Fluoride Varnish Research Articles

Comparing the Antibacterial Efficacy of Nanosilver vs Traditional Fluoride Varnishes in Caries Prevention

ABSTRACT Background: Dental caries remains a prevalent chronic condition affecting individuals worldwide, particularly children. Traditional fluoride varnishes have long been employed in caries prevention due to their ability to enhance enamel remineralization and reduce demineralization. Materials and Methods: A randomized controlled trial was conducted involving 120 participants aged 6–12 years with a high risk of dental caries. The participants were divided into two groups: one receiving nanosilver varnish and the other receiving traditional fluoride varnish. Each varnish was applied bi-weekly for six months. Salivary samples were collected at baseline, three months, and six months to measure bacterial counts, focusing on Streptococcus mutans. The data were analyzed using ANOVA to assess differences between the groups over time. Results: At baseline, both groups exhibited similar levels of Streptococcus mutans (P > 0.05). After three months, the nanosilver group showed a significant reduction in bacterial counts (mean reduction of 45%, P < 0.01), compared to a 30% reduction in the fluoride varnish group (P < 0.05). At six months, the nanosilver group maintained a 55% reduction, whereas the fluoride group showed a 40% reduction. The difference between the groups at six months was statistically significant (P < 0.01). Conclusion: Nanosilver varnish demonstrated superior antibacterial efficacy compared to traditional fluoride varnish in reducing Streptococcus mutans levels over six months. These findings suggest that nanosilver could serve as a valuable alternative or adjunct to fluoride varnish in caries prevention strategies.

Glass ionomer fissure sealants versus fluoride varnish application on children's behaviour: a randomised controlled trial.

Glass ionomer fissure sealant (GIS) and fluoride varnish (NaFV) are two preventive interventions applicable to pre-school children. However, their application effects on young children's behaviour are understudied. The study compared the effects of GIS and NaFV applications on dental anxiety (DA), cooperativeness and pain level in pre-school children when applied to primary second molars in outreach settings. Four hundred and thirteen children were recruited for the study, out of which 228 were allocated to NaFV group whilstand 185 allocated to the GIS group. One calibrated examiner screened and randomly allocated the children into either group. Another calibrated examiner recorded the children's DA level and cooperativeness with Frankl Behaviour Rating Scale (FBRS) and Venham Behaviour Rating Scale (VBRS) throughout the treatment period. Subjects self-reported their pain levels using Wong-Baker Faces Scale (WBFS). Significant difference in postoperative anxiety was found using VBRS, with children in NaFV group having more positive scores post-treatment (p = 0.016). Only the type of preventive interventions significantly affected postoperative DA and patient cooperation (p = 0.032), whereas no other clinical findings and socio-demographic factors significantly influenced the children's behaviour postoperatively. NaFV application is associated with less DA and more cooperative behaviour in pre-school children compared to GIS application although similar pain levels were recorded.

Prevention of occlusal caries using VanishTM XT: an 18-month follow-up randomized clinical trial

AimTo evaluate the effectiveness of a light curable resin-modified glass ionomer varnish (VanishTM XT) in the prevention of occlusal caries compared to topical fluoride varnish in newly erupted first permanent molars over 18 months.MethodsA randomized controlled clinical trial was conducted using a split-mouth design. A total of 53 participants aged 6–9 years with 97 pairs of caries-free newly erupted first permanent molars were enrolled in the study. Each molar in the pair was randomly assigned either to the experimental group, which received the VanishTM XT Extended Contact Varnish, or to the control group, which received topical fluoride varnish (VanishTM 5% Sodium Fluoride White Varnish). Follow-ups were performed at 6, 12, and 18 months to evaluate dental caries development.ResultsAt the 6-month follow-up, caries development was significantly higher in the control group (7.8%) than that in the experimental group (0%) (P = 0.031). At the 12-month follow-up, significantly (P = 0.012) more occlusal caries developed in the control group (12.2%) compared to the experimental group (1.2%). At the 18-month follow-up, significantly (P = 0.002) more occlusal caries developed in the control group (14.3%) compared to the experimental group (1.1%).ConclusionCompared to fluoride varnish, VanishTM XT was significantly more effective in preventing caries on the occlusal surfaces of newly erupted first permanent molars at 6, 12, and 18 months.Trial registrationRegistration number at ClinicalTrials.gov: NCT04579536 on 08/10/ 2020, retrospectively registered.

Effects of Silver Diamine Fluoride and Potassium Iodide Solutions on the Anti-Caries Properties, Surface Hardness, and Bond Strength of Resin Modified Glass Ionomer in Dentin

This study evaluated the effects of silver diamine fluoride (SDF) and potassium iodide (PI) on carious dentin. The antibacterial efficacy, surface hardness, and bond strength of resin-modified glass ionomer cement (RMGI) were assessed. Dentin specimens were prepared and subjected to artificial caries formation. The antibacterial effect of SDF/PI was compared to sodium fluoride varnish using Streptococcus mutans colony counts. Surface microhardness was measured using the Vickers hardness test. Shear bond strength of RMGI to treated surfaces was evaluated after thermocycling. Results showed that SDF/PI had superior antibacterial effects compared to NaF varnish. Surface hardness significantly increased one week after SDF/PI application. While SDF/PI treatment did not immediately affect RMGI bond strength to carious dentin, delayed bonding after one week significantly improved bond strength. These findings suggest that SDF/PI is effective in arresting caries and enhancing remineralization of carious dentin. The study also indicates that delaying restoration placement for one week after SDF/PI application may be beneficial for improving bond strength. This research provides valuable insights into the clinical application of SDF/PI for caries management and subsequent restorative procedures.

Comparative Evaluation of Ion Release and Uptake of Fluoride Varnish Containing Dicalcium Phosphate Dihydrate and Casein Phosphopeptide-Amorphous Calcium Phosphate – An Experimental Approach.

The effectiveness of fluoride varnish may be restricted due to inadequate bioavailability of phosphate and calcium ions in the oral cavity. Dicalcium phosphate dihydrate and Casein phosphopeptide–amorphous calcium phosphate have exhibited ability to enhance absorption of calcium and fluoride. The present study aims to compare the remineralization potential of fluoride varnishes containing DCPD and CPP-ACP. Materials and Method: The ion release, precipitation and surface microhardness of enamel blocks were compared following topical application of various Floride varnishes. Thirty enamel blocks were divided into 3 groups following randomization that included: NaF varnish (Group A), CPP-ACP NaF varnish (Group B) and DCPD- NaF varnish (Group C). Pre- and post-treatment microhardness was evaluated using Vickers Microhardness Tester. UV-Vis Spectroscopy assessed the fluoride release at 2 hrs, 4 hrs and 6 hrs. The uptake of fluoride, calcium and phosphates were determined using SEM-EDX. The statistical significance was tested with One-way ANOVA variance for normality followed by post-hoc tests (p ≤ 0.05). Results: All the groups showed statistically significant increase in microhardness post-treatment (Group A: p=0.03, Group B, C: p=0.00). The mean increase in VHN was Group B (53.67) > Group C (34.75) > Group A (27.40). No significant difference in the F release was noted over time (p=0.00). The fluoride release over all three time intervals was Group C > Group B > Group C. Fluoride, Calcium and Phosphates showed highly significant differences between groups (p=0.00) with Group C > Group A> Group B. Conclusion: The novel NaF-DCPD Varnish displayed a promising remineralization potential, however it cannot be conclusively considered to be superior to the commercially available NaF-CPP ACP Varnish. Further in-vivo investigations need to be undertaken to determine the efficacy of NaF-DCPD varnish to determine its feasibility in clinical practice.

Affordable Care Act's Preventive Services Coverage Mandate and Receipt of Fluoride Varnish.

The Affordable Care Act required private insurers to cover a set of recommended preventive services without cost-sharing. This included coverage of fluoride varnish (FV) applications without cost-sharing for children aged 1 through 5 during medical visits, an evidence-based treatment that prevents tooth decay. We examined if this coverage mandate was associated with more young children receiving FV. Using the Massachusetts All-Payer Claims Database (2014-2018), we examined the likelihood that a privately insured child received FV during a medical visit in a month. We used a difference-in-differences approach, comparing those included in the coverage mandate (aged 1-5) to those excluded from the mandate (aged 6-9), before and after the mandate was enacted (January 2015). We repeated analyses in children with Medicaid because this mandate may have had spillover effects for this population. Among children aged 1 through 5 years with private insurance, 1-year postmandate the probability of FV receipt in a month increased 0.16 percentage points more relative to December 2014 (premandate) compared with the change among children aged 6 to 9 years (P < .001; 95% confidence interval = 0.1-0.22). When examining spillover to children with Medicaid, the mandate was not associated with a significant increase in the probability of monthly FV receipt 1-year postmandate. This Affordable Care Act mandate requiring coverage of FV without cost-sharing was associated with higher rates of young children receiving FV in medical settings, with the largest result observed among children with private insurance.

Hipomineralização molar-incisivo - HMI: relato de caso clínico

Molar Incisor Hypomineralization (MIH) is a qualitative defect in the dental enamel that affects one or more permanent molars, where the permanent incisors may also be involved. The objective of this work was to report a clinical case of Molar-Incisor Hypomineralization (MIH) following a choice of treatments according to the different severities present in the patient. The case report is of a patient, 12 years old, female, who attended the Pediatric Dentistry clinic of Faculdade do Amazonas - IAES accompanied by her guardian, with the following main complaint: “I want to remove these stains”. In the extra and intraoral examination, marked opacities ranging from yellow to brown in elements 26 and 17 and white to yellow in dental elements 11, 21, 23 were observed. 11, 21, and 23 and proservation with fluoride varnish after previous prophylaxis on molars 17 and 26. It is concluded that it is very important for the dental surgeon to know how to identify MIH in order to choose the best treatment for each patient with different levels of severity. And in this way, we provide satisfactory results both in the execution of the treatment of choice and in the patient's life, remedying her main complaint.

Effect of application of dental varnishes on the properties and chemical composition in irradiated teeth.

To analyze the protective properties of fluor dental varnishes in teeth subjected to radiotherapy. Eighty teeth were irradiated with a single dose of 60Gy. Samples were randomized, and the following groups were made: negative control (n=16); irradiation control (n=16); irradiation + Duraphat (n=16); irradiation + Mi Varnish (n=16); and irradiation + Rivastar (n=16). Energy dispersive x-ray (EDX) analysis and Raman spectrometry were performed to analyze the elemental composition and enamel's chemical structure. The Mi Varnish group presented a lower value (p<.05) in the Ca/F ratio than the other groups. Duraphat group presents differences (p<.05) in the ratio 1070cm1-960cm-1 compared to all the other groups. Based on these in vitro results, the different varnishes used showed a similar preventive effect on the lesions produced by radiotherapy, with none standing out over the others.

Long-term costs of dental care for thailand preschool children by using a system dynamics model

BackgroundA System Dynamics Model (SDM) is a computer simulation to alleviate the problem by comparing strategies and policies. Addressing the costs by using SDM helps in allocating the resources efficiently in managing the strategies.ObjectiveTo describe the costs of primary, secondary, and tertiary prevention of dental caries for 0–5-year-old children by SDM.MethodsThe SDM was developed to explore the cost of primary and secondary prevention (supervised toothbrushing, STB and fluoride varnish, FV), the treatment cost for caries (tertiary prevention), and the total cost under three scenarios; STB, FV and base case (no intervention).ResultsWhen the children aged 5 years, the treatment cost under the base case was the highest at 57.6 million baht while 53.5 million baht in FV and 51.9 million baht in STB. As a total cost, 64.1 million baht under FV, 60.9 million baht under STB, and 57.6 million baht under base case. Sensitivity analysis reveals that the effective rate of STB must be at least 30%, and FV should be a minimum of 50% to ascertain the total cost reduction relative to the base case scenario.ConclusionCaries treatment costs were lower when STB and FV were implemented than in the base case scenario. The overall cost under FV was the highest, followed by STB, with no total cost savings observed as compared to the base case situation. Despite that, carrying out the STB rather than the FV would save a total of 3.2 million baht. Treatment costs under interventions would be lower than expected, and overall cost reductions might be obtained by comparing the base case if the intervention's effective rates are higher, according to sensitivity analysis.

Preventive oral healthcare for children: towards appropriate care

In recent decades, oral healthcare has shifted from curation to prevention. Preventive oral healthcare for children consists mainly of oral health education to improve health behaviors and clinical prevention such as fissure sealants, application of fluoride varnish, removal of supragingival plaque and dental polishing. In addition, the periodic clinical examination is an important preventive instrument. These 5 preventive interventions for children up to 12 years of age can be discussed using the principles of 'appropriate care'. Appropriate care is an approach of the Dutch government to ensure the accessibility, quality and affordability of care in the Netherlands. Central to the approach are the effectiveness, efficiency and patient-centeredness of care. This article describes to what extent preventive oral healthcare meets these principles based on literature, care consumption data and recommendations from the clinical guidelines 'Oral care for children: prevention and treatment of dental caries' and the 'Advice on Caries Prevention' by the Ivory Cross, a Dutch scientific association for oral health. Appropriate oral healthcare is best served by care that is tailored to both the individual oral disease burden of the patient and their risk of disease as well as to the wishes of the patient.

"Evaluation of Silver Diamine Fluoride Modified Atraumatic Restorative Treatment (SMART) on hypomineralized first permanent molar"- a randomized controlled clinical study.

Restoring first permanent molars affected with molar incisor hypomineralization (MIH) is challenging. Focusing on improving the quality of life for children affected by MIH, at least until the complete eruption of first permanent molars to receive full coverage, to decrease the hypersensitivity and to be able to perform proper oral hygiene measures, the purpose of this study was to compare silver modified atraumatic restorative technique (SMART) versus the conventional restoration and fluoride varnish application on moderate to severe hypomineralized molars. The comparison considered the restoration survival, hypersensitivity, and digital surface area changes after one year follow up. Twenty-eight children were selected (20 girls and 8 boys) with at least 2 MIH molars with the same defect severity. The study comprised 2 groups; MOD group (moderate hypomineralized molar severity) and SEV group (Severe hypomineralized molar severity) (n = 28 tooth). Each group was further subdivided into 2 subgroups according to the technique of restoration: SMART subgroup and CONV subgroup (high viscosity glass ionomer restoration and fluoride varnish application) (each = 14 tooth). Evaluation was done in terms of the restoration survival (6 months and 12 months), hypersensitivity at 1 weak, 6 months and 12 months and occlusal surface area changes at 12 months). Professional Fluoride varnish application and home prophylaxis using MI paste were the protocol for each child patient. There was no significant difference between the 4 subgroups, regarding tooth restoration integrity at 6-months vs. 12-months. However, a statistically significant difference in tooth restoration integrity between the 4 subgroups at 12-months (P = .049). Also, the hypersensitivity score, there was a statistically significant difference between the 4-time intervals (P < .001) and a statistically significant difference in surface area changes between the 4 subgroups. Selective removal of carious tissue and SMART restoration, combined with dental home and professional preventive measures every 3 months maintained the integrity of restorations in severely and moderately affected permanent molars up to 1 year. The study protocol was retrospectively registered on Clinical Trials (NCT05931822-05/ 07/2023).

Empowering Mothers: Self-efficacy Strategies and Fluoride Varnish Therapy Behavior in Preschool Children

Background: Oral health poses significant challenges, particularly among preschool children, emphasizing the critical role of mothers in preventive care. Self-efficacy, as a determinant of behavior, holds promise in shaping oral health practices. Objectives: The present study was conducted to determine the effect of Bandura's self-efficacy strategies on the fluoride varnish therapy behavior of mothers of preschool children. Methods: This intervention study, conducted from 2021 to 2023, involved 88 mothers with children aged 3 to 6 years. Participants were randomly divided into intervention and control groups. Data collection included a demographic questionnaire, a researcher-developed self-efficacy assessment tool, and an observational checklist of mothers' fluoride varnish therapy behavior. The intervention comprised educational sessions focusing on self-efficacy strategies. Data were analyzed with descriptive and inferential statistics in SPSS software version 20. Results: Before the intervention, there were no significant differences in self-efficacy scores between the intervention and control groups (Cohen's d = 0.18). Similarly, there were no significant differences between the two groups in the varnish therapy behavior score of the mother before the intervention (Cohen's d = 0.05). However, two months later, significant improvements were observed in both self-efficacy scores (Cohen's d = 2.28) and fluoride varnish therapy behavior (Cohen's d = 3/32) among mothers in the intervention group compared to controls. Conclusions: This study underscores the pivotal role of self-efficacy strategies in empowering mothers to effectively engage in fluoride varnish therapy behavior, and highlights the significant improvements observed in both self-efficacy and varnish therapy behavior that emphasize the educational interventions aimed at enhancing mothers' self-efficacy, ultimately contributing to improved oral health outcomes for children.

Influence of PRG barrier coat versus sodium fluoride varnish on enamel subjected to erosive-abrasive challenge

Influence of PRG barrier coat versus sodium fluoride varnish on enamel subjected to erosive-abrasive challenge

The Effectiveness of Remineralization with Compound Silver Nanoparticles and Fluoride Varnish in Carious Lesions in Primary Teeth: A Randomized Split-Mouth Clinical Trial.

Background: Anti-cariogenic properties of silver nanoparticles and fluorides have been probed mainly in vitro and with the objetive to evaluate the remineralizing effects of an applied silver nanoparticle compound plus fluoride varnish, a randomized split-mouth clinical trial was conducted in children aged 6 to 7 years. Methods: The project was approved by the ethics committee of the faculty. Primary molars were randomly distributed into two groups, as follows: Group A was treated with a compound based on silver nanoparticles plus fluoride varnish (SNP-FV), and Group B was treated with a silver diamine fluoride compound (SDF-KI), which is the current standard treatment. Laser fluorescence with a DIAGNOdent pen was used for the evaluation, with follow-up examinations at 15 days, 6 months, and 12 months. ANOVA test was used to compare the groups. The results showed a decrease in demineralization was observed after treatment with SNP-FV; similar results were observed after treatment with SDF-KI. Within each group, there were favorable changes. In the SDF-KI group, the differences in demineralization were 25.63 at 15 days, 29.37 at 6 months, and 30.6 at one year (p < 0.05). Meanwhile, in the SNP-FV group, the decreases were 22.7 at 15 days, 28.78 at 6 months, and 31.11 at one year (p < 0.05). Conclusions: The SNP-FV combined treatment represents an alternative remineralizing treatment for the management of carious lesions in the dentin of primary molars.

Effectiveness of glass-ionomer sealant versus fluoride varnish application to prevent occlusal caries among preschool children over 18–24 months – A randomised controlled trial

ObjectivesTo compare the clinical efficacies of 5 % sodium fluoride varnish (NaFV) and glass-ionomer sealant (GIS) in preventing occlusal caries in primary second molars (PSMs). Materials and MethodsA total of 736 children were recruited from 18 kindergartens and randomised into either Group 1- receiving NaFV quarterly, or Group 2 - single placement of GIS at baseline. Interventions were performed on 1431 and 1264 PSMs in Group 1 and Group 2, respectively. The primary outcome was the development of ICDAS≥4 dentine caries at the occlusal surfaces of PSMs. ResultsA total of 736 children (383 in Group 1; 353 in Group 2) received the intervention. After 18–24 months, 479 children with 1764 PSMs were reviewed. Despite a low GIS retention rate of 2.4 % by 18–24 months, only 17.1 % of PSM in the GIS group developed caries into dentine. No significant difference was identified when compared to the proportion of PSMs with caries into dentine in the NaFV group (17.0 %). Regression analysis with GEE revealed that only baseline dft score and plaque level had a significant influence on development of ICDAS≥4 dentine caries in PSMs. ConclusionsQuarterly-applied NaFV and a single placement of medium viscosity GIS have similar clinical efficacies in preventing occlusal caries among preschool children. Clinical SignificanceThere is no significant difference between quarterly-applied NaFV and GIS in preventing occlusal caries at PSMs. Dental clinicians can choose to use either of these preventive methods after considering their own and parents’ preferences, children's cooperation and other practical factors.

In-vitro and in-vivo comparative studies of treatment effects on enamel demineralization during orthodontic therapy: implications for clinical early-intervention strategy

ObjectivesThis study aimed to investigate if CPP-ACP / infiltrating resin was superior in treating enamel demineralization during orthodontic therapy compared with fluoride varnish, in order to provide early-intervention implications for dental professionals.Materials and methodsIn the in-vitro study, premolars were grouped into four: remineralization with fluoride varnish / CPP-ACP, sealing with infiltrating resin, and negative control. Experimental demineralization of enamel surfaces was analyzed using techniques of QLF, SEM, EDS and micro-hardness testing. An in-vivo intervention study was conducted on patients randomly assigned into three groups. At the baseline and every-3-month follow-up, QLF parameters were compared temporally and parallelly to yield potential implications for promotion in clinical practice.ResultsThe in-vitro study performed on 48 experimental tooth surfaces demonstrated that sealing with infiltrating resin reduced enamel surface porosity and increased surface micro-hardness significantly. In the in-vivo intervention study on 163 tooth surfaces, it was suggested that for those who meet the criteria of -10 < ΔF < -6 and − 1000 < ΔQ < -20 at the baseline, all these treatment methods could achieve acceptable outcomes; with the rising of absolute values of ΔF and ΔQ, sealing with infiltrating resin showed more evident advantages.ConclusionFor enamel demineralization during orthodontic therapy, all the treatment methods involved in this study showed acceptable effectiveness but had respective characteristics in treatment effects. QLF parameters could be used as indicators for clinical early-intervention strategy with regards to this clinical issue.Clinical relevanceWith QLF parameters, clinical early-intervention strategy for enamel demineralization during orthodontic therapy could be optimized.

Effectiveness of topical 25% silver nitrate solution followed by 5% fluoride varnish compared to 38% silver diamine fluoride in arresting and preventing dental caries among beta-thalassemia major patients: A randomized clinical trial

IntroductionThis is the first randomized non-inferiority clinical trial in the evidence literature to examine the effectiveness of topical 25% silver nitrate (SN) followed by 5% sodium fluoride (NaF) varnish is not much worse or acceptable to 38% silver diamine fluoride (SDF) in preventing and arresting dental caries among Beta-Thalassemia Major (BTM) patients. Method170 BTM participants aged 18 years and older with at least 1 or more active carious lesions were randomly allocated into 2 groups (1:1). 25% silver nitrate solution application followed by 5% NaF varnish was administered to Group I, and Group II received 38% SDF. The Nyvad criteria and DMFT index were used to assess caries arrest and prevention among both groups at 3- and 6-months interval. ResultsCaries arrest rate at 3 months was significantly higher in Group I (83.10%) when compared to Group II (76.16%) (p<0.05). While at 6 months, both the groups were comparable with arrest rate (76.16%) (p>0.05). The caries increment was comparable among both groups at 3 months, while at 6 months, caries increment was almost half in SN with NaF group compared to SDF group (p>0.05). Kaplan–Meir survival estimated the median survival time for caries increment was 17 and 39 weeks for Group I and 15 and 36 weeks for Group II at 3 and 6 months, respectively. ConclusionOne time application of 25% SN followed by 5% NaF is no worse than a 38% SDF in arresting and preventing dental caries among Thalassemia Major participants at 3 and 6 months. Clinical SignificanceThe study provides clinicians with a cost-effective, safer, readily available, non-invasive treatment option (25% SN followed by 5% NaF) for caries management.

Comparison of various chitosan-based in situ forming gels with sodium fluoride varnish for enamel biomineralization: an in-vitro pH cycling model

This study aimed to evaluate chitosan (CS)-based formulations loaded with 5% sodium fluoride (NaF) and/or 10% nanohydroxyapatite (nHA) to remineralize the demineralized primary tooth enamel surface. Ninety enamel blocks were demineralized and were divided into six groups (n = 15): (1) CS-based hydrogel, (2) CS-based hydrogel loaded with NaF, (3) CS-based hydrogel loaded with nHA, (4) CS-based hydrogel loaded with NaF and nHA, (5) 5% NaF varnish, and (6) negative control with no intervention. After intervention, the specimens were pH cycled by 2 h immersion in demineralizing solution and 22 h immersion in remineralizing solution for 8 days. The remineralization effects were evaluated by Vickers microhardness measurements and field emission scanning electron microscopy coupled with energy-dispersive X-ray spectrometry (FESEM-EDS). The best mean ± SD percentage microhardness recovery in remineralized enamel (%REMH) was found in group 4 (56.90 ± 5.49). The %REMH of groups 2 (30.74 ± 3.51) and 5 (29.23 ± 5.65) were statistically the same (p = 0.943). FESEM images confirmed partial coverage of the porous demineralized enamel with a newly formed mineralized layer. Based on EDS findings, the Ca/P ratio values of the treated enamel surfaces with CS-based hydrogels ranged between 1.71 and 1.87, and the highest F content was noticed in group 2 (1.02 ± 0.03). Although, all tested CS-based hydrogels demonstrated the potential to repair demineralized enamel, nHA- and NaF-containing CS-based hydrogel showed the highest remineralization effect. We infer that this new hybrid hydrogel is a potentially useful dental material for tooth biomineralization.

An open-label, parallel-group, randomized clinical trial of different silver diamine fluoride application intervals to arrest dental caries

BackgroundSilver diamine fluoride (SDF) is an antimicrobial agent and alternative treatment option that can be used to arrest dental decay. While there is optimism with SDF with regard to caries management, there is no true consensus on the number and frequency of applications for children. The purpose of this study was to examine the effectiveness of 38% SDF to arrest early childhood caries (ECC) at three different application regimen intervals.MethodsChildren with teeth that met International Caries Detection and Assessment System codes 5 or 6 criteria were recruited from community dental clinics into an open-label, parallel-group, randomized clinical trial from October 2019 to June 2021. Participants were randomized to one of three groups using sealed envelopes that were prepared with one of three regimens inside: visits one month, four months, or six months apart. Participants received applications of 38% SDF, along with 5% sodium fluoride varnish (NaFV), at the first two visits to treat cavitated carious lesions. Lesions were followed and arrest rates were calculated. Lesions were considered arrested if they were hard on probing and black in colour. Statistics included descriptive and bivariate analyses (Kruskal one-way analysis of variance and Pearson’s Chi-squared test). A p-value of ≤ 0.05 was considered significant.ResultsEighty-four children participated in the study (49 males and 35 females, mean age: 44.4 ± 14.2 months). Treatment groups were well matched with 28 participants per group. A total of 374 teeth and 505 lesions were followed. Posterior lesions represented only 40.6% of affected surfaces. Almost all SDF treated lesions were arrested for the one-month (192/196, 98%) and four-month (159/166, 95.8%) interval groups at the final visit. The six-month group experienced the lowest arrest rates; only 72% (103/143) of lesions were arrested (p < 0.001). The duration of application intervals was inversely associated with improvements in arrest rates for all lesions.ConclusionsTwo applications of 38% SDF and 5% NaFV in one-month and four-month intervals were comparable and very effective in arresting ECC. Applications six months apart were less effective and could be considered inferior treatment.Trial registrationClinicalTrials.gov NCT04054635 (first registered 13/08/2019).

Comparative evaluation of remineralizing efficacy of calcium sodium phosphosilicate, ginger, turmeric, and fluoride

ABSTRACT Background: White lesions, also known as white spots, are the earliest signs of tooth decay. At this stage, noninvasive preventive treatments, such as fluoride application, can help to slow down or even reverse the progression of white lesions. For decades, fluoride has held the spotlight as the go-to agent in oral preventive care, demonstrating significant remineralizing power. Recent scientific literature reveals a growing interest in alternative products as natural substances that demonstrate potential remineralizing effects on tooth enamel. This in vitro study aimed to evaluate the potential remineralizing effect of calcium sodium phosphosilicate (CSP), ginger, and turmeric. Materials and Methods: This in vitro study was designed to evaluate the remineralizing effects of various materials on the enamel of extracted human teeth. The aim was to compare the effectiveness of these different substances in promoting enamel remineralization. Enamel blocks were prepared and were divided into seven experimental groups: CSP, fluoride toothpaste, nonfluoride toothpaste, turmeric, ginger, fluoride varnish, and distilled water. In this study, sample mineralization is assessed through the quantitative photo-induced fluorescence test before demineralization, after demineralization, and after remineralization. Statistical analysis of the data was conducted using a one-factor analysis of variance test. The significance level was set at P &lt; 0.05. Results: The best results were obtained by groups treated with turmeric (P &lt; 0.0001), Enamelast fluoride varnish (P &lt; 0.0001), and NovaMin (P &lt; 0.01), as compared to other remineralizing treatments. Conclusion: While fluoride has undeniably revolutionized oral preventive care, the exploration of alternative products as natural substances and innovative compounds in recent scientific literature signals a shift in focus toward safer and potentially more diverse options.