Fluoride Mouthrinse Research Articles

The antimicrobial sensitivity of Streptococcus mutans and Streptococcus sangius to colloidal solutions of different nanoparticles applied as mouthwashes.

Metal nanoparticles have been recently applied in dentistry because of their antibacterial properties. This study aimed to evaluate antibacterial effects of colloidal solutions containing zinc oxide (ZnO), copper oxide (CuO), titanium dioxide (TiO2) and silver (Ag) nanoparticles on Streptococcus mutans and Streptococcus sangius and compare the results with those of chlorhexidine and sodium fluoride mouthrinses. After adding nanoparticles to a water-based solution, six groups were prepared. Groups I to IV included colloidal solutions containing nanoZnO, nanoCuO, nanoTiO2 and nanoAg, respectively. Groups V and VI consisted of 2.0% sodium fluoride and 0.2% chlorhexidine mouthwashes, respectively as controls. We used serial dilution method to find minimum inhibitory concentrations (MICs) and with subcultures obtained minimum bactericidal concentrations (MBCs) of the solutions against S. mutans and S. sangius. The data were analyzed by analysis of variance and Duncan test and P < 0.05 was considered as significant. The sodium fluoride mouthrinse did not show any antibacterial effect. The nanoTiO2-containing solution had the lowest MIC against both microorganisms and also displayed the lowest MBC against S. mutans (P < 0.05). The colloidal solutions containing nanoTiO2 and nanoZnO showed the lowest MBC against S. sangius (P < 0.05). On the other hand, chlorhexidine showed the highest MIC and MBC against both streptococci (P < 0.05). The nanoTiO2-containing mouthwash proved to be an effective antimicrobial agent and thus it can be considered as an alternative to chlorhexidine or sodium fluoride mouthrinses in the oral cavity provided the lack of cytotoxic and genotoxic effects on biologic tissues.

Comparative Evaluation of the Effects of Fluoride Mouthrinse, Herbal Mouthrinse and Oil Pulling on the Caries Activity and Streptococcus mutans Count using Oratest and Dentocult SM Strip Mutans Kit.

ABSTRACTBackground: As the technological level of healthcare increases, it is important not to lose sight of the basics of patient care. No matter how sophisticated dental techniques have become, preventive dentistry still remains the foundation for oral health. Therefore, antimicrobial mouthrinses are developed to provide an effective means of preventing colonization by micro-organisms.Aim: The aim of this study was to evaluate and compare the antimicrobial activity of oil pulling, herbal mouthrinses and fluoride mouthwash on the caries activity and S. mutans counts in the saliva of children, using Oratest and Dentocult SM kit.Design: Fifty-two healthy children between the age group of 6 to 12 years were selected for the study and divided into four groups based on the mouthrinse used as group 1: fluoride, group 2: herbal, group 3: oil pulling and group 4: control. The estimation of caries activity and S. mutans was done prior to and after the subjects were instructed to use the mouthrinse twice daily for a period of 2 weeks.Statistical analysis: The comparisons were made by applying paired ‘t’ test with the level of significance set at p < 0.05. Difference between more than two mean values was done by using ANOVA and Post hoc Bonferroni test was used for multiple comparisons.Results and conclusion: The efficacy of fluoride and herbal mouthrinses was found to be comparable while oil pulling did not provide any additional benefit to be used as an effective antimicrobial agent in reducing the bacterial colonization of an individual.How to cite this article: Jauhari D, Srivastava N, Rana V, Chandna P. Comparative Evaluation of the Effects of Fluoride Mouthrinse, Herbal Mouthrinse and Oil Pulling on the Caries Activity and Streptococcus mutans Count using Oratest and Dentocult SM Strip Mutans Kit. Int J Clin Pediatr Dent 2015;8(2):114-118.

Effect of School-Based Fluoride Mouth Rinsing Program in a Socially Deprived Community

Purpose: The objective of this study was to evaluate the caries prevention effect of school-based fluoride mouth rinsing (FMR) program implemented in the Hanuul district of Mongolia, which has a very low socioeconomic status and extremely poor infrastructure for oral health. Materials and Methods: One hundred and seventy children aged from 6 to 8 years of the FMR school and 187 children aged from 6 to 8 years of the control school completed the baseline survey. Children from the FMR school rinsed with 0.05% sodium fluoride everyday under supervision, while those from the control school did not. Adjusted caries preventive fraction (CPF) for 2 years were calculated to evaluate the effect of the FMR program. Result: After 2 years, 288 schoolchildren remained in the study. Decayed, missing or filled permanent teeth (DMFT) and index of the FMR and the control schools at baseline were 0.11 and 0.12, respectively, and the average DMFT increment of the FMR and the control schools after 2 years were 0.35 and 0.65, respectively. The adjusted CPF of DMFT was 48.5%. Conclusion: These findings show that a school-based FMR is an effective caries preventive program in a socially deprived community with poor infrastructure for oral health.

Evaluation of the effect of sodium fluoride addition on some mechanical properties of heat cure acrylic denture base materials

Background: The geriatric patients wearing removable partial dentures are increasing in proportion. At the same time, the root caries prevalence accompanied by gingival recession is increasing. A variety of vehicles can deliver fluoride into the oral cavity, including fluoride mouth-rinse, fluoride dentifrice, topical fluoride, and fluoride-releasing restorative materials, all of which effectively prevent root caries and suppress recurrent caries. This study aimed to evaluate the effect of sodium fluoride addition on some mechanical properties of heat cure acrylic denture base material. Material and method: A total of 90 samples were prepared in this study, then divided into three main groups according to the type of test used (hardness, tensile and transverse strength tests). Each main group was subdivided into three main subdivisions according to percentage of sodium fluoride addition to the heat cure acrylic denture base material (control no addition, 2%NaF ,and 5%NaF sodium fluoride groups) Results: The sodium fluoride addition to acrylic denture base materials showed slight but non significant increase in transverse strength and tensile strength tests while the results showed significant and highly significant differences for 2%NaF and for 5%NaF shore D hardness groups respectively. Conclusions: Addition of 2% and 5% sodium fluoride to heat cure acrylic resin is considered advantageous as the mechanical properties of resin denture base materials in respect to hardness tensile and transverse strength were not adversely affected.

Tooth staining potential of experimental amine fluoride/stannous fluoride mouth rinse formulations-a randomized crossover forced staining study.

It was the aim to investigate experimental mouth rinses concerning their tooth and tongue staining potential using the standardized short-term forced staining model. A single centre, clinically controlled, randomized, investigator-blinded study was conducted in a crossover design. In healthy dental students, three experimental AmF/SnF2 (A, B, C) mouth rinses and a phenolic/essential oil rinse (D) were compared to a water control (E). Four treatment days consisted of eight hourly rinses with mouth rinse and black tea. Mechanical oral hygiene was ceased. At the fifth day, tooth and tongue staining indices were recorded. Between treatment periods, a 10-day washout phase was performed. Twenty-eight participants entered and completed the study. All mouth rinses including the water control led to tooth and tongue staining. Most tooth staining occurred after rinsing with test rinse A, followed by B, D, C and E. Statistically significant differences existed between products A and C, D, and E. Most tongue staining happened in group B, followed by A, D, C and E (not statistically significant). Within the limitations of the model, mouth rinse C has a promising potential of causing less tooth discoloration than other AmF/SnF2 rinses. C is highly recommended to be investigated in further long-term clinical studies on its in vivo staining potential and antiplaque efficacy. This forced staining study has proven that one of the experimental AmF/SnF2 rinses leads to less staining than the other experimental AmF/SnF2 rinses. These experimental results have to be confirmed by further clinical investigations.

An Investigation of Fluoride Release from Orthodontic Elastomeric Ligatures

Objective: The study aimed to investigate the amount of fluoride release from 3 brands of elastomeric ligatures in vitro, after exposure to daily fluoride mouthrinse. Materials and Methods: The study used 3 brands of elastomeric ligatures (Morelli, Brazil; Unitek, USA; Thai, Thailand). Two elastomeric ligatures from each brand were moistened by de-ionized water and then divided into control and test groups (n=5 per group). In both groups, elastomeric ligatures were placed in individual plastic bottle with 3 ml of de-ionized water. However, In the test group, They were exposed to fluoride mouthrinse (250 ppm fluoride/0.05%NaF) for 1 minute daily. All samples were stored at 37°C for 1, 3, 5, 7 days. After the end of each observation period, the amount of fluoride release in de-ionized water was measured by fluoride ion electrode. The data were analyzed by Kraskal-Wallis and Mann-Whitney U tests (p&lt;0.05). Results: Amount of fluoride release in test group was greater than in the control group in all 3 brands. Within 7 days of daily fluoride exposure, the fluoride released from elastomeric ligatures was continuously increased. Fluoride release from Morelli (0.067±0.013 ppm) and Unitek (0.067±0.012 ppm) were significantly higher than Thai (0.040±0.03 ppm). The fluoride level measured from Morelli and Unitek were not significantly different. Conclusion: The orthodontic elastomeric ligatures can absorb fluoride from mouthwash and release the detectable amount of fluoride within seven days. This fluoride might help prevention of enamel decalcification adjacent to the bracket during orthodontic treatment.

Fluoride retention in saliva and in dental biofilm after different home-use fluoride treatments.

This single-blind, randomized, crossover study aimed at assessing the long-term fluoride concentrations in saliva and in dental biofilm after different home-use fluoride treatments. The study volunteers (n = 38) were residents of an area with fluoridated drinking water. They were administered four treatments, each of which lasted for one week: twice-daily placebo dentifrice, twice-daily fluoride dentifrice, twice-daily fluoride dentifrice and once-daily fluoride mouthrinse, and thrice-daily fluoride dentifrice. At the end of each treatment period, samples of unstimulated saliva and dental biofilm were collected 8 h after the last oral hygiene procedure. Fluoride concentrations in saliva and dental biofilm were analyzed using a specific electrode. The fluoride concentrations in saliva and dental biofilm 8 h after the last use of fluoride products did not differ among treatments. The results of this study suggest that treatments with home-use fluoride products have no long-term effect on fluoride concentrations in saliva and in dental biofilm of residents of an area with a fluoridated water supply.

Influence of light curing units and fluoride mouthrinse on morphological surface and color stability of a nanofilled composite resin.

Composite resin is a dental material susceptible to color change over time which limits the longevity of restorations made with this material. The influence of light curing units and different fluoride mouthrinses on superficial morphology and color stability of a nanofilled composite resin was evaluated. Specimens (N = 150) were prepared and polished. The experimental groups were divided according to the type of light source (halogen and LED) and immersion media (artificial saliva, 0.05% sodium fluoride solution-manipulated, Fluordent Reach, Oral B, Fluorgard). Specimens remained in artificial saliva for 24-h baseline. For 60 days, they were immersed in solutions for 1 min. Color readout was taken at baseline and after 60 days of immersion. Surface morphology was analyzed by Scanning Electron Microscopy (SEM) after 60 days of immersion. Color change data were submitted to two-way Analysis of Variance and Tukey tests (α = 0.05). Surface morphology was qualitatively analyzed. The factor light source presented no significant variability (P = 0.281), the immersion media, significant variability (P < 0.001) and interaction between factors, no significant variability (P = 0.050). According to SEM observations, no difference was noted in the surface of the specimens polymerized by different light sources, irrespective of the immersion medium. It was concluded that the light source did not influence the color stability of composite, irrespective of the immersion media, and among the fluoride solutions analyzed, Fluorgard was the one that promoted the greatest color change, however, this was not clinically perceptible. The immersion media did not influence the morphology of the studied resin.

Assessment of the Success Rate of Conservative Adhesive Resin Restoration (CAR) in First Permanent Molar Teeth Treatment in Hamadan, Iran

Background & aim: Dental caries is one of the most common childhood diseases in the world. Pit and fissure caries constitute more than 80% of all caries in children and adolescents. Although occlusal surfaces account for only 12.5% of tooth surfaces, approximately 60% of dental caries are observed in these surfaces. Caries preventive methods include fluoride therapy, fissure sealant, and conservative adhesive restoration (CAR). Although CAR method has been increasingly applied for the prevention of dental caries progression, little research has been conducted so far. Despite the advantages of CAR method, this technique is time-consuming and uneconomical for the patient and health care system. In this study, we aimed to assess the one year success rate of CAR in caries prevention at Hamadan Dental School, Hamadan, Iran. Methods & Patients: In this cross-sectional study, the estimated sample size was 150 treated first permanent molar teeth. We examined variables such as CAR success or failure (retention and caries prevention), need for re-treatment, frequency of tooth brushing, previous history of fluoride therapy, Decayed-Missing-Filled Permanent Teeth (DMFT) index, decayed-missing filled deciduous teeth (dmft) index, dental visit, and current dental treatment. Data were analyzed using SPSS version 16. Results: Fifty-seven patients were examined, among whom 24 (42%) were male and 33 were female (58 %). The age range of the subjects was 7-13 years. A total of 125 molar teeth were studied, of which 88 (70.4%) and 37 (29.6%) belonged to female and male subjects, respectively. According to the results, the association between CAR and the patient’s age was significant (P˂0.05); also, there was a significant difference in using fluoride and CAR success (P=0.001). Conclusion: There is a significant association between the patient’s age, use of fluoride mouth rinse, and treatment success rate. In addition, older cases showed better response to CAR.

Effects of immersion media and repolishing on color stability and superficial morphology of nanofilled composite resin.

This study evaluated the influence of fluoride mouth rinses and repolishing on the superficial morphology and color stability of nanofilled resin. About 150 specimens were prepared and polished using aluminum oxide discs for 15 s with a pressure of 2 kg. The experimental groups were divided according to the immersion medium (artificial saliva, 0.5% sodium fluoride, Fluordent Reach, Oral B, Fluorgard) and repolishing procedure (without and with). The specimens were continuously immersed for 1 week. Thereafter, half of each sample was repolished. A color reading was performed after 24 h of immersion in the artificial saliva baseline, after continuous immersion, and after repolishing. The superficial morphology was examined using scanning electron microscopy (SEM) in a qualitative way. Color change (∆E) data were submitted to a mixed analysis of variance using a Shapiro-Wilk test (p>0.05 for the different immersion media) and Sidak's test (p<0.05 for the differences between groups). In the interaction between the repolishing and the immersion media, Fluorgard showed a statistical difference between the ∆E values with and without repolishing (p<0.0001). On the SEM observations, both Fluordent Reach and Fluorgard caused degradation of the superficial resinous matrix of the composite after continuous immersion. This matrix was removed after repolishing.

ADA clinical recommendations on topical fluoride for caries prevention.

This guideline is intended to assist practitioners with decision making about the use of topical fluoride caries-preventive agents. It presents evidence-based clinical recommendations on professionally applied and prescription strength, home-use topical fluoride agents for caries prevention. Three clinical questions on the use of topical fluoride caries-preventive agents are addressed: In primary and permanent teeth, does the use of a topical fluoride compared to no topical fluoride reduce the incidence of new lesions, or arrest or reverse existing coronal and/or root caries? For primary and permanent teeth, is one topical fluoride agent more effective than another in reducing the incidence of, or arresting or reversing coronal and/or root caries?Does the use of prophylaxis before application of topical fluoride reduce the incidence of caries to a greater extent than topical fluoride application without prophylaxis? Sodium, stannous and acidulated phosphate fluoride for professional and prescription home use, including varnishes, gels, foams, rinses and prophylaxis pastes were evaluated. The previous version of this review (2006 ADA policy) was based on assimilation of evidence from systematic reviews. However, this update synthesises primary evidence collected through systematic review and appraisal of the literature.The Cochrane Library and Medline (via PubMed) were searched. Relevant systematic reviews and other selected articles were hand-searched.Two reviewers independently screened titles and abstracts, with one reviewer assessing all manuscripts in full for meeting the inclusion criteria. Two different members of the expert panel then approved the exclusion list. Discrepancies were resolved through discussion with the Chair of the workgroup. The USPSTF grading system was used. Five-year interval update in line with the ADA policy. For individuals at risk of dental caries: 2.26% fluoride varnish or 1.23% fluoride (APF) gel, or prescription strength, home-use 0.5% fluoride gel or paste, or 0.09% fluoride mouth rinse for children who are aged six or over.The panel judged that the benefits outweighed the potential for harm for all professionally applied and prescription strength, home-use topical fluoride agents and age groups except for children aged under six years. Only 2.26% fluoride varnish was recommended for children less than six years old, as the panel considered the risk of adverse events (particularly nausea and vomiting) associated with swallowing all other professionally applied topical fluoride agents outweighed the potential benefits.There was insufficient data to answer the question on arresting and reversing coronal and/or root caries, so these outcomes were not addressed in the clinical recommendations. These focused on development of standard methodologies for well-designed trials with standardised reporting and trial registration. Specific areas for research included: investigation of mechanisms of fluoride action and effects against a background fluoride exposure; investigation of specific sub-groups such as high-risk elderly; research on specific products; measure and outcome development for arrested caries; economics and dissemination/implementation to realise guideline use.

일부 유치원 및 보육시설 유아교사의 구강보건교육 유무에 따른 구강보건교육 및 치아우식예방효과 인식

Objectives : The purpose of this study was to investigate cognition on oral health education and dental caries preventive effect in kindergartens and child care facilities. Methods : A self-reported questionnaire was completed by 260 teachers in kindergartens and nursery facility in Daejeon from January to February, 2013. Except incomplete answers, 248 questionnaires were analyzed by using the statistical package SPSS WIN 18.0. Results : High intention to participate in oral health education was shown in the teachers who experienced the oral health education. Dental caries preventive effect included correct tooth brushing, fluoride dentifrice, fluoride mouth rinse, and use of xylitol. The teachers agreed that the fluoride mouth rinses would help good oral health in the children. Conclusions : Teachers in kindergartens and nursery facility are the most important persons in childhood oral health care. So it is necessary to provide the continuing standardized education for the teachers systematically.

Sodium fluoride mouthrinse used twice daily increased incipient caries lesion remineralization in an in situ model

ObjectivesTo investigate the remineralizing effects of fluoride mouthrinses used at different times and frequency in addition to fluoride toothpaste. MethodsA randomized crossover single blinded study comprised 4 experimental phases of 21 days each. Twelve orthodontic volunteers were fixed with an orthodontic bracket containing an artificial carious enamel slab, which was from the same tooth in all 4 phases, and were randomly assigned to the following groups: (1) brushing with F toothpaste 2× per day (F- brush), (2) F- brush+rinsing with 0.05% NaF (F- rinse) after lunch, (3) F- brush+F-rinse before bedtime, and (4) F- brush+F- rinse 2× per day. Mean mineral gain after each phase was determined from mineral density profiles obtained using Micro-CT. ResultsThe mean mineral gain in all treatments with F- brush and F-rinse were significantly greater than those in F- brush (p<0.05). Moreover F- rinse 2× per day increased lesion remineralization more than F- rinse once a day. ConclusionsThe twice-daily use of 0.05% NaF mouthrinse combined with twice-daily regular use of fluoride toothpaste resulted in the greatest remineralization of incipient caries. These data indicate that rinsing frequency is a factor affecting the effectiveness of fluoride mouthrinse. Clinical significanceThe rinsing frequency of NaF mouthrinse, when used with fluoride toothpaste, also affects the remineralization. This finding, if confirmed by a clinical study, would lead to a new recommendation for fluoride mouthrinse used in high caries risk patients who could benefit from using it twice a day.

Impact of an anticaries mouthrinse on in vitro remineralization and microbial control.

Objective. The objective of this research was to evaluate the caries control potential of a new fluoride mouthrinse that also contained antimicrobial agents and a biofilm disrupting agent using different in vitro models. Methods. Four in vitro studies were conducted to assess the performance of this three pronged approach to caries control: (1) traditional enamel fluoride uptake, (2) surface microhardness study using pH cycling model and subsequent fluoride uptake, (3) a salivary biofilm flow-through study to determine the anti-microbial activity, and (4) a single species biofilm model measuring effect on biofilm matrix disruption. Results. The data showed that a LISTERINE rinse with fluoride, essential oils and xylitol was superior in promoting enamel fluoride uptake and in enhancing antimicrobial activity over traditional commercially available fluoridated products. An increase of the surface microhardness was observed when the LISTERINE rinse was used in combination with fluoridated toothpaste versus the fluoridated toothpaste alone. Finally, it was demonstrated that xylitol solutions disrupted and reduced the biovolume of biofilm matrix of mature Streptococcus mutans. Conclusion. These in vitro studies demonstrated that a fluoride mouthrinse with antimicrobial agent and biofilm matrix disrupting agent provided multifaceted and enhanced anti-caries efficacy by promoting remineralization, reducing acidogenic bacteria and disrupting biofilm matrix.

Efficacy of mouth rinses on dental plaque and gingivitis: A randomized, double-blind, placebo-controlled clinical trial

Introduction: Over the years chlorhexidine (CHX), triclosan and sodium fluoride (NaF) mouth rinses are used alone or combined in the prevention of dental diseases. However, at present little is known about the combined effects of NaF + triclosan and CHX + NaF + triclosan mouth rinses on reducing dental plaque and gingivitis. Aim: The aim was to determine the efficacy of mouth rinses used as adjuncts to regular oral hygiene measures on reducing dental plaque and gingivitis. Materials and Methods: A randomized, placebo-controlled, double-blind, parallel-group study was conducted for 6-month, among 12-15 years old school children in Nellore, India. Eligible subjects (n = 210) with consent were randomly allocated to four groups and were provided with a mouth rinse (Group A = 0.2% CHX; Group B = 0.05% sodium fluoride + 0.03% triclosan; Group C = 0.2% CHX + 0.05% sodium fluoride + 0.03% triclosan; Group D = Placebo). All subjects used 10 ml of mouth rinse, once daily for 60 s. The clinical parameters evaluated were plaque index (PlI) and gingival Index (GI). Statistical significance within and between four groups was tested using one-way analysis of variance (ANOVA), repeated measures ANOVA with post-hoc and paired t-test. Results: At the end of clinical trial, the three test groups showed statistically significant (P < 0.001) reduction in PlI and GI scores compared with placebo group. Conclusion: The active agents demonstrated highly potent antiplaque and antigingivitis properties when compared to placebo.

Effectiveness of Fluoride Mouth Rinsing for Dental Caries Prevention

Effectiveness of Fluoride Mouth Rinsing for Dental Caries Prevention

Fluorides for the prevention of early tooth decay (demineralised white lesions) during fixed brace treatment

Demineralised white lesions (DWLs) can appear on teeth during fixed brace treatment because of early decay around the brackets that attach the braces to the teeth. Fluoride is effective in reducing decay in susceptible individuals in the general population. Individuals receiving orthodontic treatment may be prescribed various forms of fluoride treatment. This review compares the effects of various forms of fluoride used during orthodontic treatment on the development of DWLs. This is an update of a Cochrane review first published in 2004. The primary objective of this review was to evaluate the effects of fluoride in reducing the incidence of DWLs on the teeth during orthodontic treatment.The secondary objectives were to examine the effectiveness of different modes of fluoride delivery in reducing the incidence of DWLs, as well as the size of lesions. Participant-assessed outcomes, such as perception of DWLs, and oral health-related quality of life data were to be included, as would reports of adverse effects. We searched the Cochrane Oral Health Group's Trials Register (to 31 January 2013); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 12); MEDLINE via OVID (1946 to 31 January 2013); and EMBASE via OVID (1980 to 31 January 2013). We included trials if they met the following criteria: (1) parallel-group randomised clinical trials comparing the use of a fluoride-containing product versus placebo, no treatment or a different type of fluoride treatment, in which (2) the outcome of enamel demineralisation was assessed at the start and at the end of orthodontic treatment. At least two review authors independently, in duplicate, conducted risk of bias assessments and extracted data. Authors of trials were contacted to obtain missing data or to ask for clarification of aspects of trial methodology. The Cochrane Collaboration's statistical guidelines were followed. For the 2013 update of this review, three changes were made to the protocol regarding inclusion criteria. Fourteen studies included in the previous version of the review were excluded from this update for the following reasons: five previously included studies were quasi-randomised, a further five were split-mouth studies, three measured outcomes on extracted teeth only and in one, the same fluoride intervention was used in each intervention group of the study.Three studies and 458 participants were included in this updated review. One study was assessed at low risk of bias for all domains, in one study the risk of bias was unclear and in the remaining study, the risk of bias was high.One placebo-controlled study of fluoride varnish applied every six weeks (253 participants, low risk of bias), provided moderate-quality evidence of an almost 70% reduction in DWLs (risk ratio (RR) 0.31, 95% confidence interval (CI) 0.21 to 0.44, P value < 0.001). This finding is considered to provide moderate-quality evidence for this intervention because it has not yet been replicated by further studies in orthodontic participants.One study compared two different formulations of fluoride toothpaste and mouthrinse prescribed for participants undergoing orthodontic treatment (97 participants, unclear risk of bias) and found no difference between an amine fluoride and stannous fluoride toothpaste/mouthrinse combination and a sodium fluoride toothpaste/mouthrinse combination for the outcomes of white spot index, visible plaque index and gingival bleeding index.One small study (37 participants) compared the use of an intraoral fluoride-releasing glass bead device attached to the brace versus a daily fluoride mouthrinse. The study was assessed at high risk of bias because a substantial number of participants were lost to follow-up, and compliance with use of the mouthrinse was not measured.Neither secondary outcomes of this review nor adverse effects of interventions were reported in any of the included studies. This review found some moderate evidence that fluoride varnish applied every six weeks at the time of orthodontic review during treatment is effective, but this finding is based on a single study. Further adequately powered, double-blind, randomised controlled trials are required to determine the best means of preventing DWLs in patients undergoing orthodontic treatment and the most accurate means of assessing compliance with treatment and possible adverse effects. Future studies should follow up participants beyond the end of orthodontic treatment to determine the effect of DWLs on participant satisfaction with treatment.

Fluoride toothpastes and fluoride mouthrinses

To provide a brief commentary review of fluoride-containing toothpastes and mouthrinses with emphasis on their use at home. Toothpastes and mouthrinses are just two of many ways of providing fluoride for the prevention of dental caries. The first investigations into incorporating fluoride into toothpastes and mouthrinses were reported in the middle 1940s. Unlike water fluoridation (which is 'automatic fluoridation'), fluoride-containing toothpastes and fluoridecontaining mouthrinses are, primarily, for home use and need to be purchased by the individual. By the 1960s, research indicated that fluoride could be successfully incorporated into toothpastes and clinical trials demonstrated their effectiveness. By the end of the 1970s, almost all toothpastes contained fluoride. The widespread use of fluoride- containing toothpastes is thought to be the main reason for much improved oral health in many countries. Of the many fluoride compounds investigated, sodium fluoride, with a compatible abrasive, is the most popular, although amine fluorides are used widely in Europe. The situation is similar for mouthrinses. Concentrations of fluoride (F), commonly found, are 1500 ppm (1500 μg F/g) for toothpastes and 225 ppm (225 μg F/ml) for mouthrinse. Several systematic reviews have concluded that fluoride-containing toothpastes and mouthrinses are effective, and that there is added benefit from their use with other fluoride delivery methods such as water fluoridation. Guidelines for the appropriate use of fluoride toothpastes and mouthrinses are available in many countries. Fluoride toothpastes and mouthrinses have been developed and extensive testing has demonstrated that they are effective and their use should be encouraged.

Topical fluoride for caries prevention

A panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs presents evidence-based clinical recommendations regarding professionally applied and prescription-strength, home-use topical fluoride agents for caries prevention. These recommendations are an update of the 2006 ADA recommendations regarding professionally applied topical fluoride and were developed by using a new process that includes conducting a systematic review of primary studies. The authors conducted a search of MEDLINE and the Cochrane Library for clinical trials of professionally applied and prescription-strength topical fluoride agents--including mouthrinses, varnishes, gels, foams and pastes--with caries increment outcomes published in English through October 2012. The panel included 71 trials from 82 articles in its review and assessed the efficacy of various topical fluoride caries-preventive agents. The panel makes recommendations for further research. The panel recommends the following for people at risk of developing dental caries: 2.26 percent fluoride varnish or 1.23 percent fluoride (acidulated phosphate fluoride) gel, or a prescription-strength, home-use 0.05 percent fluoride gel or paste or 0.09 percent fluoride mouthrinse for patients 6 years or older. Only 2.26 percent fluoride varnish is recommended for children younger than 6 years. The strengths of the recommendations for the recommended products varied from "in favor" to "expert opinion for." As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences.

Lack of reliable evidence of the effectiveness of remineralising agents for the treatment of post orthodontic white spot lesions

PubMed, Medline, Web of Science and the Cochrane Library databases were searched. Selection was conducted independently by two reviewers, only randomised controlled trials were included. Study quality was assessed using the Cochrane risk of bias approach. Data abstraction was carried out independently by two reviewers and qualitative summary presented, because of the heterogeneity of the interventions and outcome measures. Seven studies were included, all except one (of medium risk) were considered to be at high risk of bias. Three studies evaluated fluoride preparations (50-ppm sodium fluoride mouth rinse, 5% sodium fluoride varnish and 0.5% sodium fluoride chewing sticks). Four compared remineralising agents containing casein phosphopeptide amorphous calcium phosphate or casein phosphopeptide amorphous calcium fluoride phosphate. Based on the literature, there is a lack of reliable evidence to support the effectiveness of remineralising agents for the treatment of post orthodontic white spot lesions.