Topical Fluoride Research Articles

Estimation of wettability of topical fluoride gel on anterior and posterior teeth: An in vitro study.

The surface area determination has a vital role in measuring the properties of liquid and solid substances. Fluoride is a potent remineralizing agent of the teeth. The surface area is measured using a goniometer. The main aim of this study is to estimate the wettability of topical fluoride gel on the anterior and posterior teeth surfaces. Topical acidulated phosphate fluoride (APF) gel was taken in small quantities. Anterior and posterior teeth were collected, and their superficial unaltered enamel sections were used as the surface where the contact angle (CA) is determined. The surface wettability is determined using Ossila goniometer to measure CA. Each stage was mounted on a mechanical stage of the goniometer. A calibrated microsyringe was used to dispense drops of the APF gel over the surface of the specimen Group A (anterior tooth cut section) and Group B (posterior tooth cut section). This procedure is repeated for all specimen samples. The mean of CAs of the anterior teeth (88.41°) was greater when compared with the mean of posterior teeth (80.36°) CA. P value found using the paired t-test of SPSS software is found to be 0.271 (>0.05), hence statistically not significant. The greater the CA, the lower is the degree of wettability on the teeth surfaces. The mean CA of the topical fluoride APF gel on the anterior tooth surface is greater when compared to the posterior tooth surface. This signifies that greater wettability is seen on posterior tooth surfaces.

Overview of current fluorine-free remineralization materials and methods as an alternative to topical fluoride: An up-to-date

Overview of current fluorine-free remineralization materials and methods as an alternative to topical fluoride: An up-to-date

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.

'Repair the defect' - Emerging topical fluoridated remineralizing agents : A review

A universal public health issue that affects 60% to 90% of people worldwide is dental caries, especially in youngsters. Dental caries is a cyclical event with phases of demineralization and remineralization in addition to being a continuous and unidirectional process of the demineralization of the mineral. Cavitation results from an overbalance in the demineralization process. While remineralization is the process of increasing ion deposition into crystal gaps in demineralized enamel to achieve net mineral gain, it is defined as the supply of calcium and phosphate ions from a source external to the tooth surface. Despite the fact that many other therapies have been tried in recent years to treat early enamel carious lesions, fluorides have emerged as the most popular remineralizing agent due to their superior cariostatic efficacy and affordability. Alternative preparations with additional benefits would be of interest because currently available topical fluorides require patient participation and several treatments over the course of a year.

Growth Inhibition of <i>Streptococcus mutans</i> by Fluoride Varnish Containing <i>Averrhoa bilimbi </i>L<i>.</i> and <i>Piper crocatum</i> Leaves Extracts

Fluoride varnish is commonly used as topical fluoride therapy to prevent dental caries. Dental caries is a dissolution of tooth surface caused by the metabolic activity of Streptococcus mutans in the presence of carbohydrates. Fluoride varnishes containing antibacterial agents significantly affect the inhibition zone of Streptococcus mutans. Prior studies also note the inhibitory effect of wuluh starfruit (Averrhoa bilimbi L.) leaves extracts and fast release fluoride varnish containing red betel (Piper crocatum) leaves extracts on Streptococcus mutans. The purpose of this study was to evaluate the antibacterial effect of adding wuluh starfruit leaves extracts, and red betel leaves extracts to a formulation of fluoride varnish on the growth inhibition of Streptococcus mutans, the fluoride ion release, and the pH obtained from the fluoride varnish. The concentration of antibacterial extracts used was 0.1 g/mL each and MI Varnish served as control. The growth inhibition zone of Streptococcus mutans was measured using disk-diffusion agar method with 3 repetitions. The data produced were analyzed using the Kruskal-Wallis and Mann-Whitney U-tests. Fluoride varnishes containing antibacterial agents used in this study resulted in greater inhibition zone of Streptococcus mutans than control (P < 0.05). The addition of red betel leaves extracts resulted in greater mean diameter of inhibition zone (14.22 mm) than that of wuluh starfruit leaves extracts (13.75 mm), but there was no significant difference (P > 0.05). The fluoride ion release of fluoride varnish containing red betel leaves extracts and wuluh starfruit leaves extracts after 360 minutes is 269.08 mg/L and 229.32 mg/L, respectively. The pH of both fluoride varnishes is above the critical pH of hydroxyapatite. Thus, wuluh starfruit leaves extracts, and red betel leaves extracts have the potential to be used as one of the ingredients in the formulation of fluoride varnish to achieve better growth inhibition of Streptococcus mutans.

Private Interests and the Start of Fluoride-Supplemented High-Carbohydrate Nutritional Guidelines.

Fluoride has no tangible health benefits other than preventing dental caries and there is a small difference between its minimum effective dose and its minimum toxic dose. Leading global organizations currently recommend fluoride supplementation because they recommend high-carbohydrate diets which can cause dental caries. Low-carbohydrate diets prevent dental caries making such fluoride recommendations largely unnecessary. A dental organization was among the first to initiate the public health recommendations which started fluoride-supplemented high-carbohydrate nutritional guidelines. This start required expert panels at this dental organization to reverse on three key scientific points between 1942 and 1949: (1) that topical fluoride had potential harms, (2) that dental caries was a marker for micronutrient deficiencies, and (3) that low-carbohydrate diets are to be recommended for dental caries prevention. Internal documents show that private interests motivated the events which led these expert panels to engage in pivotal scientific reversals. These private interests biased scientific processes and these reversals occurred largely in an absence of supporting evidence. It is concluded that private interests played a significant role in the start of public health endorsements of fluoride-supplemented high-carbohydrate nutritional guidelines.

Fluoride hesitancy: A mixed methods study on decision-making about forms of fluoride.

To investigate whether professionally applied topical fluoride-hesitant caregivers are also hesitant about other forms of fluoride for their child. This was a mixed methods study of 56 caregivers hesitant about professionally applied topical fluoride for their child recruited from the University of Washington Center for Paediatric Dentistry and Seattle Children's Hospital's Odessa Brown Children's Dental Clinic. A 32-item semi-structured interview script was piloted and finalized. One-time interviews with caregivers were conducted by phone in 2019. Associations between hesitancy of topical fluoride, fluoridated water and toothpaste were assessed quantitatively via two-tailed chi-squared tests. Qualitative data were coded using an inductive approach and content analytic methods to investigate reasons for hesitancy. There were significant associations between hesitancy in all three pairwise comparisons of fluoride form (p < .01). Similar proportions of caregivers strongly or somewhat opposed fluoridated water compared with toothpaste (75% and 65%, respectively), but four times as many caregivers strongly or somewhat favoured fluoridated toothpaste compared to water for their child (25% and 7%, respectively). Concerns about harm were the most common reason caregivers opposed both fluoridated water and toothpaste. However, fluoride-hesitant caregivers reported being more comfortable with fluoridated toothpaste because amount and frequency can be controlled, and ingestion can be prevented. Professionally applied topical fluoride hesitancy is significantly associated with fluoridated water and toothpaste hesitancy, but caregivers who were hesitant about topical fluoride was more comfortable with fluoridated toothpaste than fluoridated water for their child.

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.

Parental Knowledge and Awareness of Fluoride Varnish Application on Their Children - A Cross-Sectional Study.

IntroductionFluoride varnishes are forms of topical fluoride that are applied on the surfaces of teeth to prevent from dental caries. It contains sodium fluoride, which is the active ingredient in the varnish and the concentration is about 22,600 ppm. Fluoride can promote enamel remineralization which protect against dental caries and it can be professionally applied by dentists and physicians for infants and young children.MethodsIn this, cross-sectional study, a close-ended survey containing 14 items was given to 399 randomly assigned parents in Jeddah, Saudi Arabia. The questionnaire included demographic data and items to assess the general knowledge about fluoride and fluoride varnish. The responses were coded and statistical analysis was performed.ResultsAbout 65.3% of males and 47.4% females were not sure if fluoride application was safe for their children, however, 67.2% of the population revealed that tooth pastes were one among the fluoride sources for their children. Pearson’s correlation test showed high statistical significance between the parents’ educational background and awareness level of fluoride varnish was of with p-value-0.000 and correlation coefficient (r-value-0.427).ConclusionThe lack of awareness among parents on an important caries-control measure warrants the implementation of special awareness programs on fluorides and its benefits in young children.

The Demands and Awareness of Pediatric Dentists on the Korean National Health Insurance System

The aim of this study is to investigate the awareness and perception of pediatric dentists regarding dental health insurance (DHI) system in Korea. Online surveys were sent to the members of the Korean Academy of Pediatric Dentistry (KAPD), and the responses were collected. The survey, consisting of 41 questions, was subdivided into ‘general background of the respondents’, ‘the awareness on national health insurance (NHI) and DHI’, ‘the awareness on DHI pertaining to pediatric dentistry’, ‘issues that need improvement on DHI pertaining to pediatric dentistry’, ‘DHI claims’, and ‘the roles of KAPD in DHI’. In total, 302 responded, with a response rate of 28.9%. Excluding 2 questionnaires with insufficient answers, a total of 300 survey results were analyzed. According to the analysis, pediatric dentists thought that the coverage of DHI was not as sufficient compared to that of NHI, but were expecting its scope to broaden in the future. The satisfaction rate was higher in pit and fissure sealant and composite resin filling than in caries-detecting quantitative light-induced fluorescence. Pediatric dentists considered permanent tooth composite resin filling (65.7%) needed an increase in insurance copayment, while topical fluoride application (74.7%) to require insurance coverage. DHI claims were generally handled by dental hygienists and/or nursing assistants. Approximately half of the respondents answered that they have had experiences on appealing for insurance denials. Lastly, pediatric dentists generally had a positive attitude towards providing information for the DHI. This study is expected to be used as a sound dataset for the DHI policy development concerning pediatric dentistry.

Effectiveness of Silver Diamine Fluoride in Arresting Caries in Primary and Early Mixed Dentition: A Systematic Review.

Dental caries is a painful condition that could lead to nutritional problems which affects the overall health of the child, as well it is expensive to treat. The effectiveness of silver diamine fluoride (SDF) in primary and early mixed dentition is systematically reviewed in this study. This systematic review utilized the Preferred Reporting Items for Systematic reviews and Meta- Analysis statement (PRISMA, 2020). A literature search conducted using the common electronic databases (from 2010–2021). Based on the inclusion and exclusion criteria, ten randomized clinical trials (RCT) have met the inclusion criteria and were considered for the qualitative assessment. Critical appraisal of these studies was done. This systematic review found that using SDF is a successful and effective method in arresting dentin carious process in the primary teeth and first permanent molars in children. Additionally, when compared to the commonly used topical fluoride products and materials, SDF showed to have better cariostatic effect. However, these findings must be cautiously viewed since more research is required to support them.

DENTAL TREATMENT IN CRI-DU-CHAT SYNDROME: CASE REPORT

A 26-year-old White male patient with cri-du-chat syndrome was referred to the hospital dental service with the main complaint of damaged teeth. During clinical evaluation the patient displayed uncooperative behavior, requiring dental treatment under general anesthesia. On clinical examination, an increased overjet, dental crowding, ogival palate, dental caries, absence of passive lip sealing, and poor oral hygiene were observed. On panoramic radiography, it was possible to observe the presence of the included teeth 13, 18, 38, and 48. In addition, there was a remaining root of tooth 25. Dental treatment planning consisted of extraction of teeth 13, 18, 25, 37, 38, 46, 47, and 48; composite resin restoration of tooth 21; periodontal scraping; prophylaxis; and topical fluoride application. On postoperative return, the teeth sockets were well healed, and the patient was followed up in the dental office.

The Use of Fluorides in Public Health: 65 Years of History and Challenges from Brazil.

Untreated dental caries is the most common disease globally and fluoride use at the population level is crucial for its control. To investigate the economic and political conditions under which the trajectory of population-based fluoride use has occurred is key for a more comprehensive view on its current and future challenges. The objective was to give a brief history and summarize the information on the use of fluorides at the population level in Brazil from 1952 to 2017 and to point to current and future challenges. A critical overview was undertaken based on country-level analyses comprising political and economic conditions. The analytical approach adopted a set of premises applicable to the study of capitalist democracies. Fluoride methods of systemic and topic use began to be employed in Brazilian public health programs in the 1950s and in a combined way from 1974. Differences in political and economic contexts were highlighted for four periods: the first interventions from 1952 to 1974, when the fluoridated water law was approved; the expansion after 1974 until 1988, when a new constitution was enacted; the following time until 2010; and the final period. From the 1980s to 2008, water fluoridation coverage increased progressively, consolidating as a major strategy of systemic use in spite of inequalities among territories. Activities aimed to promote access to topical fluoride use increased and maintained stability until 2014, when they dropped sharply. Regulation of fluoride dentifrice’s quality remained insufficient. It was hypothesized that the strengthening of conservative liberalism and the increase in fiscal austerity observed in recent years might produce serious constraints on public investment and limit access to fluorides. To reduce inequities and promote benefits for all, including the most vulnerable groups, policies based on egalitarian and social justice theoretical perspectives are needed more than ever.

Application of fluoride disturbs plaque microecology and promotes remineralization of enamel initial caries

ABSTRACT Background The caries-preventive effect of topical fluoride application has been corroborated by a number of clinical studies. However, the effect of fluoride on oral microecology remains unclear. Objective To monitor the effect of fluoride on dental plaque microecology and demineralization/remineralization balance of enamel initial caries. Methods Three-year-old children were enrolled and treated with fluoride at baseline and 6 months. International Caries Detection and Assessment System II indices of 52 subjects were measured at baseline, 3, 6, and 12 months. Supragingival plaque samples of 12 subjects were collected at baseline, 3 and 14 days for 16S rRNA sequencing. Results Changes in microbial community structure were observed at 3 days after fluoridation. Significant changes in the relative abundance of microorganisms were observed after fluoride application, especially Capnocytophaga, unidentified Prevotellaceae and Rothia. Functional prediction revealed that cell movement, carbohydrate and energy metabolism were affected significantly after fluoride application. Fluoride significantly inhibited enamel demineralization and promoted remineralization of early demineralized caries enamel at 3 months. Conclusion Fluoride application significantly inhibited the progression of enamel initial caries and reversed the demineralization process, possibly by disturbing dental plaque microecology and modulating the physicochemical action of demineralization/remineralization. This deepened our understanding of caries-preventive effects and mechanisms of fluoride.

The Indigenous Adolescent Oral Health Partnership Study: A Co-Design Study Protocol.

Background: in this protocol we outline a method of working alongside Aboriginal communities to learn about and facilitate improvement in the oral health habits in Aboriginal adolescents. By facilitating positive oral health in Aboriginal adolescents, we hope to achieve lifelong improvement in oral health and general wellbeing. Methods: this paper outlines a co-design methodology through which researchers and Aboriginal communities will work together to create a custom oral healthcare program aimed at Aboriginal adolescents. Researchers, a youth advisory group, Aboriginal community-controlled health services and three regional NSW communities will together devise an oral health strategy focused on five components: application of topical fluoride, increasing water consumption, improving nutrition, daily toothbrushing, and enhancing social and emotional wellbeing. Capacity building is a key outcome of this program. Discussion: as the gap in health status between Aboriginal and non-Aboriginal people remains wide, it is clear that new approaches and attitudes are needed in Aboriginal public health research. This protocol is representative of this shifting approach; giving power to Aboriginal communities who seek to have sovereignty and self-determination over their healthcare. Trial registration: TRN: ISRCTN15496753 Date of registration: 20 October 2021.

COMPARISON FLUORIDE CONCENTRATION IN SALIVA BETWEEN FLUORIDE VARNISH AND GLASS IONOMER CEMENT

Background: Caries is one of the most common dental diseases. Caries prevention by improving dental health has become a major goal in the world of dentistry.Topical application of fluoride is one of the most effective ways to prevent caries.Glass ionomer cement and fluoride varnish has the effect of preventing dental caries because these materials release fluoride. There is no better treatment for demineralization than prevention itself. One of these steps is the combination of dental restorative materials with the application of topical fluoride as an additional source of fluoride.Method: A total of 32 permanent premolar teeth samples, immersed in artificial saliva before and after the application of fluoride varnish and glass ionomer cement. The measurement of fluoride levels in saliva was carried out using a spectrophotometric tool.Result: Independent T-test results obtained sig. below 0.05 indicates that there are differences in the level of fluoride levels between the fluoride varnish group and the glass ionomer cement.Conclusion: Fluoride varnish and glass ionomer cement can increase fluor concentration in salivaÂ

What are dentists seeing in older adults?

What are dentists seeing in older adults?

The antibacterial effect of nanosilver fluoride in relation to caries activity in primary teeth: a protocol for a randomized controlled clinical trial

BackgroundMinimally invasive dentistry is a highly convenient and efficient method of managing caries in pediatric patients. Silver diamine fluoride (SDF) is commonly used to arrest active caries lesions. However, the associated black stain, possibility of soft tissue injury, and unpleasant taste often limit its use. Recently, nanosilver fluoride (NSF) emerged as a promising topical fluoride agent with potent cariostatic and antibacterial potentials. This novel anticaries agent has gained attention as an alternative to overcome the drawbacks of SDF in caries arrest.ObjectivesTo assess the antibacterial effect of NSF in relation to caries activity in dentin caries lesions, as well as to investigate the change in saliva bacterial levels in primary teeth in comparison to SDF after 1 and 3 months.Materials and methodsFifty children aged 4 to 6 years old with active dentin caries lesions (score 5 according to International Detection and Assessment System (ICDAS II) criteria) will be enrolled in the study. They will be equally and randomly allocated into 2 groups: a group receiving NSF and a control group receiving SDF treatment. Microbiological samples will be collected from the carious lesions and from unstimulated saliva at the baseline and at the 1 and 3 months’ follow-up appointments. Bacterial counts will be assessed using Mitis Salivarius agar (selective culture media for S. mutans) and Rogosa agar (selective culture media for lactobacilli), and the results will be expressed in colony-forming units. Data regarding the children’s oral health will be collected and their dmf index will be scored. The arrest of active carious lesions will be measured at the follow-up appointments according to ICDAS II criteria.ResultsThe relation between bacterial colony counts and lesion activity for both groups will be assessed, as well as the change in salivary bacterial counts. The collected data will be statistically evaluated and tabulated. This clinical trial has been registered on ClinicalTrials.gov in January 2022 (original version) with ID: NCT05221749.

Revisiting Fluoride in the Twenty-First Century: Safety and Efficacy Considerations.

Over 100 years of scientific literature is available which describes the long relationship between dentistry and the many possible applications of fluoride anion (F−) as successful therapeutic strategies. To date, systemic introduction of fluoride via water, milk and salt fluoridation, and fluoride-containing tablets, has been employed. Post-eruption topical fluoride products have also been introduced, such as fluoridated toothpaste, along with fluoride-containing rinses and varnishes. Importantly, a recent addition to the available armamentarium of fluoride therapeutics now exists in the form of metal ion-fluorido adducts, most especially silver(I)-diammine fluoride (SDF). In view of its high level of therapeutic success, very recently this agent was added to the World Health Authority's (WHO's) list of essential medicines available for the treatment and prevention of tooth decay. Overall, this current state of affairs merits a major review of all these fluoride-containing therapeutic compounds, together with their risks and benefits, both individually and collectively. In this study, a simple graphical tool has been developed for the rapid “on-site” evaluation of fluoride intake with respect to a range of oral healthcare products and body mass index is presented as a gauge of safety for the risk of fluoride toxicity in individual patients. This exposition commences with (a) an account of the history and value of fluoride therapeutics in clinical dentistry, including applications of monofluorophosphate and stannous fluoride; (b) an evaluation of the toxicological activities of fluoride, together with a summary of any reports, albeit very rare ones, arising from its clinically-driven overuse; (c) a history of the development, molecular structure, mechanisms of action, and therapeutic applications of SDF, including a summary of any possible toxic activities and effects arising from silver(I) ion rather than fluoride itself; and (d) the establishment of a working relationship between fluoride exposure and toxicity, with special reference to the instigation of newly-developed tabular/graphical reference guidelines for use by dental clinicians who employ fluoride-rich products in their practices. Particular attention is given to the oral care and treatment options of pediatric patients. In conclusion, applications of this unique monitoring tool may serve as a valuable toxicity guide for dental practitioners.