Methods. A questionnaire was designed to assess awareness of dental caries prevention in infants and young children. The questionnaire, consisting of 13 questions with multiple answer options, was distributed to senior dental students and dental interns using an online Google form. It focused on evaluating knowledge of dental disease prevention, including the relationship between dental caries and behavioral risk factors such as nutrition, recommendations for oral care in children, and the use of fluoride-containing toothpaste.&#x0D; Results. Analysis of the questionnaire responses revealed that all participants were aware of the cariogenic nature of sugar, with 82.5% recognizing the caries-causing potential of fruit juices. However, knowledge regarding the cariogenicity of other products, such as fruits (8.8%) and dietary carbohydrates (25.4%), was limited. While the benefits of breastfeeding for a growing child are well-known, only 25.4% of senior dental students and interns recognized that prolonged, unregulated breastfeeding beyond one year contributes to early childhood caries. Moreover, 38.6% believed that bottle-feeding with milk formula can lead to tooth decay. Recommendations for feeding children from a spoon and cup after the eruption of the first milk tooth were not provided by any respondents. Only two individuals (1.8%) acknowledged that co-sleeping with the mother can pose a risk factor for childhood caries. Regarding oral hygiene recommendations for parents, only 12.3% of senior dental students and medical interns suggested the use of toothpaste and a brush, while guidance on selecting appropriate toothpaste for infants and young children was disregarded by all respondents. Additionally, the quantity of toothpaste to be applied and the age at which children should start brushing their teeth were not considered, with 53.5% of respondents believing that brushing with a toothbrush alone is sufficient.&#x0D; Conclusion. The survey exposed insufficient knowledge among senior dental students and medical interns regarding risk factors and evidence-based methods for preventing dental caries in infants and young children.

Health-Promoting Schools Project for Palestine Children's Oral Health

ObjectivesThe aim of this work was to assess the oral health outcome of a 2-year comprehensive school oral health programme based on school-health education combined with supervised toothbrushing using 1450-ppm fluoride toothpaste amongst schoolchildren in Palestine. MethodsA quasi-experimental study (2016–2018) recruited 3939 schoolchildren aged 5 to 6 years from 30 intervention schools (n = 2333) and 31 comparison schools (n = 1606). At baseline and postintervention, mothers and schoolteachers completed World Health Organization (WHO) self-administered questionnaires about oral health of children, oral health behaviour, and family factors. Of the initial participants 75.8 per cent took part in the follow up studies. In addition, 25 calibrated dentists examined dental caries of children according to WHO criteria. Trained teachers provided comprehensive oral health education to children in the classrooms and held regular oral health sessions for mothers. Children brushed their teeth with fluoride-containing toothpaste (1450 ppm fluoride). Student t-test and logistic regression were used in the statistical analysis of changes in dental health and related knowledge, behaviours, and attitudes (P < .05). ResultsIn both dentitions, dental caries experience declined over the project. The reduction in Decayed, Missing and Filled permanent Teeth and Decayed, Missing and Filled Surfaces in permanent teeth was 23.3% and 23.2% (P < .001), respectively. The drop in caries experience indices in the Gaza Strip was 8 to 4 times higher than in West Bank, and it reached 47.4% reduction. Mothers and teachers showed improvement in positive knowledge and attitudes towards dental care. Involvement of schoolteachers in oral health in schools and acceptance of dental health education materials significantly enhanced oral health behaviour of children. ConclusionsThe project recommends national implementation of an intervention for the improvement of oral health of schoolchildren and their parents in conflict zones. The project shows the importance of the WHO Health Promoting Schools concept and involving classroom-based health education carried out by schoolteachers. It is suggested to explore the health care system's capacity in hosting effective oral health programme and maintain its efficacy.

Comparative Evaluation of the Remineralization Potential of Fluoride-containing Toothpaste, Honey Ginger Paste and Ozone. An In Vitro Study.

A drop in pH of the oral cavity results in demineralization, which, if continued, leads to loss of minerals from tooth structure, resulting in dental caries. A goal of modern dentistry is to manage noncavitated caries lesions noninvasively through remineralization in an attempt to prevent disease progression. A total of 40 extracted premolar teeth were selected for the study. The specimens were divided into four groups, group I, the control group; group II, remineralizing agent as fluoride toothpaste; group III, the treatment material as ginger and honey paste; and group IV, the treatment material as ozone oil. An initial reading of surface roughness and hardness was recorded for the group (control group). Repeated treatment has continued lasting 21 days. This saliva was changed each day. Following the lesion formation procedure, the surface microhardness was measured for all specimens. The parameters were 200 gm force for 15 seconds with a Vickers indenter and the roughness of the demineralized area of each specimen was obtained by using the surface roughness tester. Surface roughness was checked by using a surface roughness tester. Before starting the pH cycle, the baseline value for the control group was calculated. The baseline value for the control group was calculated. The surface roughness average value for 10 samples is 0.555 µm and the average surface microhardness is 304 HV; the average surface roughness value for fluoride is 0.244 µm and the microhardness is 256 HV, 0.241 µm, and 271 HV value for honey-ginger paste. For ozone surface roughness average value is 0.238 µm and the surface microhardness average mean value is 253 HV. The future of dentistry will rely on the regeneration of tooth structure. There is no significant difference seen between each treatment group. Considering the adverse effect of fluoride, we can consider honey-ginger and ozone as good remineralizing agents for fluoride. Kade KK, Chaudhary S, Shah R, et al. Comparative Evaluation of the Remineralization Potential of Fluoride-containing Toothpaste, Honey Ginger Paste and Ozone. An In Vitro Study. Int J Clin Pediatr Dent 2022;15(5):541-548.

Transverse Microradiography Evidence on the Effect of Phosphoryl Oligosaccharides of Calcium (POs-Ca) in Toothpaste on Decalcified Enamel

In the current study, we sought to evaluate the effects of phosphoryl-oligosaccharides of calcium (POs-Ca) and/or fluoride-containing toothpaste on enamel. Six groups of experimental toothpaste were prepared by adding various concentrations of POs-Ca and/or fluoride. A 5 × 10-mm window on the enamel of the bovine incisor was immersed in resin and divided into three areas for “sound”, “demineralized (DEM)”, and “after pH cycle (aft. pH cycle)”. All specimens were subjected to pH cycling, including soaking in a slurry with toothpaste diluted threefold for 5 min. Transverse microradiography was employed to evaluate the mineral recovery, and the pH values of each demineralization solution were measured. The high fluoride concentration group showed a significantly better mineral recovery rate than the others, with no statistical differences between before and after pH cycling among the POs-Ca with low fluoride, POs-Ca only, low fluoride only, and control groups. In the low-concentration fluoride groups, the group containing POs-Ca tended to have a higher remineralization effect than the non-POs-Ca group. After pH cycling, the demineralization solution showed no pH changes in any group. The addition of POs-Ca and fluoride to toothpaste may recover the mineral density in enamel subsurface lesions at low-fluoride concentrations, but the high-fluoride concentrations did not show a meaningful difference in the two groups with and without POs-Ca.

Chapter 5.3: Diet and Coronal Caries.

In this chapter, diet is revisited to shed light on its role in caries development and management in contemporary populations. Measures applied to promote a rational consumption of sugars and changes observed in sugars consumption are also addressed. A cariogenic diet provokes an imbalance in the oral microbiome, resulting in dysbiosis with predominance of acidogenic and aciduric bacteria in the dental biofilm. Both a cariogenic diet and a balanced diet modulate caries development and progression in contemporary populations. A cariogenic diet particularly impacts high-risk groups and should be avoided. A rational consumption of sugars presents a low risk for caries development in populations with regular oral hygiene practices and exposure to fluoride-containing toothpaste or combined exposure to fluoride-containing toothpaste and fluoridated water. Some initiatives have been developed to promote a rational consumption of sugars, but further efforts should be made in this respect. Although the consumption of sugars has remained high and stable, some countries observed a decrease in caries prevalence. A reduction in the daily consumption of sugars provides general and oral health benefits. Therefore, the intake of sugars should be as low as possible in the context of a nutritionally balanced diet.

Effectiveness of fluoride-containing toothpastes associated with different technologies to remineralize enamel after pH cycling: an in vitro study

BackgroundTo evaluate the efficacy of fluoride-containing toothpastes with different technologies to remineralize artificial caries lesions in enamel.MethodsBovine enamel blocks were divided into three thirds: intact (untreated), demineralized (artificial caries lesion), and treated (caries lesion, pH cycling with dentifrices). Enamel blocks were randomly distributed into five groups (n = 12): Fluoride-free toothpaste, Colgate Oral Care (NC); Arginine-containing toothpaste, Colgate Total Daily Repair (PC); Silicate-based fluoride toothpaste: REFIX technology, regenerador + sensitive (RDC), NR-5 technology, Regenerate Enamel Science (RES), and NOVAMIN technology, Sensodyne Repair and Protect (SRP). The specimens were submitted to a pH cycling model for 6 days. The efficacy of the toothpastes was estimated by calculating the surface microhardness recovery (%SMHR) and the fluorescence recovery (ΔFRE) with quantitative light-induced fluorescence. The cross-sectional micromorphology of the enamel surface was also assessed using scanning electron microscopy. Elemental analyses (weight%) were determined with an energy-dispersive X-ray spectrometer (EDS). The results were compared to that of the control (NC). Data were statistically analyzed (5%).Results%SMHR could be ranked as follows: RDC = PC = RES = SRP > NC. Significantly higher %SMHR and ΔFRE means were observed after enamel treatment with RDC (22.7 and 46.9, respectively). PC (%SMHR = 18.8) was as efficacious as RDC to recover the surface microhardness with a significantly lower mean of ΔFRE (19.5). Only RDC was able to promote the formation of a mineralized layer on the surface of enamel enriched with silicon on the surface.ConclusionsThe silicate-based fluoride toothpaste containing REFIX technology demonstrated greater efficacy in the remineralizing artificial caries than the other products.

Functional changes in the oral microbiome after use of fluoride and arginine containing dentifrices: a metagenomic and metatranscriptomic study

BackgroundTooth decay is one of the most prevalent diseases worldwide, and efficient tooth brushing with a fluoride-containing dentifrice is considered fundamental to caries prevention. Fluoride-containing dentifrices have been extensively studied in relation to enamel resistance to demineralization. Arginine (Arg) has also been proposed as a promising prebiotic to promote pH buffering through ammonia production. Here, we present the first metagenomic (DNA sequencing of the whole microbial community) and metatranscriptomic (RNAseq of the same community) analyses of human dental plaque to evaluate the effect of brushing with fluoride (Fl) and a Fl+Arg containing dentifrices on oral microbial composition and activity. Fifty-three patients were enrolled in a longitudinal clinical intervention study with two arms, including 26 caries-active and 27 caries-free adults. After a minimum 1-week washout period, dental plaque samples were collected at this post-washout baseline, 3 months after the use of a 1450-ppm fluoride dentifrice, and after 6 months of using a 1450-ppm fluoride with 1.5% arginine dentifrice.ResultsThere was a shift in both the composition and activity of the plaque microbiome after 3 months of brushing with the fluoride-containing toothpaste compared to the samples collected at the 1-week post-washout period, both for caries-active and caries-free sites. Although several caries-associated bacteria were reduced, there was also an increase in several health- and periodontitis-associated bacteria. Over 400 genes changed proportion in the metagenome, and between 180 and 300 genes changed their expression level depending on whether caries-free or caries-active sites were analyzed. The metagenome and metatranscriptome also changed after the subjects brushed with the Fl+Arg dentifrice. There was a further decrease of both caries- and periodontitis-associated organisms. In both caries-free and caries-active sites, a decrease of genes from the arginine biosynthesis pathway was also observed, in addition to an increase in the expression of genes associated with the arginine deiminase pathway, which catabolizes arginine into ammonia, thereby buffering acidic pH. Bacterial richness and diversity were not affected by either of the two treatments in the two arms of the study.ConclusionsOur data demonstrate that long-term use of both assayed dentifrices changes the bacterial composition and functional profiles of human dental plaque towards a healthier microbial community, both in caries-free and caries-active sites. This observation was especially apparent for the Fl+Arg dentifrice. Thus, we conclude that the preventive benefits of tooth brushing go beyond the physical removal of dental plaque and that the active ingredients formulated within dentifrices have a positive effect not only on enamel chemistry but also on the metabolism of oral microbial populations.-kQdKShqK4FxgvJNrxZQaCVideo

Remineralization and protection from demineralization: effects of a hydroxyapatite-containing, a fluoride-containing and a fluoride- and hydroxyapatite-free toothpaste on human enamel in vitro

BackgroundThe aim was to evaluate the remineralization potential as well as the extent of protection against renewed demineralization of enamel by hydroxyapatite-containing toothpaste (Karex) in comparison to fluoride-containing (Elmex) and fluoride- and hydroxyapatite-free toothpaste (Ajona) as control.MethodsFifty-seven enamel samples were obtained from 19 human teeth. Five demarcated surfaces were created on each tooth (S0—S4). Four of the surfaces (S1—S4) were exposed to lactic acid (pH 3) for 8 h (demineralization). S0 was left untreated as control. S1 was solely treated with acid. After demineralization, S2 was exposed to Karex for 2 min, of which 15 s were brushing. S3 was treated with Elmex and S4 with Ajona, accordingly. Then, the samples were evaluated using a scanning electron microscope and ImageJ image analysis software to determine the percentage of demineralization. Afterwards, S2-S4 were again exposed to lactic acid for 2 h, and subjected to pixel analysis another time. Data were statistically analysed using ANOVA with post-hoc Scheffé test and the Kurskal-Wallis test.ResultsThe surfaces treated with Elmex showed the lowest percentage of demineralization (mean 5.01 ± 0.98%) (p < 0.01). Thus, Elmex remineralized more effectively compared to Ajona (8.89 ± 1.41%) and Karex (9.85 ± 1.63%) (p < 0.01). Furthermore, Elmex showed the lowest percentage of demineralized enamel after new demineralization (median 6.29%), followed by Ajona (11.92%) and Karex (13.46%) (p < 0.001).ConclusionIn terms of remineralization and protection against renewed demineralization, a hydroxyapatite-containing toothpaste (Karex) appears to be inferior to a fluoride-containing toothpaste (Elmex) and a fluoride- and hydroxyapatite-free toothpaste (Ajona). Hence, the recommendation to use Karex to protect against demineralization should be critically questioned.

Assessment of White Spot Lesion and Enamel Demineralization in Orthodontic Patients With Fixed Brackets—A Clinical Appraisal Using Fluoride Mouth Rinse, Fluoride Varnish Containing CPP-ACP, and CPP-ACFP

Purpose: Efficacy evaluation of casein phosphopeptide amorphous calcium phosphate complex (CPP-ACP), casein phosphopeptide amorphous calcium fluoride phosphate complex (CPP-ACFP), fluoride mouthrinse, and fluoride containing toothpaste as compared to control group for the remineralization of white spot lesions (WSLs) in orthodontic patients with fixed brackets in an in vivo study. Methods: Seventy-five subjects with WSL determined by DIAGNOdent were randomly divided into 5 groups. The WSLs DIAGNOdent values for 0, 3, 6, 9, and 12 months were tabulated and subjected to statistical analysis. Results: Among the groups, the remineralizing potential of fluoride mouth rinse, fluoride containing toothpaste, and CPP-ACP were similar; however, CPP-ACFP value was superior in comparison to all other groups. Conclusion: The CPP-ACFP technique is highly beneficial for the remineralization of WSL in an orthodontic patient when compared to fluoride mouth rinse, fluoride-containing toothpaste, and CPP-ACP paste.

DIAGNOdent pen quantification of the synergy of NovaMin® in fluoride toothpaste to remineralize white spot lesions in patients with fixed orthodontic appliances: A double-blind, randomized, controlled clinical trial

White spot lesions (WSLs) are a real problem in patients with fixed orthodontic appliances with inadequate hygiene and eating habits. This study aimed at evaluating the synergic effects of NovaMin in fluoride toothpaste on remineralization of WSLs in patients with fixed orthodontic appliances. In the present double-blind, randomized, controlled, parallel, clinical trial, Patients with a minimum of 1 WSL on the buccal surface of the anterior teeth and the first premolar on both arches were recruited between 12 February 2021 and 12 April 2021 at the Faculty of Dentistry of X. They were randomly divided into 2 groups, the control group receiving fluoride toothpaste (Sensodyne® Rapid Relief, England), and the study group receiving the fluoride-containing toothpaste and NovaMin (Sensodyne® Repair and Protect, England). A DIAGNOdent pen (KAVO Dental Corporation, Germany) was used to score the WSLs at baseline and then after the usage for 1 and 3months. The primary outcome measures were the difference in DIAGNOdent score in patients with fixed orthodontic appliances that used fluoride toothpaste and NovaMin/fluoride toothpaste. The secondary outcome measures were the intragroup comparison of the DIAGNOdent score in patients with fixed orthodontic appliances that used fluoride toothpaste and NovaMin/fluoride toothpaste. The type of toothpaste used was blinded for the participants, examiner, and data analyser. A sample size comprising 38 patients (19 patients in each group) was determined. In each group, statistical analysis was conducted on 18 patients. A patient in each group refused to contribute to the study. In both groups (P<0.001), the DIAGNOdent reading of the WSLs decreased significantly after 1 and at 3months, though no significant difference was found between the two groups at different intervals. Each patient had no adverse effects. In this 3-month follow-up study, NovaMin/fluoride toothpaste provided a slight improvement in WSL remineralisation, but not significant compared to fluoride toothpaste. NovaMin therefore did not have a significant synergistic effect. Both types of toothpaste can improve WSLs in orthodontic patients. IRCT20140215016582N5.

Dental tissue remineralization by bioactive calcium phosphate nanoparticles formulations

Recent health care products are based on formulations claimed to provide enamel remineralization and dentinal tubules occlusion through calcium-phosphate bioactive nanocompounds (ion-doped hydroxyapatite and precursor, amorphous calcium phosphate nanoparticles). This study aimed to characterize, test, and compare for the first time the structure and performance of a representative, market-available sample of remineralizing toothpastes and topical mousses. Formulations were characterized to determine their composition and investigate the presence of bioactive compounds and doping elements. A conventional fluoride-containing toothpaste was used as reference. The enamel remineralization and efficacy of dentinal tubules occlusion by tested formulations were investigated ex vivo on human hard tissues. All formulations containing Ca-P bioactive nanocompounds showed remineralizing ability by epitaxial growth of a layer showing the morphology and composition of human hydroxyapatite. Such layers also embedded nanosilica clusters. The presence of doping elements or casein phosphopeptide seemed essential to allow such performances, especially when hydroxyapatite and amorphous calcium phosphate compounds were doped with small amounts of CO32−, F−, Mg2+, and Sr2+. Topical mousse formulations showed a higher tubules occlusion capability than toothpastes, independently from their composition. Therefore, all tested formulations could be useful in restoring tooth structures in a biomimetic way, contrasting dental demineralization processes leading to caries.

Effects of Tooth Brushing and MouthWashing on Leaching Bisphenol A Levels From an Orthodontic Adhesive: An In Vitro Study

To assess the levels of bisphenol A (BPA) released from an orthodontic adhesive with respect to the effects of tooth brushing and mouth washing. Three groups, each containing fifteen adhesive samples were prepared. In Group 1, samples were polymerized according to manufacturer instructions. In Group 2, after the same polymerization protocol, each sample was brushed with a fluoride-containing toothpaste. For Group 3, samples were immersed in a mouth washing solution after polymerization. Later, all samples were placed into glass tubes containing 5 mL distilled water. High-performance liquid chromatography (HPLC) measurements were performed to assess the leaching amount of BPA. Intergroup comparison was performed by one way ANOVA test. Mean amounts of BPA were found to be 0.2674 µg/L, 0.2692 µg/L, and 0.2705 µg/L, respectively. Only a significant difference was found between Group 1 and 3 (P < .01), revealing higher BPA levels with the mouth washing solution. Measurable amounts of BPA release were observed in all groups of orthodontic adhesive samples, but the detected amounts were below the toxic levels. From a clinical point of view, alcohol-containing mouth washing solutions might increase the amount of leaching monomer, since alcohol is solvent of BPA.

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).