Topical Fluoride Application Research Articles

Methods of Primary Clinical Prevention of Dental Caries in the Adult Patient: An Integrative Review.

Preventive approaches to oral health diseases, mainly dental caries, require individual and collective policies. Thus, this review was conducted to identify the primary prevention methods of dental caries in adults to improve oral health at the clinical and community levels. This review followed the PICO strategy with the research question: "What are the methods of primary prevention of dental caries, in adults, for improving and maintaining oral health integrating clinical and community-based strategies?" Electronic screening was carried out by two independent reviewers in five databases (MedLine/PubMed, SciELO, Web of Science, Cochrane Library, and LILACS) to find relevant publications between 2015-2022. We applied eligibility criteria for selection of the articles. The following MeSH terms were used: "Primary Prevention"; "Adult"; "Oral Health"; "Dental Caries"; "Fluorides, Topical"; "Fluoride Varnishes"; "Pit and Fissure Sealants"; "Preventive Dentistry". Although the term "Prevention strategy" is not a MeSH descriptor, several correlated terms appeared and were used in the search engines: "Preventative Care", "Disease Prevention, Primary", and "Prevention, Primary". The tool provided by the JBI organization (Joanna Briggs Institute) was used to assess the quality of the included studies. Nine studies were included. Overall, it was found that the main primary prevention methods applied in dentistry in adults are the application of pit and fissure sealants, topical application of fluoride performed in the dental clinic, use of fluoridated toothpaste, mouthwash with chlorhexidine at home, use of xylitol, the recommendation for regular appointments with the dentist, and the need to inform patients about the saliva buffer capacity and adoption of a non-cariogenic diet. For that purpose, preventive policies should be taken to prevent dental caries. These include three major challenges: providing the adult population with more knowledge regarding their oral health, empowering patients through adopting healthy lifestyles, and developing new preventive strategies and awareness campaigns aimed at the adult population to promote proper oral health habits. A small number of studies were found whose participants were adult patients. There was some consistency regarding primary prevention methods in our studies. However, good quality randomized control studies are still required to define the best intervention strategies for adult caries prevention.

The effectiveness of topical fluoride agents on preventing development of approximal caries in primary teeth: a randomized clinical trial

BackgroundThis 18-month randomized clinical trial aimed to compare the effectiveness of two topical fluoride applications versus placebo control on preventing development of approximal caries in primary teeth.MethodsPreschool children were recruited if they had at least one initial approximal carious lesion at the distal surface of the canines, both approximal surfaces of the first molars, or the mesial surface of the second molars assessed from bitewing radiographs. The participants were randomly allocated into 3 intervention groups: Group 1 (placebo control), Group 2 (5% sodium fluoride [NaF] varnish), and Group 3 (38% silver diamine fluoride [SDF]). All agents were applied semiannually. Two calibrated examiners evaluated the caries development from bitewing radiographs. Caries development was recorded when the baseline sound surface or initial approximal carious lesion surface developed dentin caries (beyond the outer one-third of dentine) at the follow-up examination. The intention-to-treat approach was adopted. The Chi-square test was used to analyze the effectiveness of topical fluoride agents in preventing approximal caries development and the effect of other variables. The multi-level logistic regression analysis was performed to assess the relative effectiveness of topical fluoride agents in preventing approximal caries development at the 18-month follow-up.ResultsAt baseline, 190 participants with 2,685 sound or initial carries at the approximal surfaces were recruited. No differences in participant demographic backgrounds, oral health related habits, or caries experience were observed among the 3 groups (P > 0.05). After 18 months, 155 (82%) participants remained in the study. The rates of developing approximal caries in Groups 1, 2, and 3 were 24.1%, 17.1%, and 27.2%, respectively (P < 0.001, χ2 test). After adjusting for confounding factors and clustering effect, the multilevel logistic regression analysis showed no differences in caries development rates between the 3 groups (P > 0.05). Tooth type and the extent of a carious lesion at baseline were the significant factors for caries development.ConclusionAt 18-month follow-up, after adjusting for confounding factors and clustering effect, there were no statistically significant differences in preventing of approximal caries development between the semiannual application of 5%NaF, 38%SDF, or placebo.Trial registrationThe study was registered in the Thai Clinical Trials Registry under the number TCTR20190315003 on 15/03/2019.

The Application of a Fluoride-and-Vitamin D Solution to Deciduous Teeth Promotes Formation of Persistent Mineral Crystals: A Morphological Ex-Vivo Study.

Background: The use of effective, low-cost, and easy-to-use products for early caries management will avoid loss of dental vitality and impairment in oral function. The ability of fluoride to re-mineralize dental surfaces has been widely reported as well as vitamin D demonstrated to have significant potential in improving the remineralization of early lesions on enamel surfaces. The aim of the present ex vivo study was to evaluate the effect of a fluoride and vitamin D solution in terms of formation of mineral crystals on the enamel of primary teeth, and their permanence over time on dental surfaces. Methods: Sixteen extracted deciduous teeth were cut to obtain 64 specimens that were divided into two groups. The first consisted of immersion of specimens for 4 days in a fluoride solution (T1); in the second group, the specimens were immersed for 4 days (T1) in fluoride and Vitamin D solution, and for a further 2 (T2) and 4 days (T3) in saline solution. Then, samples were morphologically analyzed by using Variable Pressure Scanning Electron Microscope (VPSEM) and underwent 3D surface reconstruction. Results: After a 4-day immersion in both solutions, octahedral-shaped crystals were formed on the enamel surface of primary teeth, demonstrating any statistically significant differences in terms of number, size, and shape. Moreover, the binding of the same crystals seemed to be strong enough to be maintained until 4 days in saline solution. However, a partial dissolution was observed in a time-dependent manner. Conclusions: A topical application of fluoride and Vitamin D promoted the formation of persistent mineral crystals on enamel surfaces of deciduous teeth and should be further studied to be potentially used as an alternative strategy in preventive dentistry.

Correlation between dental professionally topical fluoride application and children's dental use for dental caries under the National Health Insurance system in Taiwan from 2008 to 2021

Background/purposeDental caries is one of the most common oral diseases in children worldwide, especially in Taiwan. This study investigated dental professionally topical fluoride application (PTFA) and children's dental use for dental caries under the National Health Insurance (NHI) system in Taiwan from 2008 to 2021. Materials and methodsThe population data and medical records of the NHI system were obtained from the websites of the Ministry of the Interior and the Ministry of Health and Welfare, respectively. The dental PTFA services and dental use indicators for dental caries were analyzed from 2008 to 2021. ResultsThe number of out-patient visits for dental PTFA services increased from 221,675 in 2008 to 1,078,099 in 2021. The total increase of the out-patient visits was 856,424 with a total increase rate of 386.34%. The one-year increase was 65,879 with a one-year increase rate of 29.72%. Among the 3 age groups of children, their dental use indicators almost presented decreasing trends from 2008 to 2021. Moreover, in general, the dental use indicators showed a negative correlation with the number of the overall out-patient visits for dental PTFA services from 2008 to 2021. ConclusionIn Taiwan, there is a negative correlation between the dental use indicators in NHI system and the number of the overall out-patient visits for dental PTFA services from 2008 to 2021. However, the problem of dental caries in children is still serious and there is still a space for improvement in the oral health education for child caregivers and children.

Effects of topical fluoride application on oral microbiota in young children with severe dental caries.

While the effect of fluoride on severe early childhood caries (S-ECC) is clear, knowledge of how it influences the oral microbiota and the consequential effects on oral health is limited. In this cohort study, we investigated the changes introduced in the oral ecosystem before and after using fluoride varnish in 54- to 66-month-old individuals (n=90: 18 children were sampled at 5 different time points). 16S rDNA was amplified from bacterial samples using polymerase chain reaction, and high-throughput sequencing was performed using Illumina MiSeq platforms. Many pronounced microbial changes were related to the effects of fluoride varnishing. The health-associated Bacteroides and Uncultured_bacterium_f_Enterobacteriaceae were enriched in the saliva microbiome following treatment with fluoride varnishing. Co-occurrence network analysis of the dominant genera showed that different groups clearly showed different bacterial correlations. The PICRUSt algorithm was used to predict the function of the microbial communities from saliva samples. The results showed that starch and sucrose metabolism was greater after fluoride use. BugBase was used to determine phenotypes present in microbial community samples. The results showed that Haemophilus and Neisseria (phylum Proteobacteria) was greater before fluoride use. We conclude that the changes in oral microbiology play a role in fluoride prevention of S-ECC.

Effect of Interdental Enamel Reduction on Clinical Attachment Loss, Bleeding on Probing, and Incidence of Caries in Treating Class I Malocclusion Cases: A Retrospective Cohort Study.

Introduction Interdental Enamel Reduction (IER) is a clinical procedure that reduces the mesiodistal size of permanent teeth by enamel removal and anatomical re-contouring. The aim of this study was to investigate the effect of IER on patients' gingival health status, including clinical attachment loss (CAL) and bleeding on probing (BOP). Furthermore, in this study, the incidence of caries after IER with or without fluoride therapy was evaluated. Methods In this retrospective cohort study, 90 patients who had started and completed their orthodontic treatment within the past two years were divided into three groups as follows: In group 1, patients had received interproximal stripping on their anterior mandibular teeth. Patients in group 2 had also received interproximal stripping on their mandibular anterior teethand topical fluoride had been applied after IER. Patients in group 3 had only received orthodontic treatment without any interproximal stripping. Then, patients were examined for CAL, BOP, and incidence of caries. Results CAL for patients in the IER and control groups were 2.06±0.18 and 2.08±0.16, respectively. Also, BOP for patients in the IER and control groups were 3.01±0.14 and 3.05±0.19, respectively. Incidences of caries, BOP, and CAL were not significantly different between the group of patients who received IER and the control group (P>0.05). Moreover, the incidence of caries was not significantly different between the patients who received topical fluoride after IER and those who did not receive fluoride (P=0.999). Conclusion Interproximal stripping of mandibular anterior teeth before orthodontic treatment does not significantly increase the incidence of caries, BOP, and CAL. Moreover, the application of topical fluoride after IER has no significant effect on the incidence of caries.

Overview of dental professionally topical fluoride application in public health measure in Taiwan in 2021

Background/purposeIn Taiwan, it has been 16 years since the policy of children's dental professionally topical fluoride application (PTFA) services was implemented. This study investigated the differences in the number of children's dental PTFA outpatient visits among cities and counties or different regions of Taiwan in 2021. Materials and methodsThe population data and medical records of the number of children's dental PTFA outpatient visits were obtained from the websites of Ministry of the Interior and Ministry of Health and Welfare, respectively. The secondary data were divided by cities and counties to analyze the urban-rural gap and regional differences in the number of children's dental PTFA outpatient visits in Taiwan in 2021. ResultsIn Taiwan, municipalities had the largest number of dental PTFA visits (721,338, 66.91% of the total dental PTFA visits), while remote and outlying island counties had the smallest number of dental PTFA visits (84,509, 7.84%). The northern region had the largest number of dental PTFA visits (466,728, 43.29%), while outlying islands had the smallest number of dental PTFA visits (25,055, 2.32%). Based on the children aged 3–5 years, municipalities had the lowest dental PTFA use rate (171.70%), while remote and outlying island counties had the highest dental PTFA use rate (482.96%). ConclusionIn Taiwan, there is a higher number of children's dental PTFA outpatient visits in municipalities than in non-municipalities or remote and outlying island counties as well as in northern region than in each of other four regions (central, southern, and eastern regions and outlying islands).

Children's electronic screen time exposure and its relationship to dental anxiety and behavior

ObjectivesThe purpose of this study was to assess the association between electronic screen time and dental anxiety and behaviour among children aged six to twelve years during dental examination, prophylaxis, and topical fluoride application. Material and methodsThis was a cross-sectional study which included 402 paediatric dental patients aged six to twelve years who came to King Abdulaziz University Dental Hospital in Jeddah, Saudi Arabia. The data was collected from September 2020 to December 2021. Self-constructed questionnaire was used to collect data from the patient and his/her guardian. It was comprised of eight demographic questions as well as 13 multiple-choice questions regarding the patients' screen time. Child dental anxiety was assessed by using Abeer Children Dental Anxiety Scale (ACDAS). Assessment of child's behaviour was done by using Frankl Behavioural Rating Scale. ResultsThis study had a response rate of 100%. Out of the 402 participants, 248 (61.7%) were found to have anxiety while 154 (38.3%) were not. Of all participants 274 (68.2%) were cooperative and 128 (31.8%) were not. A Significant relationship between anxiety and behavioural problems during a dental visit and the participant's total exposure hours to electronic devices was found (p < 0.001). Children exposed to electronics at the age of two years or before displayed more anxiety and uncooperative behaviour (p < 0.001). Conclusionsearly exposure to electronic screens, especially for entertainment purposes and longer exposure can be associated with increased dental anxiety and uncooperative behaviour in children age 6–12 years. RecommendationsParents should be educated about the risks of permitting their children to use electronic devices and encouraged to replace such devices with activities that incorporate physical activity.

Effect of topical fluoride applications on residual monomer release from resin-based restorative materials

BackgroundThe effects of topical fluoride applications on the release of monomer ingredients from resin-based dental materials by immersion in various extraction solutions are unclear. The aim of this study was to determine the effect of topical fluorides (APF and NaF) on the elution of residual monomers (Bis-GMA, TEGDMA, UDMA, and HEMA) from resin-based materials.MethodsNinety specimens were prepared, 30 bulk-fill composite resin, 30 nanohybrid universal composite resin, and 30 polyacid-modified composite resin (compomer). These were randomly divided into three groups based on fluoride application procedures. Each specimen was kept in 75% ethanol solution, and residual monomers released from materials were analyzed using high-performance liquid chromatography (HPLC) after 10 min, 1 h, 24 h, and 30 days. The groups were compared using the Mann Whitney U and Kruskal Wallis tests. Measurements were analyzed using the Friedman and Wilcoxon signed-rank tests.ResultsFluoride applications generally had no considerable effect on the amount of residual monomer released from resin-based restorative materials. The amount of monomer release after topical APF application was similar to the release in the control group and was lower than the release in the NaF group. The release of monomers from the resin-based material used in the study did not approach toxic levels at the applied time intervals. The compomer released lower amounts of monomer than other resin-based materials.ConclusionsFluoride applications do not increase monomer release from resin-based restorative materials. However, compomers should be employed by clinicians due to their lower monomer release compared to other resin restorative materials. The release of monomers from all the resin-based materials did not approach toxic levels at the applied time intervals.

Attitude, knowledge and practice of pediatricians in the prevention of early childhood caries

Background/Aim: The aim of the research was to examine the general attitude, knoweledge and practice of pediatricians about caries in children of preschool age. Material and Methods: The research was conducted from November 2019 to the end of January 2020. The research consisted of a survey of pediatricians. The questionnaire consisted of 4 modules and 37 questions, which related to the attitude, knowledge and practice of pediatricians on the prevention of early childhood caries. Results: The majority of pediatricians (84.9%) stated that they assess the nutrition of their patients, while 32.1% of them always do oral health assessment, and half of them in the second month of the child's life; and 39.6% assess oral health only if there is a problem. The majority of pediatricians (86.8%) recommended the first dental examination, most often in the first year of the child's life (79.5%), and then every 6 months (43.5%). The majority of respondents did not required information about the dental health of their patients' mothers, fluoride toothpastes and topical application of fluoride as well (62.3-75.5%). The majority of pediatricians (79.2%) have never provided or sometimes provided educational material on caries prevention and control to the parents of their patients. The most accurate answers and the highest percentage of correct answers that the pediatricians had were about attitudes (Z=8.98, 66.63%), while the fewest correct answers and the lowest percentage of correct answers regarding the practices on the prevention of early childhood caries (Z=11.91, 58.90%). Conclusions: The research showed that pediatricians have the good attitudes and knowledge, but do not implement prevention of early childhood caries in practice. The basic deficiency of attitude, knowledge and perception of the importance of prevention is a consequence of insufficient education of pediatricians.

Research progress of laser caries prevention

Overview Caries is an infectious disease of chronic progressive destruction, mainly affected by a variety of factors of bacteria, if it cannot be treated timely, it gradually develops into a series of complications, such as endodontic disease and periapical disease, which affects the whole body health and reduces the quality of life of patients. The report of the fourth national oral health epidemiological survey shows that the caries rate of 12-year-old children's permanent teeth is 34.5% and the caries rate of 5-year-old children's milk teeth is 70.9%, which are 7.8 and 5.8 percentage points higher than the caries rate of the third national oral abortion respectively, and the caries rate is on the rise and the pattern is still serious. It is important to strengthen the oral health education, improve the caries prevention awareness of the public, and improve the caries prevention ability of dental hard tissues through certain measures to reduce the incidence of caries. In the past 30 years, the topical application of fluoride containing drugs and fluoride toothpaste has greatly reduced the prevalence of dental caries. However, the widespread application of fluoride has also increased the incidence of dental fluorosis and fluorosis bone disease. Laser caries prevention has good safety and convenient operation compared with other methods, and this paper will review the research on laser in caries prevention in recent years.

Study of topical fluoride combined with semiconductor laser for the prevention of dental enamel caries

The prevention of dental caries is one of the main goals of modern dentistry. Other major goals include remineralization of caries, rather than the traditional "drill and fill". Remineralization is a restorative process that restores minerals and occurs daily through the presence of calcium, phosphate and fluoride in the saliva. Enamel demineralization occurs when acids produced by bacteria attack the enamel. A dynamic balance between enamel demineralization and remineralization is maintained under normal conditions, and disruption of this balance leads to progression of the lesion and eventually to cavitation formation. Fluoride plays an important role in enhancing remineralization. Topical application of fluoride is one of the most effective ways to stop or prevent dental caries. Fluoride ions can replace the hydroxyl group in hydroxyapatite, which leads to the formation of fluorapatite. The solubility of fluorapatite in acid is lower than that of hydroxyapatite. The effect of laser irradiation on the prevention of dental caries has been reported by numerous scholars. Studies have shown that when fluoride, calcium or phosphorus ions are present, laser irradiation can effectively enhance the acid resistance of tooth enamel by altering its chemical or morphological structure and promoting the remineralization process. Laser combined with fluoride has good effect and easy operation compared with other methods for caries prevention, and this paper will review the research on laser combined with fluoride in caries prevention in recent years.

Effectiveness of non-operative approaches in active enamel carious lesions: a retrospective longitudinal study

The aim of the study was to investigate the effectiveness of non-invasive and micro-invasive treatments in active enamel carious lesions in high-caries-risk children. Clinical records of children treated in a dental school setting were retrospectively screened for active enamel carious lesions treated non-invasively (topical fluoride applications, oral hygiene instruction, or dietary guidance) or micro-invasively (sealant). The control of active carious lesions was set as the main outcome established by the combination of inactivation and non-progression of the lesions based on Nyvad and ICDAS criteria, respectively. Individual and clinical factors associated with the outcome were analyzed by Poisson regression. The sample consisted of 105 high-caries-risk children with a mean age of 8.3 (± 2.4) years. From a total of 365 active enamel carious lesions, most lesions (84.1%) were active non-cavitated carious lesions (ICDAS scores 1 and 2) and only 15.9% presented localized enamel breakdown (ICDAS score 3). Of these, 72.6% were inactivated and 92.1% did not progress (mean time of 6.5 ± 4.1 months). The prevalence of controlled carious lesions was higher among children older than 6 years (PR:1.43; 95%CI:1.00-2.03; p = 0.04) and in those with better biofilm control (PR:0.99; 95%CI: 0.98-0.99; p = 0.03). Non-operative approaches are effective for controlling active enamel carious lesions. The majority of active enamel carious lesions became inactive and did not progress after treatment. Caries control was associated with older children and better biofilm control.

Shear bond strength fissure sealant based on glass ionomer after topical fluor application: a comparison between sodium fluoride and acidulated phosphate fluoride

Background: Application of fissure sealants to young permanent teeth is one of the preventive measures for caries in the field of dentistry. Fissure sealants based on glass ionomer cement (GIC) have the advantage of releasing fluoride. Sodium fluoride and acidulated phosphate fluoride (APF) are remineralization agents because they can increase remineralization by altering hydroxyapatite to fluorapatite and this in turn makes fluorine able to increase pH. Fluoride can prevent caries by increasing remineralization of the enamel that has just been demineralized by acids produced by plaque bacteria. The aim of this study is to compare the shear bond strength fissure sealant based on glass ionomer between sodium fluoride and APF topical fluor application Method: This research applied true experimental design with post test only control group design. The 21 maxillary permanent premolars were distributed into 3 groups, namely the control group (K1), the treatment group added 5% sodium fluoride (K2), and the treatment group added 1.23% APF (K3). Result: One Way ANOVA and post hoc LSD analysis test displayed no significant difference in each group. This could be due to the material used as a conditioner prior to the GIC application. The addition of fluoride ions will inhibit the demineralization process of the enamel produced by the application of conditioner. So it does not rule out that it will interfere with the attachment of the GIC material used as a fissure sealant in this research. Conclusion: There was no significant difference in shear bond strength of fissure sealant based on glass ionomer between sodium fluoride and acidulated phosphate fluoride topical application.

Evaluation of the enamel nano-topography influenced by different techniques of interproximal reduction: An atomic force microscopic study.

Interproximal enamel reduction is a part of the orthodontic treatment as a method of space generation in addition to other vast indications. Some studies found that different techniques might impose changes to the enamel surface that alter its topography, which in turn might influence its integrity and susceptibility to caries. Polishing, however, after this procedure is thought to be helpful to reduce these adverse effects. To evaluate the nano-topography of the enamel surfaces after interproximal reduction (IPR) and determine its influence on enamel surface roughness and examine the need for polishing to minimise these influences, when combined with topical fluoride application. A total of 60 proximal surfaces of 40 extracted maxillary premolars (10 premolars left unprepared as the control group) were reduced with different stripping instruments (discs, burs and manual strip system). The surface roughness of enamel was analysed with an atomic force microscope to determine the results quantitatively as well as qualitatively on the nanoscopic scale. One of each proximal surface was followed by polishing and fluoride varnish after the reduction. The results showed that surface roughness was increased in all groups without polishing. The greatest mean roughness was recorded for the disc group (212 ±125.7), followed by the bur group (172 ±93.1) and manual strips (153.8±106.7). The difference between the groups, however, was not significant for both mean roughness (P = 0.656) and height (P = 0.737). The parameters were decreased after polishing in all groups but the difference between methods was not significant for both parameters (P = 0.946 and P = 0.849); however, the mean height was reduced to nearly half the reading in the bur and manual strip method. The disc group only showed a statistically significant decrease in surface roughness with polishing (P < 0.05). All other results were not significant. All methods of interproximal reduction do not influence enamel surface nanotopography significantly with and without polishing. Polishing resulted in significant reduction of surface roughness only in the disc group.

Development of Root Caries Prevention by Nano-Hydroxyapatite Coating and Improvement of Dentin Acid Resistance.

There is no established method for optimizing the use of dentin to prevent root caries, which are increasing in the elderly population. This study aimed to develop a new approach for root caries prevention by focusing on bioapatite (BioHap), a new biomaterial, combined with fluoride. Bovine dentin was used as a sample, and an acid challenge was performed in three groups: no fluoride (control group), acidulated phosphate fluoride treatment (APF group), and BioHap + APF treatment (BioHap group). After applying the new compound, the acid resistance of dentin was compared with that of APF alone. The BioHap group had fewer defects and an increased surface hardness than the APF group. The BioHap group had the smallest lesion depth and least mineral loss among all groups. Using a scanning electron microscope in the BioHap group showed the closure of dentinal tubules and a coating on the surface. The BioHap group maintained a coating and had higher acid resistance than the APF group. The coating prevents acid penetration, and the small particle size of BioHap and its excellent reactivity with fluoride are thought to have contributed to the improvement of acid resistance in dentin. Topical fluoride application using BioHap protects against root caries.

Prevention of Dental Erosion Caused by Fermented Milk: An In-vitro Study.

This study aimed to assess the efficacy of three techniques for preventing dental erosion and thereby identify effective methods. The three techniques were: 1) adding calcium to fermented milk (2% Ca and 0.5% Ca); 2) topical application of fluoride to the teeth before exposure to fermented milk (acidulated phosphate fluoride [APF] gel and 0.05% NaF); and 3) a combination of the two techniques (APF gel + 0.5% Ca, 0.05% NaF + 0.5% Ca). pH cycling was performed on bovine-tooth specimens alternately immersed in experimental solutions and artificial saliva. After treatment, the microhardness and roughness of the enamel surfaces were measured, and changes in the surface morphology were observed using atomic force microscope images. Microhardness did not differ statistically significantly between the 2% Ca and mineral water (negative control) groups (2% Ca: 295.34 ± 11.50; mineral water group: 294.76 ± 10.67; p > 0.05). Surface roughness did not differ statistically significantly between the 2% Ca, 0.05% NaF + 0.5% Ca, and mineral water groups (2% Ca: 16.81 ± 7.23; 0.05% NaF + 0.5% Ca: 15.77 ± 2.86; mineral water group: 13.35 ± 5.53; p > 0.05). The surface morphology did not change in the mineral water and 2% Ca groups. Considering that 2% calcium is a high concentration, adding a low concentration of calcium to fermented milk and applying a low concentration of fluoride daily decreased the reduction of surface microhardness and reduced the increase in surface roughness without causing marked changes in surface morphology. This confirms that combining the two techniques is an effective strategy to prevent dental erosion in-vitro.

Improved Enamel Acid Resistance Using Biocompatible Nano-Hydroxyapatite Coating Method.

In this study, we attempted to develop a dental caries prevention method using a bioapatite (BioHap), an eggshell-derived apatite with nanoparticle size and biocompatibility, with a high-concentration fluoride tooth surface application method. The enamel acid resistance after the application of the proposed method was compared with that of a conventional topical application of fluoride using bovine tooth enamel as an example. The tooth samples were divided into three groups based on the preventive treatment applied, and an acid challenge was performed. The samples were evaluated for acid resistance using qualitative and quantitative analytical methods. The BioHap group demonstrated reduced enamel loss and improved micro-Vickers hardness, along with a thick coating layer, decreased reaction area depth, and decreased mineral loss value and lesion depth. The combination of BioHap with high-concentration fluoride led to the formation of a thick coating layer on the enamel surface and better suppression of demineralization than the conventional method, both qualitatively and quantitatively. The proposed biocompatible nano-hydroxyapatite coating method is expected to become a new standard for providing professional care to prevent dental caries.

Assessing Risks of Early Childhood Caries in Primary Care Practice Using Electronic Health Records and Neighborhood Data.

Early childhood caries (ECC) is a persistent public health challenge, affecting more than 56% of US toddlers and preschool-aged children. Despite this, ECC is largely preventable with routine oral hygiene practices, diet, and application of topical fluoride. This study assessed the utilization of preventive oral health care in primary care practices and evaluated the variation in patient characteristic and geographic disparities. We conducted a retrospective study using electronic health records (EHRs) over a 2-year period. Patients' home addresses were geocoded and linked to census-based neighborhood statistics and fluoridated water accessibility. Multiple logistic regression modeling was used to assess the risk of ECC in patients with fluoride preventive care, controlled for demographics, comorbid conditions, and neighborhood risk factors. Patients aged 6 to 71 months who had primary care providers at family medicine and general pediatric clinics in a large academic medical center. The presence of dental caries based on diagnoses in EHRs. The study consisted of 10 836 patients: 17% treated with topical fluoride varnish (TFV), 12% prescribed oral fluoride supplement, 6.1% with both TFV and supplement, and 64% without fluoride treatment. Patients with fluoride treatment were 24% to 53% less likely to have ECC. Children living in rural and nonfluoridated water communities had 1.7 to 1.8 times greater risk of developing ECC. Minority, under/uninsured, and low-income patients also were at an increased risk of ECC. Despite continuing efforts to improve access to dental care for vulnerable populations, substantial disparities remain among socioeconomically disadvantaged children. To address dental care shortage, primary care clinicians should serve as the safety net to care for vulnerable and underserved children who have no or limited access to oral health services. Future research into the collaboration between primary care and dental providers at the level of both practice and professional education should be considered.

Calcium and fluoride interaction in human enamel at nanoscale: an XPS assessment

Objective This research aimed to assess qualitatively and quantitatively the penetration depth of fluoride ions on nanosurface enamel (30 nm). Topical fluoride application reduces acid erosion on tooth enamel, which is the main contributing factor to tooth decay and dental caries. Our goal is to study the mechanics of chemically reacting free fluoride into the CaP crystals in the enamel's first atomic layers.Materials and Methods Unerupted third molars were randomly selected, and enamel tooth samples were fragmented. Two fluoridated agents (gel and foam; APF 1.23% F ion) were used: at two application times (1 and 4 min; n-6). X-ray photoelectron spectroscopy (XPS) technique was utilized to characterize the enamel nanosurface of the samples to a profile depth of 0, 10, 20, and 30 nanometers. Statistical analysis using three-way ANOVA (factors: agent, time, and depth) was performed on the results (α = 0.05)Results There was a statistically significant difference between the control and the fluorinated surfaces (p = 0). However, factor time was not significantly different (p = 0.47), and in the same way, its interaction with the factors APF agent (p = 0.16). Factor depth was significantly different (p = 2.29×10−11).The highest atomic percentage of elemental fluoride was discovered within the surface layers of enamel at a profile depth of 10 nm for both application times and either fluoridated agent. This study showed that CaF2-like is formed mainly by substituting CaOH than HAp in the first layers of enamel (30 nm depth).Conclusion This research has demonstrated that fluoride ions stay in a very superficial layer of enamel regardless of application time and or the APF agent utilized. This information is critical to understanding the demineralization and remineralization processes.