Fluoride Mouthrinse Research Articles

Application of chlorhexidine, fluoride and artificial saliva during radiotherapy: an in vitro study of microleakage in Class V restorations

The aim of this study was to evaluate the effect on microleakage in Class V restorations of daily applications of artificial saliva, fluoride mouthrinses and chlorhexidine to irradiated bovine teeth. Class V cavities were created in 60 bovine teeth. The teeth were divided randomly into two groups: the first group (n=30) was subjected to radiotherapy until the teeth had received a total accumulated dose of 60Gy; the second group (n=30) was used as a control group. Both groups were divided into three subgroups (n=10): in Group A teeth were submerged in Xeros Dentaid(®) artificial saliva; Group B teeth were submerged in a solution of 1% amine fluoride; Group C teeth were submerged in 0.12% chlorhexidine. All treatments were applied three times a day for six weeks. Afterwards microleakage into the composite restorations was measured using MIP4 image software. It was seen that radiation caused increases in microleakage in composite restorations. Statistically significant differences were found in the artificial saliva group (p=0.013) and the chlorhexidine group (p=0.023). Microleakage in composite restorations was greater among radiated teeth.

Scanning Electron Microscopy of Growing Dental Plaque: A Quantitative Study with Different Mouth Rinses

The aim of this study was to quantify the influence of different mouth rinses on dental plaque. Wearing splints with enamel pieces 24 volunteers rinsed with essential oils, amine/stannous fluoride, or chlorhexidine digluconate (0.12%) mouth rinses. After 24, 48, 72, and 96 h the enamel pieces were analyzed by scanning electron microscopy. The counts of cocci and bacilli in different plaque layers and the plaque thickness were almost similar using essential oils and amine/stannous fluoride. These results differed significantly from those of chlorhexidine digluconate mouth rinses. The results for plaque thickness were without significant differences between the groups at any appointment.

The effect of fractional CO2 laser irradiation on remineralization of enamel white spot lesions

This study investigated the combined effect of fractional CO(2) laser irradiation and fluoride on treatment of enamel caries. Sixty intact premolars were randomly assigned into four groups and then stored in a demineralizing solution to induce white spot lesions. Tooth color was determined at baseline (T1) and after demineralization (T2). Afterwards, the teeth in group 1 remained untreated (control), while group 2 was exposed to an acidulated phosphate fluoride (APF) gel for 4 min. In groups 3 and 4, a fractional CO(2) laser was applied (10 mJ, 200 Hz, 10 s) either before (group 3) or through (group 4) the APF gel. The teeth were then immersed in artificial saliva for 90 days while subjected to daily fluoride mouthrinse and weekly brushing. Color examinations were repeated after topical fluoride application (T3) and 90 days later (T4). Finally, the teeth were sectioned, and microhardness was measured at the enamel surface and at 30 and 60 μ from the surface. In both lased groups, the color change between T1 and T4 stages (∆E(T1-T4)) was significantly lower than those of the other groups (p < 0.05). Laser irradiation followed by fluoride application (group 3) caused a significant increase in surface microhardness compared to APF alone and control groups (p < 0.05). Microhardness at depths of 30 and 60 μ was also significantly greater in group 3 compared to those of all other groups (p < 0.05). Application of a fractional CO(2) laser before fluoride therapy is suggested for recovering the color and rehardening of demineralized enamel.

Comparative evaluation of fluoride release and recharge of pre-reacted glass ionomer composite and nano-ionomeric glass ionomer with daily fluoride exposure: An in vitro study

This in vitro study was designed to investigate the effects of daily fluoride exposures on fluoride release and recharge by prereacted glass ionomer (PRG) composite and nano-ionomeric glass ionomer. Seventy-two specimens (36 of each material) were prepared and by placing the restorative materials into Teflon mold. Each specimen was subjected to one of three daily treatments (n = 12): (1) No fluoride treatment (control); (2) application of a fluoride dentifrice (1,000 ppm) once daily; and (3) the same regimen as (2), plus immersion in a 0.05% sodium fluoride (NaF) mouth rinse (225 ppm) immediately following the dentifrice application. Specimens were suspended in a storage vial containing 10 ml demineralizing solution for 6 h and transferred to a new test tube containing 10 ml remineralizing solution for 18 h. Fluoride treatments of the specimens were completed every day prior to their immersion in the demineralizing solution. Media solutions were buffered with equal volumes of total ionic strength adjustment buffer (TISAB) II; fluoride levels were measured using a digital ion analyzer and fluoride electrode throughout the 21 day duration of the experiment. Nano-ionomeric glass ionomer showed a better amount of fluoride release than PRG composite irrespective of the fluoride treatment supplementation (P < 0.01). Additional fluoride supplementation improved fluoride release and recharge ability for both the materials when compared to their respective control groups. The fluoride recharge for both materials did not show any sustained pattern of release. Nano-ionomeric glass ionomer demonstrated a greater ability to release and recharge compared with that of PRG composite.

Remineralisation of occlusal white spot lesion with a combination of 10% CPP-ACP and 0.2% sodium fluoride evaluated using Diagnodent: a pilot study.

To evaluate the efficacy of 10% casein phosphopeptide amorphous calcium phosphate complex (CPP-AC P) used alone or with fluoride as compared to fluoride mouthrinse for the remineralisation of occlusal white spot lesions in an in vivo pilot study. Forty-five subjects with occlusal white spot lesions (WSL) determined by visual examination and confirmed with Diagnodent were randomly divided into 3 groups: group 1: 10% CPP-AC P + 0.2% NaF; group 2: 10% CPPAC P; group 3: 0.5% NaF mouthrinse for 30 days. The pre-treatment and post-intervention Diagnodent values were tabulated and subjected to statistical analysis. Among the groups, the remineralising potential of 10% CPP-AC P + 0.2% NaF (group 1) and 10% CPP-AC P (group 2) were similar, however, both groups were superior to 0.5% NaF mouthrinse (group 3). The CCP-AC P technique is highly beneficial for the remineralisation of non-cavitated occlusal white spot lesions when compared to 0.5% NaF mouthrinse.

What are the unmet needs in the dental office/at home to treat dentin hypersensitivity?

Oral discomfort due to tooth hypersensitivity is a common occurrence and a frequent reason why patients visit their dentists. Epidemiological oral studies demonstrated that in populations of 18–65 years old patients, 40–60 % have signs of hypersensitivity. Tooth hypersensitivity manifests itself clinically as a painful tooth reaction to sensory stimulus because of a loss of tooth hard tissue. This loss may be a reason of cracked enamel, tooth decay, non-carious lesions as well as tooth neck or root exposure as a result of periodontal diseases and therapy [1]. The successful management of dentin hypersensitivity is a very challenging treatment for dental professionals. The intensity can range between the different patients and is referred to the subjective perception. The temperature sensitivity assessment by cold air and the pain expression by a VAS scale are very subjective measurements that vary from patient to patient. Some approaches for objectification of the pain are the tactile hypersensitivity measurement with the Yeaple probe and the electrical stimulus sensitivity assessment with the Vitality scanner [2]. The caries-preventive benefits of fluoride are well-known established and proofed for decades [3]. Fluoride does some prevention to demineralization, controls remineralisation, promotes wear resistance, interferes with microbiology, reduces hypersensitivity, interferes directly with the biofilm and changes acid resistance in biofilm. Fluoride works for everyone independent of age [4]. The upgoing stairway of therapy starts at non-invasive tooth pastes to mouthrinses to topical agents and ends at invasive therapy like resins or that leads to endodontics if an irreversible pulpitis occurs. Additional possible local treatments are a desensitisation by the Er:YAG laser or application of ozone. For immediate release of sensations concerning exposed dental necks and hypersensitivity, the topic application of desensitising materials is of big interest. Recommendations for daily treatments in the dental offices are the use of solutions containing fluorides, varnishes with solvents and dentin bonding agents. Recommendations for home treatments are use of non-abrasive desensitising tooth pastes and rinsing solutions, habits change and patient’s education to smart brushing with soft toothbrushes. So, more brushing should mean less caries, but not more erosions as Patrick Schmidlin mentioned. One problem mentioned by Lars Petersson is the lack of efficient products which suit for elderly and mouth-dried patients. On the market, available toothpastes are not tolerated by mouth-dried patients. Manufacturer should be focused on that. There is a need for toothpastes without the necessity of rinsing because the elderly, especially mouth-dried patients, swallow it. It might be a matter of flavour because the slightest flavour is too strong for them. Recent studies show that hypersensitivity can be reasonably well controlled by using toothpastes with a fluoride concentration of 1,500 ppm in long-term therapy, especially in the combination containing 8.0 % arginine [5]. Stannous fluoride creates a layer on the surface; aminefluoride precipitates for mineralizing solutions. In theory, potassium nitrate blocks the synapse between nerve cells, but no clear evidence is available for the support of potassium-containing toothpastes for dentine hypersensitivity [6]. By protein precipitation, glutaraldehyde leads to an occlusion of the dentinal tubules. A single topical application of fluoride varnish reduces cervical hypersensitivity for up to 24 weeks [7]. Fluoride varnish has a momentarily effect on hypersensitivity, but it must be repeated after some months and works best in combination with fluoride mouthrinses [8]. Beside the fluoride effect, colophonium as an ingredient in varnishes can additionally plug dental tubules. In case of hypersensitivity, the fluoride rinsing is recommended twice a day as Peterson stated. As fluoridated toothpaste primarily led to a higher degree of remineralisation of dentine caries lesions, the additional use of fluoridated dental rinse will enhance this effect [9]. The option of application of casein CPP-ACP has no long-lasting effect on dental hypersensitivities [10]. Clinical recommendation for patients with a risk of root caries, toothpaste with aminofluoride in a concentration of 1,500 ppm twice a day has the highest priority. It is effective and cost-effective [11]. The next step is the application of a dentin bonding agent. Problem is that the dentine sealing is not visible, only if a filling is placed [12]. Dentin adhesives are plugging the tubules while coating the dentin. One important additional therapeutical effect is the placebo effect. Because in clinical studies we find a success rate in placebo groups up to 40 %, this is a big issue. With this, a dentist should be aware and influence his therapeutic strategy. So we can state that a big part of the needs to treat exposed dental necks are met.

Effect of Conventional Mouthrinses on Initial Bioadhesion to Enamel and Dentin in situ

Aim: The study aimed to investigate the effect of a customary fluoride solution, containing sodium fluoride and amine fluoride, on initial biofilm formation on enamel and dentin in situ compared directly to chlorhexidine. Methods: Bovine enamel and dentin specimens were mounted on maxillary splints carried by 9 subjects. After 1 min of pellicle formation, rinses with tap water (control), chlorhexidine (meridol med CHX 0.2%, GABA) and a fluoride mouthrinse (elmex, GABA) were performed for 1 min. Subsequently, the slabs were carried for another 8 h. The adherent bacteria were determined by DAPI staining, live-dead staining and determination of colony-forming units after desorption; glucan formation was visualized with concanavalin A. Additionally, energy-dispersive X-ray spectroscopy (EDX) analysis of the in situ biofilm layers was conducted, and contact angle measurements were performed. Statistical evaluation was performed by means of the Kruskal-Wallis test followed by the Mann-Whitney U test (p < 0.05). Results: In the control group, significantly higher amounts of adherent bacteria were detected on dentin (4.8 × 10⁶ ± 5.4 × 10⁶ bacteria/cm²) than on enamel (1.2 × 10⁶ ± 1.5 × 10⁶ bacteria/cm², DAPI). Chlorhexidine significantly reduced the amount of adherent bacteria (dentin: 2.8 × 10⁵ ± 3.4 × 10⁵ bacteria/cm²; enamel: 4.2 × 10⁵ ± 8.7 × 10⁵ bacteria/cm²). Rinses with the fluoride solution also significantly reduced bacterial adherence to dentin (8.1 × 10⁵ ± 1.5 × 10⁶ bacteria/cm²). Fluoride could not be detected by EDX analysis of the biofilms. Fluoride mouthrinsing did not influence the wettability of the pellicle-covered enamel surface. Conclusion: In addition to the reduction of demineralization and antibacterial effects, fluorides inhibit initial biofilm formation on dental hard tissues considerably, especially on dentin.

Antimicrobial efficacy of 0·05% cetylpyridinium chloride mouthrinses

This study evaluated the antimicrobial activity of two commercially available 0·05% cetylpyridinium chloride (CPC) mouthrinses with or without alcohol and examined its antimicrobial activity on oral bacterial species including fresh clinical isolates compared to a chlorhexidine mouthrinse and a control fluoride mouthrinse without CPC. Two different approaches were used to evaluate antimicrobial activity. First, the minimum inhibitory concentration (MIC) was determined for each mouthrinse against a panel of 25 micro-organisms including species associated with dental caries, gingivitis and periodontitis. Second, supragingival dental plaque obtained from 15 adults was incubated with the four mouthrinses to evaluate antimicrobial activity on micro-organisms in oral biofilms. Both CPC mouthrinses exhibited lower MIC's, that is, greater antimicrobial activity, against oral Gram-negative bacteria especially periodontal pathogens and species implicated in halitosis such as Aggregatibacter actinomycemcomitans, Campylobacter rectus, Eikenella corrodens, Porphyromonas gingivalis, Prevotella intermedia and Solobacterium moorei than the control mouthrinse. Ex-vivo tests on supragingival plaque micro-organisms demonstrated significantly greater antimicrobial activity by the CPC mouthrinses (>90% killing, P<0·001) and the chlorhexidine rinse (>98% killing, P<0·05) compared to the control fluoride mouthrinse. Whilst the chlorhexidine mouthrinse was most effective, mouthrinses containing 0·05% CPC formulated with or without alcohol demonstrated broad-spectrum antimicrobial activity against both laboratory strains and supragingival plaque bacteria compared to a control mouthrinse without CPC. These in vitro and ex-vivo studies provide a biological rationale for previous clinical studies demonstrating the efficacy of CPC mouthrinses in reducing supragingival plaque and plaque-associated gingivitis.

The Effect of Daily Fluoride Mouth Rinsing on Enamel Erosive/Abrasive Wear in situ

It is not known whether application of fluoride agents on enamel results in lasting resistance to erosive/abrasive wear. We investigated if one daily mouth rinse with sodium fluoride (NaF), stannous fluoride (SnF₂) or titanium tetrafluoride (TiF₄) solutions protected enamel against erosive/abrasive wear in situ (a paired, randomised and blind study). Sixteen molars were cut into 4 specimens, each with one amalgam filling (measurement reference surface). Two teeth (2 × 4 specimens) were mounted bilaterally (buccal aspects) on acrylic mandibular appliances and worn for 9 days by 8 volunteers. Every morning, the specimens were brushed manually with water (30 s) extra-orally. Then fluoride solutions (0.4% SnF₂ pH 2.5; 0.15% TiF₄ pH 2.1; 0.2% NaF pH 6.5, all 0.05 <smlcap>m</smlcap> F) were applied (2 min). Three of the specimens from each tooth got different treatment, and the fourth served as control. At midday, the specimens were etched for 2 min in 300 ml fresh 0.01 <smlcap>m</smlcap> hydrochloric acid and rinsed in tap water. This etch procedure was repeated in the afternoon. Topographic measurements were performed by a white-light interferometer. Mean surface loss (±SD) for 16 teeth after 9 days was: SnF₂ 1.8 ± 1.9 µm, TiF₄ 3.1 ± 4.8 µm, NaF 26.3 ± 4.7 µm, control 32.3 ± 4.4 µm. Daily rinse with SnF₂, TiF₄ and NaF resulted in 94, 90 and 18% reduction in enamel erosive/abrasive wear, respectively, compared with control (p < 0.05). The superior protective effect of daily rinse with either stannous or titanium tetrafluoride solutions on erosive/abrasive enamel wear is promising.

Comparative studies of casein phosphopeptide-amorphous calcium phosphate and fluoride products in inhibiting enamel demineralization

To evaluate casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and several fluoride products in inhibiting enamel demineralization. Seventy healthy premolars extracted before orthodontic treatment were divided into seven groups (A: CPP-ACP; B: CPP-ACP + fluoride mouth rinses; C: fluoride mouth rinses; D: fluoride glass ionomer protection; E: fluoride resin binder; F: fluoride varnish; G: control group). There were ten samples in each group. The teeth were dipped into an artificial caries solution ten minutes at a time, then applied separately with CPP-ACP, CPP-ACP + fluoride mouth rinses, fluoride mouth rinses, fluoride glass ionomer protection, fluoride resin binder and fluoride varnish on labial enamel. The samples were dipped into an artificial saliva solution (37°C). Then all samples were examined with atomic force microscope (AFM) at the end of first, second and third monthes. At the end of the first month, surface roughness in group D [(114 ± 1) nm] was significantly lower than that in group G[(172 ± 9) nm]. At the end of the second month and the third month, significant difference was found in surface roughness between group G and the rest of groups (P < 0.05); between group B and the rest of groups; and between group C and groups (D, E and F). CPP-ACP and fluoride could both inhibit enamel demineralization in vitro. Solid fluoride (groups D, E and F) had better results than liquid fluoride (group C).

Analysis of pH, fluoride concentration, viscosity and the total soluble solids content of commercially available fluoride mouthrinses in the city of Manaus-AM

Objetivo: Avaliar o potencial erosivo e cariogenico dos enxaguatorios bucais fluoretados disponiveis comercialmente na cidade de Manaus – AM, atraves da analise da concentracao de fluor, do pH, da viscosidade e o do teor de solidos soluveis totais (SST) destes. Metodo: Foram selecionadas aleatoriamente seis marcas de enxaguatorios bucais fluoretados, adquiridos em drogarias da cidade de Manaus em triplicata, com lotes diferentes. A analise da concentracao de fluor e do pH foi realizada mediante o uso do analisador de ions ORION® 720A, enquanto na determinacao da viscosidade foi utilizado um viscosimetro AVS – 350 (Schott®), em temperaturas de 20 e 37⁰C e o teor de solidos soluveis totais (SST) foi determinado atraves da leitura da refratometria na escala °Brix. Os dados foram submetidos a analise de variância de ANOVA e ao teste de Tukey para demonstrar diferencas estatisticamente significantes entre os enxaguatorios e os seus respectivos lotes. Resultados: A concentracao de fluor encontrada nos enxaguatorios analisados variou entre 213,22 e 249,78 ppm, enquanto o pH da maioria dos enxaguatorios mostrou-se acido, mas apenas duas marcas apresentaram-se potencialmente erosivas, com pH inferior a 5,5. A viscosidade a 20⁰C apresentou um intervalo de 1,28 – 2,56 mm2/s, e quando a 37 ⁰C, um intervalo de 1,02 e 1,90 mm2/s. O teor de SST variou entre 7 e 22,50% na escala °Brix. Conclusao: Os enxaguatorios quando necessarios devem ser utilizados de maneira racional, nao estando recomendado seu uso em longo prazo, dado a sua composicao. Alem disso, quando utilizados por criancas, os pais devem supervisionar para evitar o uso excessivo ou ate mesmo a degluticao, visto que a cor e o sabor sao muito atrativos ao publico infantil.

Relationship between Duration of Fluoride Exposure in School-Based Fluoride Mouthrinsing and Effects on Prevention and Control of Dental Caries.

The objective of this paper was to assess the effects of school-based fluoride mouthrinsing (S-FMR: weekly using 0.2% NaF solution) in two groups of school children with different periods of exposure to S-FMR in elementary school. Subjects were the S-FMR group consisted of 599 children, participated for six years. The control group consisted of 282 children, participated for less than one year in the sixth year of elementary school. From the results of the present survey, the caries reduction rate of S-FMR in the permanent teeth was 36.6% for DMFT and 42.8% for DMFS, and person rates with DMF, DMFT, DMFS, and CO (questionable caries under observation) were inhibited in both boys and girls. Girls in the control group showed clearly higher values for all parameters of dental caries because of earlier teeth eruption; however, no gender differences were observed in the S-FMR group. As caries prevalence in the first molars accounted for about 85% regardless of participation to S-FMR, and first molar caries were more common in the mandible than in the maxilla, consideration should be given to preventive measures against pit-and-fissure-caries in addition to S-FMR.

Influence of topical fluoride application on mechanical properties of orthodontic bonding materials under pH cycling

To evaluate in vitro the influence of topical fluoride application on the mechanical properties of orthodontic cements containing fluoride under pH cycling conditions. Edgewise brackets for maxillary central incisors were bonded to 192 bovine incisors using Transbond XT (G1), Transbond Plus Color Change (G2), and Fuji Ortho LC (G3) (n = 64 for each group). The specimens of each group were subdivided (n = 16) into different subgroups. Subgroup A received no topical fluoride application during pH cycling, while the experimental subgroups received topical fluoride treatments as follows: B, application three times per day of fluoride dentifrice (1450 ppm F); C, application one time per day of fluoride mouth rinse (250 ppm F); and D, combination of fluoride dentifrice and fluoride mouth rinse. After 14 days of pH cycling, the shear bond strength and Adhesive Remnant Index were evaluated statistically. Polarized light microscopy showed that pH cycling induced mineral loss in all specimens. The topical application of fluoride did not have an influence on shear bond strength, although the association of fluoride dentifrice and mouth rinse increased the shear bond strength of the resinous cement without fluoride (P < .01). Regarding the Adhesive Remnant Index, no statistical differences were found within the groups G1 (P = .23), G2 (P = .47), and G3 (P = .74). Topical fluoride treatments improved the shear bond strength of resinous cement, regardless of the material's fluoride-releasing capacity, and reached the adhesive fractures.

The effect of a tin-containing fluoride mouth rinse on the bond between resin composite and erosively demineralised dentin

To evaluate the effect of a tin-containing fluoride (Sn/F) mouth rinse on microtensile bond strength (μTBS) between resin composite and erosively demineralised dentin. Dentin of 120 human molars was erosively demineralised using a 10-day cyclic de- and remineralisation model. For 40 molars, the model comprised erosive demineralisation only; for another 40, the model included treatment with a NaF solution; and for yet another 40, the model included treatment with a Sn/F mouth rinse. In half of these molars (n = 20), the demineralised organic matrix was continuously removed by collagenase. Silicon carbide paper-ground, non-erosively demineralised molars served as control (n = 20). Subsequently, μTBS of Clearfil SE/Filtek Z250 to the dentin was measured, and failure mode was determined. Additionally, surfaces were evaluated using SEM and EDX. Compared to the non-erosively demineralised control, erosive demineralisation resulted in significantly lower μTBS regardless of the removal of demineralised organic matrix. Treatment with NaF increased μTBS, but the level of μTBS obtained by the non-erosively demineralised control was only reached when the demineralised organic matrix had been removed. The Sn/F mouth rinse together with removal of demineralised organic matrix led to significantly higher µTBS than did the non-erosively demineralised control. The Sn/F mouth rinse yielded higher μTBS than did the NaF solution. Treatment of erosively demineralised dentin with a NaF solution or a Sn/F mouth rinse increased the bond strength of resin composite. Bond strength of resin composite to eroded dentin was not negatively influenced by treatment with a tin-containing fluoride mouth rinse.

Can white spot lesions be treated effectively?

To compare the effects of sodium fluoride mouth rinse, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and the microabrasion technique in treating white spot lesions. The study population consisted of 80 patients (46 females, 34 males; 966 affected teeth) who had developed multiple decalcified enamel lesions after fixed orthodontic therapy. The study population was divided into four groups of 20 patients each. The control group (group I) participants were to just brush their teeth, the fluoride group (group II) participants were instructed to use 20 ml of neutral 0.025% sodium fluoride rinse, the participants in the CPP-ACP group (group III) were instructed to use tooth mousse twice a day in addition to fluoride toothpaste for 6 months, and the participants in the microabrasion group (group IV) were to undergo treatment by the microabrasion technique, which is a commonly used mixture of 18% hydrochloric acid. Data were analyzed with the generalized linear mixed model and Tukey HSD at the P < .05 level. The area of the white spot lesions decreased significantly in all groups. Inter group differences in the treatment success rates were significant. The highest success rate was observed for group IV (97%). The success rate of group III (58%) was significantly higher than that of groups II (48%) and I (45%). The use of CPP-ACP can be more beneficial than fluoride rinse for postorthodontic remineralization. Microabrasion is an effective treatment for cosmetic improvement of long-standing white spot lesions.

HOW TO COMBAT WHITE SPOT LESION IN ORTHODONTIC CASES-REVIEW STUDY

All over the world fixed orthodontic cases face a common problem -enamel hypoplasia that is white spot lesion. It can be remineralised by brushing with fluoridated toothpaste, fluoride mouth rinses and topical application of fluoride gel/foam. Efficiency of remineralisation is enhanced with daily usage of 0.05%(225ppm) sodium fluoride or 0.2% (900ppm) weekly; or with 0.4%Stannous Fluoride gel. But Stannous Fluoride stains the enamel. Enamel can also be remineralised with casein phosphopeptide-amorphous calcium phosphate(CCP-ACP). Remineralised white spot lesion can be bleached to mask the colour and can be microabraded followed by bleaching leaving a highly polished surface with calcium phosphate packed into the interprismatic enamel surface area.

Methods used for prevention of white spot lesion development during orthodontic treatment with fixed appliances

Objectives: The aim of this study was to survey methods that Dutch orthodontists use to prevent development or progression of enamel decalcifications during orthodontic treatment. Materials and methods: A pre-tested questionnaire was sent by post to all orthodontists in the Netherlands with a private practice (n = 189). Results: The response rate was 81%. At the start of orthodontic treatment a basic practice protocol for prevention of enamel demineralization was used by 93% of the orthodontists. This included oral hygiene instructions (92%) and the advice for additional use of a fluoride mouth rinse (64%). Other preventive measures were rarely prescribed. About 85% of those who prescribed a fluoride mouth rinse advised to rinse once a day, directly after evening tooth brushing. Conclusions: The results suggest that the commonly used practice of fluoride mouth rinsing directly after evening tooth brushing by orthodontic patients during fixed appliance treatment ignores actual evidence of preventive advices. This study recommends mouth rinsing at another moment than after evening tooth brushing, thus increasing the frequency of fluoride intakes, which might enhance the effectiveness in preventing WSL development or progression during orthodontic treatment.

Effective Use of Self-care Fluoride Administration in Asia

The caries-preventive benefits of fluoride are generally accepted by dental researchers and practicing professionals worldwide. The benefits of fluoride toothpastes and mouthrinses have been supported by several high-quality systematic reviews. The formulation of a fluoride toothpaste and biological (salivary flow rate) and behavioral factors (brushing frequency, brushing time, post-brushing rinsing practices, timing of brushing, and amount of toothpaste applied) can influence anticaries efficacy. Fluoride mouthrinses have simpler formulations and can have better oral fluoride retention profiles than fluoride toothpastes, depending on post-brushing rinsing behaviors. Fluoride continues to be the mainstay of caries control; however, there is still the need to determine the most effective approach for fluoride utilization in children and adults who remain caries-active.

Effect of fluoride mouth rinses on various orthodontic archwire alloys tested by modified bending test: An in vitro study

Fluorides can cause corrosion and degradation in mechanical properties of commonly used archwires by forming hydrofluoric acid HF and causing disruption of protective titanium oxide layer. Hence, the aim of this study was to assess the change in load deflection characteristics of Ni-Ti, Cu Ni-Ti, S.S, and β-Ti wires on immersing in fluoride mouth rinses of two types- Phosflur and neutral NaF mouth rinse utilizing a modified bending test and comparing it to control. Round preformed wires were immersed in 10 ml of control and test solution (Phosflur and S-Flo mouth rinse) for 1.5 hours and incubated at 37°C. Modified bending test was carried out to evaluate load-deflection characteristics of different wires using Instron. Analysis of variance (ANOVA) was applied to determine if statistically significant difference exist among the mean load values obtained at various deflections in control and test solutions. There was no statistically significant reduction in load deflection characteristics of Ni-Ti, copper Ni-Ti, β-Ti, and S.S wires on immersing in Phosflur mouth rinse and neutral sodium fluoride mouth rinses as compared to control at 2.5 and 1 mm of deflection in unloading phase. Phosflur and a neutral sodium fluoride mouth rinse did not affect the mechanical bending properties of Ni-Ti, copper Ni-Ti, B-Ti, and SS wires in in vitro conditions.

Effect of school-based fluoride mouth-rinsing on dental caries incidence among schoolchildren in the Kingdom of Tonga

Since 1998, the authors have been working to improve the oral health of children at kindergartens and primary schools in the Kingdom of Tonga (Tonga). Our primary activity has been a school-based fluoride mouth-rinsing (FMR) program. FMR is performed using 7-10 mL of a 0.2% NaF solution for 1 min once per week at each school. In the present study, we evaluated the effect of school-based FMR on dental caries incidence among Tongan schoolchildren. A total of 109 children aged 10 years were evaluated at six primary schools on Tongatapu Island. The FMR group comprised 46 children who had participated in the school-based FMR program for at least 5 years 6 months; the control group comprised 63 children who had participated in the school-based FMR program for 1 year or less. During standardized dental examinations, decayed, missing, and filled teeth were counted by a single dentist at each school. The school-based FMR program effectively decreased the number of dental caries. A school-based FMR program may thus be very beneficial in preventing caries among children in Tonga.