Fluoride Dentifrice Research Articles

An exploratory clinical trial to evaluate the efficacy of an experimental dentifrice formulation in the relief of dentine hypersensitivity

ObjectivesThis study aimed to investigate whether addition of an octadecene/maleic anhydride copolymer (O/MA) to a potassium nitrate (KNO3) dentifrice could facilitate delivery of potassium to dentine and enhance its efficacy in dentine hypersensitivity relief. MethodsThis was a randomised, examiner-blind, controlled, parallel group study in 139 healthy subjects with at ≥2 sensitive teeth. Assessment of dentine hypersensitivity to tactile (Yeaple probe) and evaporative (air) stimuli (Schiff Sensitivity Scale, visual analogue scale [VAS]) was carried out at baseline and after 1, 2, 4 and 8 weeks twice daily treatment with an experimental 5% KNO3/3% O/MA dentifrice, a comparator 5% KNO3 dentifrice (active comparator), a 0% KNO3/3% O/MA dentifrice (placebo) and a regular fluoride dentifrice (negative control). This study was not powered to detect statistically significant differences between treatments. ResultsAcross the treatment period an improvement in sensitivity to evaporative air stimulus was observed for all products and to a tactile stimulus for the potassium-containing treatments, with the greatest reductions for the experimental dentifrice (5% KNO3/3% O/MA). Reductions in sensitivity observed for the potassium-containing dentifrices compared to the placebo and negative control dentifrices were statistically significantly for Schiff sensitivity score and tactile threshold at all time-points and for VAS at Weeks 4 and 8. Trends in the study data also favoured the experimental dentifrice, compared to the active comparator dentifrice, for all clinical measures. Study treatments were generally well tolerated. ConclusionThis study provides initial clinical evidence to suggest that addition of a polymer excipient may enhance the anti-sensitivity efficacy of potassium-containing dentifrices. Clinical significanceDaily use potassium-containing dentifrices are established as efficacious for the relief of dentine hypersensitivity. Inclusion of a polymer excipient in such formulations may facilitate delivery of potassium to the dentine surface and so enhance clinical efficacy. Further clinical studies are required to confirm this hypothesis.

Effect of toothbrushing duration and dentifrice quantity on enamel remineralisation: An in situ randomized clinical trial

ObjectivesThe influence of toothbrushing duration and dentifrice quantity on fluoride efficacy against dental caries is poorly understood. This study investigated effects of these two oral hygiene factors on enamel remineralisation (measured as surface microhardness recovery [SMHR]), enamel fluoride uptake (EFU), and net acid resistance (NAR) post-remineralisation in a randomized clinical study using an in situ caries model. MethodsSubjects (n=63) wore their partial dentures holding partially demineralised human enamel specimens and brushed twice-daily for two weeks, following each of five regimens: brushing for 120 or 45s with 1.5g of 1150ppm F (as NaF) dentifrice; for 120 or 45s with 0.5g of this dentifrice; and for 120s with 1.5g of 250ppm F (NaF) dentifrice. ResultsComparing brushing for 120s against brushing for 45s, SMHR and EFU increased by 20.0% and 26.9% respectively when 1.5g dentifrice was used; and by 22.8% and 19.9% respectively when 0.5g dentifrice was used. Comparing brushing with 1.5g against brushing with 0.5g dentifrice, SMHR and EFU increased by 35.3% and 51.3% respectively when brushing for 120s, and by 38.4% and 43.0% respectively when brushing for 45s. Increasing brushing duration and dentifrice quantity also increased the NAR value. The effects of these two oral hygiene factors on SMHR, EFU, and NAR were statistically significant (p<0.05 in all cases). ConclusionBrushing duration and dentifrice quantity have the potential to influence the anti-caries effectiveness of fluoride dentifrices. Study NCT01563172 on ClinicalTrials.gov. Clinical significanceThe effect of two key oral hygiene regimen factors – toothbrushing duration and dentifrice quantity – on fluoride’s anticaries effectiveness is unclear. This 2-week home-use in situ remineralisation clinical study showed both these factors can influence fluoride bioactivity, and so can potentially affect fluoride’s ability to protect against caries.

Remineralizing potential of a 60-s in vitro application of Tooth Mousse Plus.

No published studies exist on the remineralizing potential of Tooth Mousse Plus® (TMP) when applied for less than 3 min. To evaluate (i) the remineralizing potential of TMP on artificial carious lesions, when applied thrice daily for 60 s, and (ii) the benefit of using a fluoridated dentifrice prior to TMP application. Carious lesions, 120-200 μm deep, were produced by placing molars in demineralizing solution for 96 h, and sections 100-150 μm thick were then randomly assigned to four groups. Specimens were treated thrice daily with a non-fluoridated (Group A), or 1000 ppm F dentifrice (Group B), or TMP (Group C), or a 1000 ppm F dentifrice followed by TMP application (Group D), and then subjected to a 10-day pH cycling model. Lesion evaluation involved polarizing light microscopy and microradiography. Post-treatment maximum mineral content at the surface zone (Vmax ) was significantly increased and lesion depth (LD) significantly decreased in Group C, while only the Vmax increased in Group D. Increase in LD was observed in Group B; however, no significant differences were noted in percentage LD changes between groups B, C, and D (P > 0.05). TMP applied for 60 s significantly remineralized the artificial carious lesions. No additional benefit was evident when TMP was preceded by treatment with 1000 ppm F dentifrice.

Three-dimensional invitro measurements of tooth wear using fluoridated dentifrices.

The aim of this study was to compare differences in wear of human enamel and dentine invitro using a 3D measurement method comparing silica versus non-silica containing fluoridated dentifrices (Colgate Total(™) [CT] or Fluor Protector Gel(™) [FPG]). Mounted native enamel (n = 36) and polished dentine (n = 36) samples were subjected to 10 wear cycles. Each cycle consisted of: (1) 1 hour remineralization in artificial saliva (AS); (2) 10 minute erosion (0.3% citric acid; pH = 2.8); (3) 2 minute toothbrush abrasion in AS (G1, control) or a slurry of 3:1 by weight of AS:dentifrice (G2 = CT; G3 = FPG) under a load of 2 N. Each group contained 12 enamel and 12 dentine samples. Paired pre- and post-wear scans made with a contacting scanner were digitally superimposed using ball bearings as datum. Mean and (SD) enamel wear was G1 = 21.9 μm (6.4); G2 = 15.2 μm (2.8); G3 = 16.9 μm (3.2). Enamel wear was not different between dentifrices (p = 0.99). Both dentifrices resulted in less enamel wear compared to the control (p < 0.05). Dentine wear was G1 = 41.3 μm (8.1); G2 = 29.1 μm (4.4); G3 = 22.1 μm (3.5). Differences in measurements were observed between dentifrices and control (p < 0.05) and between dentifrices (p = 0.014) with FPG showing less dentine wear than CT. FPG offered protection against erosive/abrasive tooth wear in dentine compared to CT. FPG did not offer such protective effect on enamel wear.

A randomised clinical trial to evaluate the effect of a 67 % sodium bicarbonate-containing dentifrice on 0.2 % chlorhexidine digluconate mouthwash tooth staining.

BackgroundGingivitis can develop as a reaction to dental plaque. It can be limited by curtailing plaque build-up through actions including tooth brushing and the use of medicinal mouthwashes, such as those containing chlorhexidine digluconate (CHX), that can reach parts of the mouth that may be missed when brushing. This study aimed to compare dental stain control of twice-daily brushing with a sodium fluoride (NaF) dentifrice containing 67 % sodium bicarbonate (NaHCO3) or a commercially available NaF silica dentifrice without NaHCO3, while using a mouthwash containing 0.2 % CHX.MethodsThis was a 6-week, randomised, two-site, examiner-blind, parallel-group study in healthy subjects with at least ‘mild’ stain levels on the facial surfaces of ≥4 teeth and ≥15 bleeding sites. Assessment was via modified Lobene Stain Index (MLSI), the score being the mean of stain intensity multiplied by area (MLSI [IxA]).ResultsOne hundred and fifty of 160 randomised subjects completed the study. There were no significant differences in Overall (facial and lingual) MLSI (IxA) scores between dentifrices. The Facial MLSI (IxA) was statistically significant at 6 weeks, favouring the 67 % NaHCO3 dentifrice (p = 0.0404). Post-hoc analysis, conducted due to a significant site interaction, found significant differences for all MLSI scores in favour of the 67 % NaHCO3 dentifrice at Site 1 (both weeks) but not Site 2.ConclusionsNo overall significant differences were found between a 67 and 0 % NaHCO3 dentifrice in controlling CHX stain; a significant difference on facial surfaces suggests advantage of the former on more accessible surfaces.Trial registrationThis study was registered at ClinicalTrials.gov (NCT01962493) on 10 October 2013 and was funded by GSK Consumer Healthcare.

Erosion protection benefits of stabilized SnF2 dentifrice versus an arginine\u2013sodium monofluorophosphate dentifrice: results from in vitro and in situ clinical studies

ObjectivesThe aim of these investigations was to assess the ability of two fluoride dentifrices to protect against the initiation and progression of dental erosion using a predictive in vitro erosion cycling model and a human in situ erosion prevention clinical trial for verification of effectiveness.Materials and methodsA stabilized stannous fluoride (SnF2) dentifrice (0.454 % SnF2 + 0.077 % sodium fluoride [NaF]; total F = 1450 ppm F) [dentifrice A] and a sodium monofluorophosphate [SMFP]/arginine dentifrice (1.1 % SMFP + 1.5 % arginine; total F = 1450 ppm F) [dentifrice B] were tested in a 5-day in vitro erosion cycling model and a 10-day randomized, controlled, double-blind, two-treatment, four-period crossover in situ clinical trial. In each study, human enamel specimens were exposed to repetitive product treatments using a standardized dilution of test products followed by erosive acid challenges in a systematic fashion.ResultsBoth studies demonstrated statistically significant differences between the two products, with dentifrice A providing significantly better enamel protection in each study. In vitro, dentifrice A provided a 75.8 % benefit over dentifrice B (p < 0.05, ANOVA), while after 10 days in the in situ model, dentifrice A provided 93.9 % greater protection versus dentifrice B (p < 0.0001, general linear mixed model).ConclusionThese results support the superiority of stabilized SnF2 dentifrices for protecting human teeth against the initiation and progression of dental erosion.Clinical relevanceStabilized SnF2 dentifrices may provide more significant benefits to consumers than conventional fluoride dentifrices.

Eugenia uniflora Dentifrice for Treating Gingivitis in Children: Antibacterial Assay and Randomized Clinical Trial.

School-age children are frequently at high risk for the onset of biofilm-dependent conditions, including dental caries and periodontal diseases. The objective of this study was to evaluate the clinical efficacy of a dentifrice containing Eugenia uniflora Linn. (Surinam cherry) extract versus a triclosan-based comparator in treating gingivitis in children aged 10-12 years. The in vitro antibacterial potential of the dentifrice was tested against oral pathogens (Streptococcus mutans, Streptococcus oralis and Lactobacillus casei). Then a phase-II clinical trial was conducted with 50 subjects aged 10-12 years, with clinical signs of gingivitis. The subjects were randomly assigned to the experimental group (n=25) and control group (n=25), in which participants used the experimental dentifrice and a triclosan-based fluoridated dentifrice (Colgate Total 12(r)), respectively. Clinical examinations assessed the presence of gingivitis (primary outcome) and biofilm accumulation (secondary outcome) using the Gingival-Bleeding Index (GBI) and Simplified Oral Hygiene Index (OHI-S), respectively, at baseline and after seven days of tooth brushing 3x/day. The data were analyzed using paired and unpaired t-test (GBI) and Wilcoxon and Mann-Whitney (OHI-S), with p≤0.05. The experimental dentifrice showed efficient antibacterial activity in vitro. In the clinical trial, a significant reduction in gingival bleeding was observed in both experimental and control groups (p<0.0001), with no statistical difference between them (p=0.178), although a small size effect was observed. Biofilm accumulation was only reduced in the control group (p=0.0039). In conclusion, E. uniflora dentifrice showed anti-gingivitis properties in children aged 10-12 years. Thus, it may be a potentially efficient and safe product to be used alternatively in preventive dental practice.

Anticaries Potential of Low Fluoride Dentifrices Found in The Brazilian Market.

Low-fluoride (F) dentifrices (<600 µg F/g) are widely available worldwide, but evidence to recommend the use of such dentifrices, with either regular or improved formulations, is still lacking. Therefore, the aim of this study was to evaluate the anticaries potential of low-F dentifrices found in the Brazilian market, using a validated and tested pH-cycling model. Enamel blocks were selected by surface hardness (SH) and randomized into four treatment groups (n=12): non-F dentifrice (negative control), low-F dentifrice (500 μg F/g), low-F acidulated dentifrice (550 μg F/g) and 1,100 μg F/g dentifrice (positive control). The blocks were subjected to pH-cycling regimen for 8 days and were treated 2x/day with dentifrice slurries prepared in water (1:3, w/v). The pH of the slurries was checked, and only the acidulated one had low pH. After the pH cycling, SH was again determined and the percentage of surface hardness loss was calculated as indicator of demineralization. Loosely- and firmly-bound F concentrations in enamel were also determined. The 1,100 μg F/g dentifrice was more effective than the low-F ones to reduce enamel demineralization and was the only one that differed from the non-F (p<0.05). All F dentifrices formed higher concentration of loosely-bound F on enamel than the non-F (p<0.05), but the 1,100 μg F/g was the only one that differed from the non-F in the ability to form firmly-bound F. The findings suggest that the low-F dentifrices available in the Brazilian market, irrespective of their formulation, do not have anticaries potential.

Fluoride and calcium concentrations in the biofilm fluid after use of fluoridated dentifrices supplemented with polyphosphate salts.

The present study evaluated fluoride (F) and calcium (Ca) concentrations in the biofilm fluid formed in situ under cariogenic challenge after using F dentifrices supplemented or not with sodium trimetaphosphate (TMP) or calcium glycerophosphate (CaGP). Volunteers (n=12) were randomly divided into 5 groups according to the toothpastes used: placebo (without F, CaGP or TMP), 1100ppmF (1100F) and low-fluoride dentifrice (LFD, 550ppmF) with no supplementation (550F) or supplemented with 1% TMP (550F-TMP) or 0.25% CaGP (550F-CaGP). In each phase, volunteers wore palatal appliances containing 4 bovine enamel blocks. Cariogenic challenge was performed with 30% sucrose solution, 6 times/day. On the morning of the eigth day, biofilm samples were collected 12h and 1h after brushing and cariogenic challenge. F and Ca analyses in the biofilm fluid were performed with the inverted electrode after buffering with TISAB III and using the Arsenazo III method, respectively. Data were submitted to two-way ANOVA (repeated measures) and Student-Newman-Keuls test (p<0.05). A dose-response relationship was verified between F concentrations in the dentifrices and in the biofilm fluid. Significant differences were observed among placebo, 550F, and 1100F only 1h after brushing, without statistical differences among 550F, 550F-TMP, and 550F-CaGP. No defined trend was observed among the groups regarding Ca concentrations, with the highest values seen for placebo and 550F-CaGP. The anticaries effect of LFDs supplemented with CaGP or TMP cannot be related to an increased availability of F and Ca in the biofilm fluid. The better performance of LFDs containing CaGP or TMP shown in previous studies should be attributed to their ability to interact with tooth enamel and with the biofilm, rather to their effect on the biofilm fluid.

Remineralizing potential of CPP-ACP applied for 1 min in vitro

To evaluate (1) the remineralizing potential of Tooth Mousse(®) (TM) on artificial carious lesions, when applied for 1min, and (2) the benefit of a fluoridated dentifrice prior to TM application. Demineralisation caries-like lesions 120-200μm deep were produced by placing molars in demineralizing solution for 96h, sections100-150μm thick were then randomly assigned to four groups. Specimens were treated thrice daily with a non-fluoridated (Group A), or fluoridated dentifrice (1000ppm) (Group B), or TM (Group C), or a fluoridated dentifrice followed by TM (Group D) then subjected to a 10-day pH cycling model. Lesion evaluation involved polarizing light microscopy and microradiography. Application of TM in isolation (Group C) for 1min resulted in significant increase in lesion depth (LD), however, an increase in mineral content deposition (V max) was not significant. Post treatment LD increases were greatest in Group A, then Group C and Group B respectively. A decrease in LD (by 19.9%) was noted only after fluoridated dentifrice and TM (Group D) were applied consecutively for 1min each (p<0.05). Mineral content deposition was also greatest in this group (Group D) and both V max and LD changes were statistically significant when compared to other groups. TM alone failed to remineralize carious lesions when applied for 1min. However, remineralization occurred after a prior application of a fluoridated dentifrice.

High Fluoride Dentifrices for Elderly and Vulnerable Adults: Does It Work and if So, Then Why?

The primary aim of this work is to present the available evidence that toothpastes containing >1,500 ppm fluoride (2,500-2,800 and 5,000 ppm F) provide an additional caries preventive effect on root caries lesions in elderly patients compared to traditional dentifrices (1,000-1,450 ppm F). The secondary aim of this paper is to discuss why high fluoride dentifrices in general should perform better than traditional F-containing toothpaste. When examining the few studies that have considered the preventive benefits of high fluoride products on root caries the relative risk appears to be around 0.5, and the risk can thus be halved by exchanging traditional F-containing toothpaste for toothpaste containing 5,000 ppm F. There is reasonable evidence that high fluoride dentifrices significantly increase the fluoride concentration in saliva during the day and the fluoride concentration in plaque compared to traditional F toothpaste. Furthermore, the use of toothpaste with 5,000 ppm F significantly reduces the amount of plaque accumulated, decreases the number of mutans streptococci and lactobacilli and possibly promotes calcium fluoride deposits to a higher degree than after the use of traditional F-containing toothpaste.

Frequency of Fluoride Dentifrice Use and Caries Lesions Inhibition and Repair

The clinical relevance of the frequency of fluoride dentifrice (FD) use on enamel caries is based on evidence. However, the relative effect of FD on reduction of demineralization or enhancement of remineralization is unknown and the effect of frequency on root dentine caries has not been explored. The aim of this double-blind, crossover, in situ study, which was conducted in 4 phases of 14 days each, was to evaluate the relationship between the frequency of FD use and enamel and root dentine de- and remineralization. Eighteen volunteers wore palatal appliances containing enamel and root dentine slabs, either sound or carious. Biofilm accumulation on the slab surface was allowed, and 20% sucrose solution was dripped 3 or 8 times per day on the carious and sound slabs, respectively. Volunteers used FD (1,100 μg F/g) in the frequencies 0 (fluoride-placebo dentifrice), 1, 2 and 3 times per day. The demineralization and remineralization that occurred in sound or carious slabs was estimated by the percentage of surface hardness loss (%SHL) or recovery (%SHR). Loosely (CaF₂) and firmly (FAp) bound fluoride concentrations were also determined. The relationship between the variables was analyzed by linear regression. The %SHL, CaF₂ and FAp concentrations were a function of the frequency of FD use for enamel and dentine, but the %SHR was a function of the frequency of FD use only for enamel (p < 0.05). The results suggest that demineralization in enamel and root dentine is reduced in proportion to the frequency of FD use, but for remineralization the effect of the frequency of FD use was relevant only to enamel.

Theobromine: A Safe and Effective Alternative for Fluoride in Dentifrices

During the process of studying caffeine's effects on developing teeth, a serendipitous discovery was made. Teeth comprise hydroxylapatite (HAP). Ingestion of caffeine (1,3,7-trimethylxanthine) caused the formation of smaller crystallites of HAP in the developing teeth. This resulted in the increased release of calcium and phosphorus ions from the enamel surface when exposed to acidic solutions in vitro. Furthermore, animal study confirmed the hypothesis that smaller HAP crystallites caused the increased incidence of dental caries. In contrast, theobromine (3,7-dimethylxanthine), which is similar to caffeine, caused formation of larger HAP crystallites in vitro. The ingestion of theobromine by lactating dams showed a decreased release of calcium and phosphorus ions from the enamel surface in the developing teeth of neonates in vivo. The use of fluoride dentifrices is controversial. It is also well documented that young children who brush their teeth often ingest fluoride-containing dentifrices. Based upon ...

Effects of dentifrices differing in fluoride compounds on artificial enamel caries lesions in vitro.

The aim of this study was to compare the caries-preventive effect of a stabilized stannous fluoride/sodium fluoride dentifrice containing sodium hexametaphosphate with those of a regular, solely sodium fluoride-containing and amine fluoride-containing dentifrice on pre-demineralized bovine enamel specimens using a pH-cycling model. Bovine enamel specimens with two artificial lesions each were prepared. Baseline mineral loss of both lesions was analyzed using transversal microradiography (TMR). Eighty-five specimens with a mean (SD) baseline mineral loss of 3393 (683) vol%×µm were selected and randomly allocated to five groups (n=13/15). Treatments during pH-cycling (28days and 2×20min demineralization/day) were: brushing twice daily with slurries of AmF (1400ppm F-), NaF (1450ppm F-), SnF2/NaF (1100ppm F-/350ppm F-), and fluoride-free (FF) dentifrices or they were immersed in distilled water and remained unbrushed (NB). Subsequently, from each specimen one lesion was covered with acid-resistant varnish, while the remaining lesion was demineralized for another 14days. Differences in integrated mineral loss (∆∆Z) were calculated between values before and after pH-cycling (∆∆Z E1) as well as before pH-cycling and after second demineralization (∆∆Z E2) using TMR. Treatments AmF and NaF induced a significantly higher mineral gain (∆∆Z E1/∆∆Z E2) compared to treatments FF and NB (p<0.05; ANOVA test). Except for treatments AmF and NaF no significant differences in mineral loss between before and after pH-cycling could be observed (p<0.05; t test) [∆∆Z E1: AmF:1563 (767); NaF:1222 (1246); SnF2/NaF:258 (1259); FF:-52 (1223); NB:-151 (834)]. Both dentifrices with either AmF or NaF promoted remineralization, whereas SnF2/NaF dentifrice did not promote remineralization in a biofilm-free pH-cycling model.

Fluoride toothpaste supplemented with sodium hexametaphosphate reduces enamel demineralization in vitro.

The aim of this study was to evaluate the effect of fluoride dentifrices combined with sodium hexametaphosphate (HMP) on enamel demineralization in vitro. Enamel bovine blocks were selected by initial surface hardness (SHi) and then divided into five experimental groups (n = 12): placebo (without fluoride and without HMP); 1100ppm F (1100F); and 1100F associated with HMP at 0.5% (1100HMP0.5%), 1% (1100HMP1%), and 2% of HMP (1100HMP2%). Blocks were submitted to five pH cycles (demineralizing/remineralizing solutions) at 37°C. After pH cycling, final surface hardness (SHf), percentage of surface hardness loss (%SH), integrated differential hardness (ΔIH), integrated loss of subsurface hardness (ΔKHN), and enamel firmly bound fluoride (F) were determined. Data were submitted to one-way ANOVA, followed by Student-Newman-Keuls test (p < 0.05). Significant differences were observed among all groups regarding %SH and ΔKHN. 1100HMP1% promoted the lowest mineral loss among all groups (p < 0.001), and led to significantly lower demineralization in the deeper regions of the subsurface lesion when compared with the other HMP-containing toothpastes (p < 0.001). Significantly higher mineral loss was observed for 1100HMP2% when compared to the other fluoridated dentifrices, mainly in the outer part of the lesion (p < 0.001). Enamel F uptake was similar for 1100F and 1100HMP1% but significantly reduced for other HMP concentrations. The supplementation of a 1100-ppm F dentifrice with 1% HMP promoted a higher inhibitory effect against enamel demineralization when compared to a dentifrice containing the same amount of fluoride in vitro. This dentifrice could potentially be indicated to patients at high risk of caries.

The effect of CO2 laser irradiation plus fluoride dentifrice on the inhibition of secondary caries on root surfaces adjacent to glass ionomer cement or composite resin restorations

Although the cariostatic effects of CO2 laser on the root surface have been shown, there is scarce information regarding its effects on root secondary caries. The objective of this research was to investigate the effect of the association of CO2 laser and a fluoride dentifrice on the inhibition of secondary caries on root surfaces adjacent to composite-resin or glass-ionomer-cement restorations. Dental blocks of human roots were divided into two groups: composite resin (CR) or glass ionomer cement (GIC). Subsequently, the blocks were divided into four subgroups (n = 10): C, non-fluoride dentifrice; FD, fluoride dentifrice; L, CO2 laser with an energy density of 6.0 J cm−2 + non-fluoride dentifrice; and L + FD, CO2 laser + fluoride dentifrice. The blocks were subjected to pH cycling to simulate a high cariogenic challenge. Dental demineralization around the restorations was quantified by microhardness analysis. The results were subjected to analysis of variance (ANOVA) and the Tukey–Kramer test (p ⩽ 0.05). As for mineral loss, it can be observed that all the groups that were treated with a fluoride dentifrice and laser, used alone or not, were statistically similar and superior to the RC–C group. It was concluded that CO2 laser irradiation and a fluoride dentifrice used alone or combined with each other are efficient surface treatments for preventing secondary root caries, regardless of the restorative material used.

Social and Behavioural Factors Associated with Dental Caries Experience among Adolescent School Children in Bengaluru City, India

Aim: To assess the influence of social and behavioural factors on dental caries experience among adolescent school children in Bengaluru city, India. Study Design: Cross sectional study. Place and Duration of the Study: Primary schools of Bengaluru City, between November 2012 and March 2013. Methodology: A cross sectional study was conducted on 11 year old 814 adolescents attending upper primary schools of Bengaluru city and their parents. Separate interview for adolescent students and parents was conducted on behavioural and social factors respectively. Dental caries was recorded according to WHO criteria using mouth mirrors and CPI probes under natural light. Statistical analysis included descriptive analysis, bivariate analysis using chi-square tests and t-tests. Later the variables were subjected to logistic regression analysis. Results: Dental caries experience of the children studied was associated with social factors such Original Research Article Kadanakuppe and Hiremath; BJMMR, 14(1): 1-10, 2016; Article no.BJMMR.24021 2 as occupation of the mother (OR=1.9; 95% CI=1.3-2.3), presence of social support for mother during adulthood (OR=2.1; 95% CI=1.4-2.0), possession of television (TV)/computer at home (OR= 1.6; 95%=0.9-3.0); and behavioral factors such as adolescents who consume at least one serving of dairy/legumes/eggs/meat or poultry per day (OR=1.8; 95% CI=0.14-1.32), those who consume sweet snacks >1times in a day (OR=1.42; 95% CI=0.82-1.83). Influence of parents and TV on snacking, tooth brushing frequency and fluoridated dentifrice were also shown to be significantly associated with dental caries experience. Conclusion: Social factors such as occupation of the mother and social support play an important role in shaping the more proximal behavioural habits such as snacking among 11 year old children. These interactions ultimately influenced dental caries experience in this age group.

Comparative evaluation and effect of organic and inorganic fluoride dentifrices on enamel microhardness: An in vitro study.

Aim:To compare and evaluate the microhardness of enamel surface after the application of organic fluoride and inorganic fluoride dentifrices.Materials and Methods:Twenty freshly extracted premolars were collected and decoronation of all the teeth was done at cementoenamel junction. The crowns were sectioned mesiodistally into two halves with the help of diamond disc, and then the subsequent forty samples kept in 1% citric acid for the demineralization and divided into two groups by simple randomization, that is, Group A (inorganic sodium fluoride dentifrice) and Group B (organic amine fluoride dentifrice). They were treated using same protocol for 3 min, daily twice for 7 days. Those samples preserved in artificial saliva in between treatment. The enamel surface microhardness evaluated using Vickers hardness test at base level, after demineralization, as well as after remineralization. Statistical analysis of surface microhardness obtained at different stages done by Student's t-test and P < 0.05 was considered statistically significant.Results:The samples which were treated with sodium fluoride (Group A) could not restore the mean microhardness after treatment to that of preoperative level whereas amine fluoride (Group B) treated samples showed a statistically significant increase in mean surface microhardness from baseline.Conclusion:Organic fluoride (amine fluoride) remineralization was more effective in restoring enamel microhardness than inorganic fluoride (sodium fluoride) remineralization.

Clinical effect of a mouthwash containing Anacardium occidentale Linn. on plaque and gingivitis control: A randomized controlled trial.

Plaque-associated gingivitis is a prevalent disease and research in its treatment using herbal agents must be encouraged to verify which would be a useful addition to the current range or chemotherapeutic treatment options. The aim of this study was to evaluate the clinical effect of a mouth rinse containing 10% Anacardium occidentale (AO) Linn., a typical plant commonly found in the Northeast Region of Brazil, on the reduction of plaque and gingivitis in comparison to a gold-standard chemotherapeutic agent. Thirty normosystemic adult volunteers of both genders, who had a minimum of twenty natural teeth, aging between 18 and 32 years, were enrolled in this crossover, controlled, examiner-blind clinical study. They were randomly allocated into three groups: 10% AO Linn. (n = 10); 0.12% chlorhexidine digluconate (CLX, n = 10); or placebo (PB, n = 10). All volunteers were instructed to brush their teeth with a fluoridated dentifrice two times a day (12/12 h) and to rinse for 1 min with one of the mouthwashes (AO, CLX, or PB) 30 min after tooth brushing for 1 month. Plaque index (PLI) and gingival bleeding index (BLI) were recorded on days 0 and 30. Nonparametric Kruskal-Wallis and Wilcoxon tests (α = 0.05) were performed to evaluate statistical differences among groups. There was a significant reduction (P < 0.05) on plaque and gingivitis at day 30 just in CLX ([PLI = 0.47 ± 0.16; -30%]; [BLI = 0.15 ± 0.09; -55.8%]) and AO ([PLI = 0.49 ± 0.21; -31%]; [BLI = 0.13 ± 0.10; -56.6%]) groups, but no statistically significant difference was observed among them (P > 0.05). Mouthwash containing 10% AO was effective as an antiplaque and antigingivitis agent, in a similar manner that 0.12% CLX.

Effective Fluoride Mouthwash Delivery Methods as an Alternative to Rinsing.

Special-needs patients with high caries risk cannot benefit from the proven caries-reducing effect of fluoride mouthrinse because of poor rinsing compliance and a lack of home-use fluoride application recommendations. This study aimed to evaluate whether two modified delivery methods-spray or swab application-could raise the salivary fluoride to levels similar to that of rinsing. Five healthy men and 16 healthy women, ages 18-22 years, participated in this crossover study. The subjects performed a standardized brushing routine twice a day with 1,000-ppm fluoride dentifrice 1 week before and during the experimental period. The three fluoride mouthwash (0.05% NaF; 226-ppm fluoride) administration methods consisted of rinsing, spray, and cotton swab application. Each application was separated by at least 1 week. Unstimulated whole saliva was sampled for 2 minutes at baseline and at 0, 5, 10, 20, 30, 60, and 120 minutes after each fluoride mouthwash application. Salivary fluoride level (ppm) was measured by a blinded investigator using an ion-specific electrode (ORION EA940). The differences in salivary fluoride concentration for each application method were analyzed by repeated measures ANOVA at a nominal significance level of .05. The newly designed fluoride mouthwash delivery methods yielded a similar fluoride level in whole saliva compared to that of rinsing at all time points (p > .05). The t half-life of fluoride concentration ranged from 1.62 minutes (SD = 0.53) in the spray group to 2.08 minutes (SD = 0.87) in the cotton swab group; the values were not significantly different. Our results indicate that the spray and cotton swab fluoride delivery methods were effective alternatives to conventional mouth rinsing. Caregivers of individuals with acute and chronic illness, including developmental disabilities affecting cognitive or physical abilities, may consider using these alternative fluoride delivery methods to help promote dental hygiene.