Fluoride Toothpaste Research Articles

Interplay Between Minerals in Bottled Water and Fluoride Toothpaste and Caries Lesion Remineralization.

he aim of this in vitro study was to evaluate the effects of some bottled waters on fluoride toothpaste efficacy in enhancing caries lesion remineralization. Early caries lesions were created in bovine enamel specimens and stratified into treatment groups based on Vickers surface microhardness (VHN). The present study followed a two (fluoride and fluoride-free toothpaste) by five (four bottled waters and tap water) factorial design. The treatment groups were bottled water with the following attributes: (a) 309.9 ppm Ca/1.20 ppm F; (b) 118.4 ppm Ca/0.16 ppm F; (c) 1.00 ppm Ca/1.01 ppm F; and (d) 0.1 ppm Ca/0.04 ppm F and tap water (48.7 ppm Ca/0.7 ppm F). The five water groups were paired either with 1100 ppm fluoride or fluoride-free toothpaste, yielding 10 groups. Specimens were pH-cycled for 10 days with the daily regimen comprised of twice daily toothpaste slurry, with four exposures to water in between. VHN was measured again and the difference was calculated (ΔVHN). Data were analyzed using two-way ANOVA at a 5% significance level. The two-way interaction between water and toothpaste was significant (p<0.001). All groups except fluoride-free toothpaste/bottled water with 0.1 ppm Ca/0.04 ppm F (p=0.411) had significant increases in VHN after pH cycling (p≤0.023). Fluoridated toothpaste resulted in a higher rate of remineralization compared to fluoride-free toothpaste (all p<0.001). Bottled water with 1.20 ppm F/309.9 ppm Ca exhibited the greatest extent of remineralization within fluoride toothpaste groups (p<0.001) and higher remineralization than lower fluoride water in fluoride-free toothpaste groups (p≤0.006). Within the fluoridated toothpaste group, tap water exhibited significantly less remineralization than all bottled waters (all p<0.001). Within the limitation of this study, bottled water with higher fluoride and calcium concentrations might improve fluoridated toothpaste efficacy by enhancing remineralization of early enamel caries-like lesions.

Effect of fluoridated water on invasive NHS dental treatments for adults: the LOTUS retrospective cohort study and economic evaluation.

Most water fluoridation studies were conducted on children before the widespread introduction of fluoride toothpastes. There is a lack of evidence that can be applied to contemporary populations, particularly adolescents and adults. To pragmatically assess the clinical and cost effectiveness of water fluoridation for preventing dental treatment and improving oral health in a contemporary population of adults, using a natural experiment design. Retrospective cohort study using routinely collected National Health Service dental claims (FP17) data. National Health Service primary dental care: general dental practices, prisons, community dental services, domiciliary settings, urgent/out-of-hours and specialised referral-only services. Dental patients aged 12 years and over living in England (n = 6,370,280). Individuals exposed to drinking water with a fluoride concentration ≥ 0.7 mg F/l between 2010 and 2020 were matched to non-exposed individuals on key characteristics using propensity scores. Primary: number of National Health Service invasive dental treatments (restorations/'fillings' and extractions) received per person between 2010 and 2020. Secondary: decayed, missing and filled teeth, missing teeth, inequalities, cost effectiveness and return on investment. National Health Service Business Services Authority dental claims data. Water quality monitoring data. Predicted mean number of invasive dental treatments was 3% lower in the optimally fluoridated group than in the sub/non-optimally fluoridated group (incidence rate ratio 0.969, 95% CI 0.967 to 0.971), a difference of -0.173 invasive dental treatments (95% CI -0.185 to -0.161). This magnitude of effect is smaller than what most stakeholders we engaged with (n = 50/54) considered meaningful. Mean decayed, missing and filled teeth were 2% lower in the optimally fluoridated group, with a difference of -0.212 decayed, missing and filled teeth (95% CI -0.229 to -0.194). There was no statistically significant difference in the mean number of missing teeth per person (0.006, 95% CI -0.008 to 0.021). There was no compelling evidence that water fluoridation reduced social inequalities in treatments received or missing teeth; however, decayed, missing and filled teeth data did not demonstrate a typical inequalities gradient. Optimal water fluoridation in England in 2010-20 was estimated to cost £10.30 per person (excluding original setup costs). Mean National Health Service treatment costs for fluoridated patients 2010-20 were 5.5% lower per person, by £22.26 (95% CI -£23.09 to -£21.43), and patients paid £7.64 less in National Health Service dental charges per person (2020 prices). Pragmatic, observational study with potential for non-differential errors of misclassification in fluoridation assignment and outcome measurement and residual and/or unmeasured confounding. Decayed, missing and filled teeth data have not been validated. Water fluoridation cost estimates are based on existing programmes between 2010 and 2020, and therefore do not include the potentially significant capital investment required for new programmes. Receipt of optimal water fluoridation between 2010 and 2020 resulted in very small health effects, which may not be meaningful for individuals, and we could find no evidence of a reduction in social inequalities. Existing water fluoridation programmes in England produced a positive return on investment between 2010 and 2020 due to slightly lower National Health Service treatment costs. These relatively small savings should be evaluated against the projected costs and lifespan of any proposed capital investment in water fluoridation, including new programmes. National Health Service dental data are a valuable resource for research. Further validation and measures to improve quality and completeness are warranted. This trial is registered as ISRCTN96479279, CAG: 20/CAG/0072, IRAS: 20/NE/0144. This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: NIHR128533) and is published in full in Public Health Research; Vol. 12, No. 5. See the NIHR Funding and Awards website for further award information.

Optimal fluoride levels in pediatric toothpastes: A review of the literature

Aim:Through this literature review, we seek to determine the optimal level of fluoride present in pediatric toothpastes, identifying the recommended amount according to scientific literature, in addition to evaluate the effects of fluoride on children's dental health and its effectiveness in prevention of caries and also identify the risks of excessive fluoride exposure. Materials and methods: Searches were carried out for articles published in the last 5 years in electronic databases such as PubMed, Scopus, Scielo, ScienceDirect, UpToDate, Google Academic. The search used a combination of the following keywords: "toothpaste" AND "pediatrics" AND "dosage" AND "fluoride". Results: 14,118 abstracts were registered: 1,407 from PubMed, 1,043 from Scopus, 355 from ScienceDirect, 10,200 from Google Academic, 913 from Scielo, 200 from UpToDate. After reviewing the abstracts, 14,095 records were removed according to the inclusion and exclusion criteria, leaving 31 full-text articles for examination. Finally, 19 full-text articles were included and evaluated in this review. Conclusion: The presence of adequate concentrations of fluoride in toothpastes has a positive influence in oral health, especially on the prevention of dental caries. Several reviewed studies reveal that the optimal amount of fluoride in pediatric toothpastes should be greater than 1000 ppm but not exceed 1500 ppm to obtain the maximum anti-caries effect and prevent adverse effects such as dental fluorosis.

An In Vitro Study to Evaluate the Antimicrobial Activity of a Zinc Citrate, Sodium Fluoride, Alum and Xylitol-Based Toothpaste Formulation.

Periodontitis is a prevalent condition significantly affecting oral health. Comorbid conditions, such as diabetes, can heighten the severity of periodontal disease and overall oral health. Therefore, to enhance oral health and manage comorbid conditions, comprehensive periodontal care is essential. This approach could involve using toothpaste containing antimicrobial ingredients in routine oral care. This paper presents the results of an in vitro study analysing the antimicrobial properties of the test formulation containing zinc citrate, alum, sodium fluoride, and xylitol-based toothpaste(Stolin-R).These ingredients work together to help in providing comprehensive oral care by controlling growth of bacteria majorly responsible for periodontal disease and thus maintaining optimal oral hygiene. To determine the antimicrobial properties of zinc citrate, alum, sodium fluoride, and xylitol-based toothpaste formulationagainst key periodontal pathogens through in vitro analyses. The antimicrobial efficacy of test formulationis evaluated through minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and time-dependent antibacterial assessment against key periodontal pathogens, including Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium nucleatum, Prevotella intermedia, Streptococcus mutans, and Bacteroides fragilis. The test formulationdemonstrated potent antimicrobial effectiveness against Bacteroides fragilis, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Streptococcus mutans, and Tannerella forsythia, by exhibiting low MIC and MBC. Additionally, significant bacterial reduction, exceeding 99.99%, was observed within five minutes, emphasising its potential as an effective adjunct in combating periodontal infection. Zinc citrate, alum, sodium fluoride, and xylitol-based toothpaste formulation demonstrates significant antimicrobial activity against key periodontal pathogens, suggesting its potential as an effective agent for maintaining oral health and combating gingival infection.

Effect of different brushing parameters on erosive tooth wear in primary bovine enamel and dentin.

This in-vitro study aimed to analyse the effect of brushing and different brushing parameters (kind of toothpaste, kind of toothbrush, brushing force) on erosive tooth wear of primary bovine enamel and dentin. Specimens were prepared from primary bovine enamel or dentin (each group n = 12) and cyclically eroded (6 × 60 s/d, citric acid, pH 2.4) and brushed with children's toothbrushes (2 × 15 s/d) over 5 days. The brushing parameters under investigation were: toothpaste (fluoridated, fluoride-free), toothbrush (manual; rotating-oscillating and sonic, each at two different activation modes) and brushing force (1 N, 2 N). Specimens that were only eroded and not brushed served as controls. Enamel and dentin wear was quantified using widefield confocal microscopy. Statistical analysis was performed using three- and one-way ANOVAs followed by Scheffe's (enamel) or Tamhane's (dentin) post-hoc tests (p < 0.05). Brushing with the fluoridated toothpaste was able to significantly reduce erosive wear in enamel (by 15 to 37%, 6 of 10 groups) and in dentin (by 58 to 72%, all groups), while brushing with the fluoride-free toothpaste was not different from the controls. Considering the kind of toothpaste and brushing force, slight differences between the toothbrushes were observed in enamel, but not in dentin. Within the same toothbrush and activation mode, almost no differences between 1 and 2 N brushing force were detected. In conclusion, erosive tooth wear on primary bovine dental hard tissue mainly depends on the kind of toothpaste, rather than on the kind of toothbrush and the brushing force.

Dental caries status and related factors among 5-year-old children in Shanghai.

Dental caries in young children is a difficult global oral health problem. In the last decade, China has put a great deal of effort into reducing the prevalence of dental caries. This study, which is part of the China Population Chronic Disease and Nutrition Surveillance 2021, aimed to investigate the prevalence of dental caries among children aged 5 in Shanghai, China, and its associated factors. A total of 1281 children aged 5 years from 6 districts in Shanghai were selected by a stratified sampling method. The survey consisted of an oral health questionnaire and an oral health examination. The questionnaire included questions on oral health knowledge, attitudes, and behaviours. The oral health examination used WHO standards. After screening, the data were input and analysed. Chi-square tests and logistic regression analyses were used to study the relevant factors affecting dental caries. The prevalence of dental caries among 1281 children was 51.0%, the dmft index score was 2.46, the Significant Caries Index (SiC) score was 6.39, and the SiC10 score was 10.35. Dental caries experience was related to the frequency of sweet drink consumption, the age of starting tooth brushing, eating habits after brushing, whether the children had received an oral examination provided by the government (p < 0.05), and the mother's education level but was not related to sex, the use of fluoride toothpaste, the frequency of brushing, whether the parents assisted brushing, or the frequency of flossing (p > 0.05). Logistic regression analysis showed that the region of residence, eating after brushing and the age of starting brushing were associated with dental caries. Dental caries remained prevalent among 5-year-old children in Shanghai, China. Prevention strategies that target the associated factors including region of residence, eating after brushing, and the age of starting brushing should be considered.

Oral health status, related behaviours and perceived stress in xerostomia, Sicca and Sjögren's syndromes patients - a cross-sectional study.

Mouth dryness increases the risk of some oral health-related conditions. Furthermore, it is unclear if patients with dry mouth engage in appropriate oral health-related behaviours. The study examined oral health, related behaviours, and perceived stress in dry-mouth patients and compared them to matched controls without mouth dryness. Information about 182 dry-mouth patients and 302 age- and sex-matched subjects was retrieved. Three dry mouth groups: xerostomia, Sicca syndrome and Sjögren's syndrome, were formed based on patient self-reported and objectively assessed symptoms. The World Health Organization's Oral Health for Adults and Perceived Stress Scale (PSS-10) questionnaires inquired about sociodemographic characteristics, oral health-related behaviours, and self-perceived stress. Clinical oral health assessments included: caries experience measured as total numbers of decayed (DS), missing (MS), filled surfaces (FS), number of remaining teeth, erosive tooth wear and extent of periodontal pocketing. Data were analyzed using bivariate and multivariable tests. The dry-mouth participants had higher mean (SD) DMFS scores than their matched controls: xerostomia patients vs. controls: 74.6 (34.4) and 66.3 (35.4), Sicca syndrome patients vs. controls: 88.3 (34.0) and 70.1 (33.9), and Sjögren's syndrome patients vs. controls: 95.7 (31.5) and 74 (33.2). In comparison to controls, individuals with Sicca and patients with Sjögren's syndromes had lower mean (SD) number of remaining teeth, 15.9 (10.1) vs. 21.7 (8.4) and 13.8 (10.0) vs. 20.1 (9.2), and a lower mean (SD) extent of periodontal pocketing, 20.7 (28.6) vs. 41.1 (31.0), and 21.2 (24.1) vs. 34.8 (34.2), respectively. Xerostomia, Sicca syndrome and Sjögren's syndrome patients had higher odds of using fluoridated toothpaste; OR 1.8 (95%CI 1.1-2.9), OR 5.6 (95%CI 1.7-18.3) and OR 6.9 (95%CI 2.2-21.3), respectively. Participants with Sjögren's syndrome had lower odds of the last dental visit being within the last year; OR 0.2 (95%CI 0.1-0.8). Dry-mouth patients had higher caries experience and fewer teeth than comparison groups but a lower extent of periodontal pocketing. Even though more participants with dry mouth used fluoridated toothpastes, their oral health-related behaviours were not optimal.

The world's experience of introducing prophylactic programs in dentistry

Relevance. The oral health of the global population is fundamentally influenced by the incidence and severity of dental caries and periodontal diseases. To combat these issues, developed nations devise and execute preventive programs, tailoring their efforts to address the DEF (Decayed, Extracted, and Filled teeth) index across various age demographics. This approach signifies a paradigm shift, with governments now prioritizing the support of oral health through the introduction of comprehensive preventive strategies aimed at combating prevalent oral diseases. The efficacy of these programs, however, hinges on the occurrence of dental caries and, by extension, the availability of oral health professionals. This availability, in turn, shapes the landscape of health facilities—whether public or private—determining their ability to cater to community needs for oral health services. Consequently, the capacity to implement preventive measures is gauged against these dynamics. Furthermore, the nature and scope of preventive actions within these programs vary from one country to another, influenced primarily by the allocation of healthcare budgets by respective governments.Materials and methods. Analysis of scientific articles and original research from the PubMed, ResearchGate, ScienceDirect for the last 10 years. The search was carried out by keywords: dental prevention programs in the world, prevention of dental health, organization of preventive care in the world. An examination of research articles and original papers was conducted, drawing from databases such as PubMed, ResearchGate, and ScienceDirect over the last decade. The search employed specific key phrases, including "dental prevention programs worldwide", "dental health prevention", and "global organization of preventive dental care".Results. The initial advancement towards the creation and implementation of fluoride prophylaxis programs occurred following the discovery of fluoride's presence in water. A pivotal moment occurred in 1949 at Indiana State University when J.C. Muhler introduced the idea of fluoride toothpaste (specifically sodium fluoride) as a means to combat dental caries in children. Subsequent innovations included the use of silver fluoride for argentation. European countries took a holistic approach, emphasizing oral hygiene, fluoride toothpaste usage, and balanced nutrition. Meanwhile, the US and EU shifted towards a preventive approach within health insurance frameworks. A critical factor influencing the effectiveness of these preventive care programs is the availability of oral health professionals per 10,000 people in the population, alongside social workers advocating for healthy living and oral health. The engagement of more oral health professionals in preventive efforts correlates with a reduction in the incidence and severity of common oral diseases.Conclusion. The six stages of preventive care development and transformation highlight the evolving trends in global dentistry, which are crucial for ensuring the quality of oral health care across different countries. The effectiveness of these programs in individual nations is contingent upon the specific preventive care.

Description of oral hygiene in visually impaired people in the city of Ibarra, Ecuador

People with visual impairment face challenges in maintaining optimal oral hygiene, as they may lack knowledge of proper oral cleaning techniques. The objective of the study was to describe oral hygiene in people with visual impairment in the city of Ibarra, Ecuador. It was an observational, prospective, cross-sectional and descriptive study. Surveys were conducted with 30 blind people from the Center for Specialized Therapeutic Attention for People with Disabilities (CATEPED) in the city of Ibarra, Ecuador. The findings revealed that there was a significant prevalence of oral problems among the population studied. Despite showing good oral hygiene in general, the lack of knowledge about the use of fluoride toothpaste and the need to replace toothbrushes periodically are aspects of concern. These results highlight the importance of implementing educational and dental care programs specifically designed for people with visual impairment in order to improve their oral health and prevent dental disease. The need for increased attention to the oral health of people with visual impairment is highlighted, as well as the importance of education and access to appropriate dental services. These results highlight the importance of implementing educational and dental care programs specifically designed for people with visual impairment in order to improve their oral health and prevent dental disease. The need for increased attention to the oral health of people with visual impairment is highlighted, as well as the importance of education and access to appropriate dental services. The results underscore the importance of addressing the specific needs of this population, both in terms of oral hygiene awareness and in the provision of tailored dental care. It is critical to develop comprehensive strategies that address existing barriers and promote optimal oral health for people with visual impairment

A systematic review of the association between food insecurity and behaviours related to caries development in adults and children in high-income countries.

To synthesize and appraise the evidence regarding the relationship between food insecurity and behaviours associated with dental caries development in adults and children in high-income countries. A systematic review including observational studies assessing the association between food insecurity and selected dietary (free sugar consumption) and non-dietary factors (tooth brushing frequency; use of fluoridated toothpaste; dental visiting; oral hygiene aids; type of toothbrush used; interdental cleaning frequency and mouthwash use) related to dental caries development in adults and children in high-income countries. Studies specifically looking at food insecurity during the COVID-19 pandemic were excluded. Searches were performed in MEDLINE, Embase, Global Health and Scopus from inception to 25 May 2023. Two authors screened the search results, extracted data and appraised the studies independently and in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale (with modifications for cross-sectional studies). Vote counting and harvest plots provided the basis for evidence synthesis. Searches identified 880 references, which led to the inclusion of 71 studies with a total of 526 860 participants. The majority were cross-sectional studies, conducted in the USA and reported free sugar consumption. Evidence for the association between food insecurity and free sugar intake from 4 cohort studies and 61 cross-sectional studies including 336 585 participants was equivocal, particularly in the sugar-sweetened beverage (SSB) consumption post-hoc subgroup, where 20 out of 46 studies reported higher SSB consumption in food insecure individuals. There was consistent, but limited, evidence for reduced dental visiting in adults experiencing food insecurity compared to food secure adults from 3 cross-sectional studies including 52 173 participants. The relationship between food insecurity and dental visiting in children was less clear (3 cross-sectional studies, 138 102 participants). A single cross-sectional study of 3275 children reported an association between food insecurity and reported failure to toothbrush the previous day. This review did not identify clear associations between food insecurity and behaviours commonly implicated in the development of dental caries that would explain why individuals experiencing food insecurity are more likely to have dental caries than those who have food security. There was some evidence of decreased dental visiting in adults experiencing food insecurity. Common methodological weaknesses across the evidence base related to the selection of participants or control of potentially confounding variables. Consequently, the quality of evidence for all outcomes was downgraded to very low. More research is needed to explore access to oral hygiene products and household environments conducive to habitual oral self-care in food insecure populations.

Evaluation of the Effectiveness of Three Interventions on Mineralization of Young Permanent Teeth Using DIAGNOdent™ Pen: A Double-Blind Randomized Controlled Trial

Background: The occurrence of dental caries is influenced by the interplay of host factors, microbial factors, and environment factors collectively forming the epidemiological triad of dental caries. Modification of the caries epidemiological triad limits the caries progression by shifting the equilibrium toward re-mineralization. Aim: The aim of this study was to evaluate the effectiveness of dietary sugar intake modification, plaque control measures, and fluoride toothpaste on the mineralization of enamel using DIAGNOdent™ pen scores. Methodology: 108 children aged 13–15 years, qualified the preset inclusion and exclusion criteria were randomly allocated into one among the three interventional groups such as Group 1: Diet counseling; Group 2: Educational intervention of toothbrushing and oral rinsing; and Group 3: Fluoride toothpaste. The sugar scores from 1 week’s diet history, plaque index scores, the weight of the fluoride toothpaste, and DIAGNOdent™ pen scores were recorded at the baseline visit and subsequently at 6- and 12-week intervals. Statistical analysis was done using Chi-square, repeated measure analysis of variance, and Tukey’s post hoc tests to determine the relationship between the variables. Results: The percentage reduction in DIAGNOdent pen score at 12-week time interval in Group 1 was 25.37%, Group 2 was 6.77%, and Group 3 was 13.37%. Intergroup comparison revealed that Group 1 showed a statistically significant difference (P &lt; 0.05) as compared to Group 2 and Group 3, but Group 2 was as effective as Group 3 in teeth remineralization. Conclusion: the results suggest that among the abovementioned interventions, the dietary sugar restriction group is related to improved mineralization when compared to the instructed toothbrushing, oral rinsing, and fluoride toothpaste groups.

The multifaceted role of fluoride in preventing early childhood caries: A comprehensive review

Early childhood caries (ECC) remains a prevalent and significant public health concern worldwide, particularly in underserved communities. Fluoride has long been recognized as a cornerstone in ECC prevention due to its multifaceted mechanisms of action, including topical effects on enamel, systemic effects on dental development, antimicrobial properties, and the ability to promote remineralization of early carious lesions. This comprehensive review explores the various roles of fluoride in preventing ECC, encompassing its sources, efficacy, safety considerations, delivery strategies, challenges, and future directions. Community water fluoridation, fluoride toothpaste, mouth rinses, professional treatments, and dietary sources constitute primary means of fluoride exposure. Extensive clinical trials, epidemiological studies, meta-analyses, and systematic reviews provide robust evidence supporting the effectiveness of fluoride in reducing ECC prevalence and severity. However, optimizing fluoride exposure levels while minimizing the risk of dental fluorosis remains a critical consideration, especially in vulnerable populations. Strategies for fluoride delivery in high-risk groups, such as early childhood interventions, school-based programs, and community outreach initiatives, play pivotal roles in promoting oral health equity. Nevertheless, challenges persist, including limited access to fluoride in underserved areas, public misconceptions, and the need for further research on novel fluoride formulations. Fluoride continues to be a vital tool in ECC prevention, with implications for both clinical practice and public health policy. Addressing disparities in fluoride access and enhancing community engagement are essential for maximizing its impact in reducing ECC burden globally. Future research endeavors should focus on innovative approaches to fluoride delivery and long-term oral health outcomes in diverse populations.

The use of mouthwash containing trimetaphosphate as an adjunct therapy to fluoridated toothpaste reduces enamel demineralization

IntroductionThe decline in dental caries has been attributed to the widespread use of fluoride (F). Two forms of presentation are fluoridated toothpaste (FT) and mouthwash (MW), widely used by the population. Materials and methodsThis study aimed to evaluate in vitro the effects of combining FT and MW, whether supplemented with sodium trimetaphosphate (TMP) or not, on dental enamel demineralization. Bovine enamel blocks (n = 60) were selected based on initial surface hardness (SHi) and divided into 5 experimental groups (n = 12 each): I) Placebo Toothpaste (without F/TMP); II) 1100 ppm F Toothpaste (FT); III) 1100F associated with a MW at 100 ppm F (FT + MW 100F); IV) 1100F associated with a MW at 225 ppm F (FT + MW 250F); and V) 1100F associated with a MW at 100 ppm F supplemented with 0.4 % TMP (FT + MW 100F-TMP). The blocks were treated twice a day, undergoing 5 pH cycles over 7 days. Thus, the percentage change in surface hardness (%SH), integrated subsurface hardness loss (ΔKHN), and the concentration of F, phosphorus (P), and calcium (Ca) in the enamel were determined. The data were submitted to ANOVA and Student-Newman-Keuls test (p < 0.001). ResultsThe 1100F group was statistically inferior to the groups associated with MW for %SH, ΔKHN, and the concentration of P and Ca in the enamel (p < 0.001). Blocks treated with FT + MW 225F and FT + MW 100F-TMP showed significantly lower %SH compared to the other groups (p < 0.001). The FT + MW 100F - TMP group exhibited the lowest depth mineral loss (ΔKHN), and higher concentration de P in enamel (p < 0.001). ConclusionThe adjunct use of MW with FT produces a greater protective effect in inhibiting enamel demineralization, and the supplementation of TMP to the MW with 100F provides a superior effect compared to MW with 225F. Clinical significanceThis combination of treatments could be regarded as one of several alternative fluoride supplements for subjects at elevated risk of caries.

Antibacterial effects of children's and adults' toothpastes containing different amounts of fluoride: An in vitro study.

In recent years, fluoride concentrations in toothpaste for children and adults have increased. However, the effects of different concentrations on bacterial activity have rarely been compared. We aimed to investigate and compare the antibacterial activity of children's and adults' toothpaste containing 500, 1000‒1100, and 1450‒1500 ppm fluoride. Three strains of bacteria (Streptococcus mutans, Streptococcus salivarius, and Lactobacillus casei) were cultured in brain heart infusion agar. Thirty commercially available toothpaste products for children and adults containing 500, 1000‒1100, and 1450‒1500 ppm fluoride were selected and tested. Toothpaste's ability to inhibit bacterial growth was evaluated by agar diffusion assay, in which plates were incubated for 24 hours, and then the diameter of the microbial inhibition zone was measured. Comparisons between children's and adults' fluoride toothpastes were made using the Mann-Whitney U test. The association between bacterial growth inhibition and sodium lauryl sulfate (SLS) was analyzed by the chi-square test. A P value of <0.05 was considered statistically significant. No difference in the inhibition zone was observed for different fluoride concentrations. However, there were significant differences between toothpastes for children and adults, with higher inhibition zones for adults' toothpastes. Most toothpastes for adults contained SLS, which was associated with antibacterial activity. Fluoride concentrations ranging from 500 to 1500 ppm did not affect bacterial growth. The antibacterial activity of toothpastes for adults was significantly higher than that of toothpastes for children, which was mainly attributed to the SLS usually added to adult formulations.

Effects of maternal anxiety and sociodemographic factors on fluoride knowledge and opinions about fluoride-containing oral products. A cross-sectional study.

To assess the relationship between maternal anxiety and so- cioeconomic status, focusing on mothers' knowledge of fluoride and their views on fluoride-containing oral products. In a cross-sectional study design involving 224 mother- child pairs, mothers' socioeconomic status, level of knowledge on fluoride, and perspectives on fluoride toothpaste and topical fluoride gel/varnish were assessed through self-administered questionnaires. Maternal anxiety levels were measured using the Spielberg State-Trait Anxiety Inventory. Mothers with higher socioeconomic status had a greater level of knowledge regarding fluoride. However, higher socio- economic status was associated with having negative opinions about fluoride gel/varnish. No relationship was found between mothers' anxiety levels and their perspectives toward fluoride toothpaste and topical fluoride gel/varnish. The general public should be informed about optimum fluoride dosage, possible side effects, and caries- preventive effects. More studies are required to evaluate the causes of negative thoughts about topical fluoride oral products.

Characteristics of tin-containing fluoride toothpastes related to erosive tooth wear protection

ObjectivesTo assess the effect of different tin-containing toothpastes on the control of erosive tooth wear in enamel and dentin. MethodsEnamel and dentin slabs were randomly distributed into 7 experimental groups (n = 10/substrate): C−: negative control (Artificial saliva); AmF (regular fluoridated toothpaste without tin); Sn-1 (SnF2/NaF); Sn-2 (SnF2/NaF/SnCl2); Sn-3 (SnCl2/NaF); Sn-4 (SnF2/SnCl2); Sn-5 (SnCl2/AmF/NaF/chitosan). Specimens were submitted to 5-day erosion-abrasion cycling. Surface loss (SL) was determined with an optical profilometer. Tin deposition on the tooth surfaces and some characteristics of the toothpastes (pH, potentially available F−, %weight of solid particles, and RDA) were also assessed. Data were statistically analyzed (α = 0.05). ResultsFor enamel, the Sn-2 presented the lowest SL, not differing significantly from AmF, C+, and Sn-3. The SL of these groups was significantly lower than the C−, except for Sn-3. Sn-1 and Sn-4 were also not significantly different from C−. For dentin, C− significantly showed the highest SL values, whilst, Sn-1 presented the lowest SL, not differing significantly from AmF, Sn-2, C+, and Sn-3. There was a significant positive association between enamel SL and the pH and tin deposition. Dentin SL was significantly negatively associated with the %weight of solid particles and RDA. ConclusionsMost of the tin-toothpastes were able to exhibit some protection against ETW. In this process, the toothpastes characteristics play a role, as lower enamel SL was significantly associated with lower pH values and tin deposition; and lower dentin SL was associated with higher %weight of solid particles and RDA of the toothpastes. Clinical significanceTin-containing toothpastes can be used for erosive tooth wear protection, but our study showed that their effect depends on the pH, amount of tin deposition, % weight of solid particles and RDA of the toohpastes.

A comparison of the efficacy of a probiotic toothpaste, a fluoridated toothpaste in management of Streptococci mutans in plaque around orthodontic brackets- An in vivo study

The objective of study was to evaluate and compare the efficacy of Probiotic toothpaste, fluoridated toothpaste and non-fluoridated toothpaste (control) on the levels in the plaque surrounding orthodontic brackets. The randomly selected patients are divided into 3 groups (20 each) on the basis of type of toothpaste given to them. The patients in groups were asked to brush twice daily with given toothpastes and to discontinue using their normal toothpaste. Plaque specimens were collected from the labial surfaces immediately surrounding the orthodontic brackets of the maxillary lateral incisors by four passes, each along the tooth at the bracket inter-face at the gingival, mesial, distal, and occlusal aspects. The isolated plaque is sent to Microbiology laboratory soon after collecting in a sterile container. The presence of was evaluated in colony forming unit through culture formation and statistical analysis was performed, and comparisons were made. After one month application of a probiotic containing toothpaste (group 3), a fluoridated containing toothpaste (group 2) and a non-fluoridated toothpaste(group 1) the level of significantly reduced in group 2 (non-fluoridated toothpaste) and group3 (Probiotic toothpaste) &amp; minimal reduction is shown in gruop 1. Conclusion: The use of probiotic toothpaste causes a significant decrease in the levels in the plaque around orthodontic brackets in orthodontic patients.

Efficacy of an experimental toothpaste containing sodium bicarbonate, sodium hyaluronate and sodium fluoride on gingivitis

BackgroundGingivitis is driven by plaque accumulation and, if left untreated, can progress to irreversible periodontitis. For many, the mechanical action of toothbrushing does not achieve adequate plaque control. The aim of this study was to investigate whether twice-daily use of a toothpaste containing 0.2% high molecular weight (HMW) sodium hyaluronate with 67% sodium bicarbonate and 0.221% sodium fluoride (experimental toothpaste) could improve gingival health compared with a regular fluoride toothpaste (negative control). The study also assessed whether the experimental toothpaste could provide additive gingival health benefit over a toothpaste containing only 67% sodium bicarbonate and 0.221% sodium fluoride (positive control).MethodsThis was a single-center, examiner-blinded, randomized, clinical study in healthy adults with mild-to-moderate gingivitis. At baseline, after abstaining from toothbrushing for 12 h, prospective participants underwent oral soft tissue (OST) and oral hard tissue examination followed by assessments for gingival inflammation (Modified Gingival Index [MGI]), gingival bleeding (Bleeding Index [BI]), and supra-gingival plaque (Turesky Plaque Index [TPI]). Eligible participants were stratified by gender and baseline number of bleeding sites (low: <45; high: ≥45 bleeding sites). Following randomization, participants underwent prophylactic dental treatment. Participants received a full OST examination, MGI, BI and TPI assessments after 3 days, 1, 2 and 6 weeks of product use.ResultsIn total, 110 participants were screened for study entry and all were randomized to receive one of three toothpastes (experimental: sodium hyaluronate, sodium bicarbonate, sodium fluoride; positive control: sodium bicarbonate, sodium fluoride; negative control: regular fluoride toothpaste). For all measures, significant improvements were observed in participants receiving either sodium bicarbonate-containing toothpaste (experimental or positive control) compared with the regular fluoride toothpaste (negative control) at week 6. No significant difference was observed in any assessment or visit comparing the experimental toothpaste with the positive control.ConclusionsBoth the experimental and the positive control toothpastes demonstrated clinically relevant improvements in gingival health compared with a regular fluoride toothpaste (negative control). However, no additional gingival health improvement was observed for the experimental toothpaste compared with the positive control, therefore, no additional gingival health benefit can be attributed to the inclusion of sodium hyaluronate in this formulation.Trial registrationClinicalTrials.gov Identifier: NCT04737538 (04/02/2021).

Oral and dental health promotion for children's nurses.

Tooth decay remains one of the most common preventable oral health concerns in children. After birth, advice to caregivers predominantly focuses on medical health with little attention paid to dental health. Before discharge from the maternity unit and during future hospital and community appointments, opportunistic dental advice should be provided by midwives, nurses and health visitors where possible, with the aim of preventing early onset dental disease. Registering with a dentist at birth is crucial due to long NHS dental waiting lists. Simple advice on toothbrushing should be offered, including brushing twice a day with a soft toothbrush using an age-appropriate amount of fluoride toothpaste. Mothers should be provided with information on the benefits of breastfeeding for oral health alongside tailored preventive care. Appropriate advice on bottle-feeding and weaning is required, including minimising the use of added sugar, drinking from free-flow cups after six months of age, and discouraging the use of milk bottles at bedtime and in general after one year of age. Written visual summaries can be shared with parents to consolidate verbal advice on oral and dental health.

Whitening efficacy of activated charcoal-based products: A single-blind randomized controlled clinical trial

ObjectiveThis randomized controlled clinical trial evaluated the whitening efficacy, tooth sensitivity (TS), and volunteers’ satisfaction following the use of activated charcoal powder and toothpaste. MethodsFifty-six volunteers were randomly allocated into 4 groups (n = 14) according to a 14-day toothbrushing or whitening treatment with activated charcoal powder (ACPW), activated charcoal toothpaste (ACT), regular fluoridated toothpaste (RT), and 10 % carbamide peroxide (CP). Objective (ΔE00) and subjective (ΔSGU) color and whiteness index (ΔWID) changes were calculated. Patients self-reported the risk and intensity of TS using a visual analogue scale and the volunteer's satisfaction was determined by a questionnaire. Color assessments were analyzed by Kruskal-Wallis followed by Dwas-Steel-Crithlow-Fligner, and absolute TS risk and volunteer's satisfaction by Fisher exact test (p < 0.05). ResultsACPW and ACT promoted similar effects in ΔE00, ΔSGU, and ΔWID to that observed for RT. No significant difference was found in terms of TS risk intensity. TS risk became high after 7 and 14 days, with higher TS prevalence in CP. Volunteers reported that ACPW exhibited the lowest ease-of-use, comfort, and whitening satisfaction among groups (p < 0.05). ConclusionActivated charcoal-based products presented a minor and unsatisfactory whitening effect while CP resulted in optimal tooth whitening and the highest level of satisfaction among volunteers. Risk was higher from 7 days onwards and was more pronounced in the CP. Clinical relevanceBased on the whitening effect and patient satisfaction, this controlled-randomized clinical evidence supports that the use of activated charcoal-based products should be discouraged.