Use Of Dentifrice Research Articles

A longitudinal laser fluorescence study of white spot lesions in orthodontic patients

Orthodontic treatment with fixed appliances increases the caries risk in young persons. The aim of this study was to apply a new caries diagnostic method, quantitative laser fluorescence, for longitudinal in vivo quantification of changes in incipient enamel lesions related to fixed orthodontic appliances. Seven young patients with active caries lesions disclosed at removal of the orthodontic brackets and bands were enrolled in the study. Caries preventive measures were intensified, including dietary advice, oral hygiene instructions, and the regular use of a fluoride dentifrice. The caries lesions were monitored with the quantitative laser fluorescence method after removal of the brackets and once a month thereafter. For each lesion, three quantities were measured: lesion area (mm 2), mean fluorescence loss (%) over the lesion, and maximum loss of fluorescence (%) in the lesion. During a 1-year follow-up period, the areas of the lesions decreased and the enamel fluorescence lost was partly regained indicating that a remineralization process had occurred. It was concluded that quantitative laser fluorescence seems suitable for in vivo monitoring of mineral changes in incipient enamel lesions, and useful for the evaluation of preventive measures in caries prone persons, such as orthodontic patients. (Am J Orthod Dentofacial Orthop 1998;113:595-602)

Mudança do comportamento infantil diante do hábito de escovar os dentes

This work intends to investigate the behavioral changes of 0 to 30 months babies and to associate the different patterns to the pre and post-eruptive oral phase. It was verified that when children have no teeth, most part of them (76%) have a positive behavior (D conduct) and when the eruption and cleaning procedures start there is a change for worse, passing from 76% of D conduct to 45%, showing a decrease in the predominance of the positive conduct. Another important factor verified was that mothers reported that the children are more receptive for the use of toothbrush and dentifrice than to the cleaning with gauze and dilute H202 (Hydrogen Peroxide) and they also reported that infantile toothbrushes are not adequate for children of these ages (0 to 30 months), existing the need of their adequacy to avoid that this fact deviates these children from their toothbmshing habits.

The influence of various fluoride exposures on the prevalence of esthetic problems resulting from dental fluorosis.

This study sought to determine the prevalence of esthetic problems due to dental fluorosis, and determine the relationship of different fluoride exposure histories to the occurrence of these problems. In 1993-94 2,715 children in grades 2 and 3 and 3,297 adolescents in grades 8 and 9 were examined by four dentists. Questionnaires detailing exposures to various fluoride technologies were collected from 3,022 of these study participants. Esthetic ratings of the participants' maxillary anterior teeth were made by the examiners, the participants themselves, and their parents using questionnaires designed for this purpose. Data indicate that 46 percent of the participants had dental fluorosis. Only 40 percent had fluorosis on anterior maxillary teeth. The prevalence of esthetic problems ranged from about 1 percent to 4 percent, depending on how an esthetic problem was defined. Esthetic problems as defined by the participant were more prevalent for the "over 11" age group. Logistic regression results demonstrated significant associations between several of the classifications of esthetic problems and the use of fluoride supplements and dentifrices, and exposure to fluoridated water during the third year of life. Results suggest that the prevalence of esthetic problems is low in the communities surveyed, and that exposure to any number of fluoride technologies in the third year of life can increase a child's risk for this problem.

Direct Evidence Concerning the ‘Major Role’ of Fluoride Dentifrices in the Caries Decline: A 6-year Analytical Cohort Study

Haugejorden O, Nord A, Klock KS. Direct evidence concerning the major role of fluoride dentifrices in the caries decline. A 6-year analytical cohort study.The role of fluoride (q dentifrices in caries decline was investigated by assessing the effect of variation in their use on caries scores among teenagers. The material comprised 211 subjects aged about 11 years at base line and 18 years at the last examination. Pairs of posterior bitewing radiographs were assessed by one examiner. Information concerning dental health behavior was collected by questionnaire and about treatment received from dental records. A reversal of the traditional DFS gender difference occurred during teenage years. Multivariate regression analyses showed an inverse relationship between variation in F dentifrice use and current decay (D1S) at age 18 years (P < 0.04) and with caries incidence per year (D1FS) during the whole observation period (P < 0.02). Total explained variance in 6-year AD, FS scores was 29.8%, of which variation in toothbrushing behavior contributed 1.8 percentage points. While confirming the multifactorial nature of dental caries, these results also provided quantitative evidence for the role of variation in F dentifrice use in caries incidence and decline.

The effect of supragingival plaque control on the subgibgival microflora in human periodontitis

The aim of the present trial was to study if carefully practiced supragingival plaque control influenced the subgingival microbiota at periodontal sites with suprabony, infrabony, or furcation pockets. 12 subjects, 5 males and 7 females aged 44 to 69 years (mean age 55 years) participated in the study. None of the participants had during the last 12 months received periodontal therapy, and none of the subjects had used antibiotics during a 3-month period preceding the study. Following a screening examination, 6 to 8 sites per subject were selected which had a probing depth of > or = 5 mm. Among these sites, 1-3 sites had a suprabony location, 1-3 sites had an infrabony location, and 1-3 sites were associated with a furcation defect. The selected sites were exposed to a baseline examination at which the following parameters were recorded: plaque, gingivitis, probing pocket depth and probing attachment level. A bacterial sample was obtained from each of the selected sites: 2 sterile paper points were inserted into the pocket and kept in place for 30 seconds. The paper point samples were removed, placed in a vial containing an anaerobically prepared transport medium, and processed using routine procedures. Following the baseline examination, each subject was given a case presentation, received thorough supragingival scaling and was instructed to practice proper plaque control with the use of toothbrush and dentifrice. During the subsequent 30 weeks they were recalled 2-3xper week for professional tooth cleaning. Each session was handled by a dental hygienist and required about 15 min. Re-examinations were performed after 30 weeks. The findings indicated that professionally delivered and frequently repeated supragingival tooth cleaning, combined with careful self-performed plaque control had a marked effect on the subgingival microbiota of moderate to deep periodontal pockets. Thus, at sites with suprabony and infrabony pockets, as well as at furcation sites, the meticulous and prolonged supragingival plaque removal reduced the total number of microorganisms that could be harvested, as well as the % of sites with P. gingivalis.

Risk Factors for Dental Fluorosis in Pediatric Dental Patients

Concerns have been raised recently about whether a substantial amount of dental fluorosis is resulting from the increased use of fluoride from various sources. The purposes of this study were to determine the prevalence and severity of dental fluorosis in a sample of pediatric patients seeking dental treatment in a university pediatric dental clinic and to evaluate sources of fluoride as risk factors for dental fluorosis. A convenience sample of 157 children aged 8 to 17 years were examined for dental fluorosis using the Tooth Surface Index of Fluorosis (TSIF). Fluoride history questionnaires assessing previous exposure to fluoride during the first eight years of life were completed by the children's parents. Fluoride exposures were compared among 54 cases and 54 matched controls using a case-control retrospective design. Fluorosis was found in 72 percent of the children, but was generally quite mild. The risk of fluorosis was significantly greater for children who had greater exposure to fluoridated water and who used larger amounts of fluoridated toothpaste up to age eight. This study provided evidence that increased use of fluoride toothpaste may be a risk factor for dental fluorosis. The results suggest prudent use of dentifrice by young children to minimize the risk of fluorosis.

Caries experience in Latvian nursery school children.

In 1993 the dental health was assessed in 631 Latvian 3--4-yr-old nursery school children. Forty-eight percent of the 3-yr-olds and 26% of the 4-yr-olds were caries free. The mean dmft for the total sample was 3.2 (2.2 and 3.8 in the 3-and 4-yr-olds, respectively). Molar caries, accounting for 66% of the total dmft score, was dominant in both age groups. Sixteen percent of the children had received restorations, 38% of which manifested recurrent caries. Recurrent caries was relatively more frequent in the younger children. Concomitant with a general increase in caries level, the polarization of the disease was less pronounced in the older children. The upper 25% of the distribution for 3- and 4-yr-olds contained 74% and 40% of the dmft, respectively. Daily toothbrushing was reported for 60% of the children. Of those, 38% used fluoride-containing dentifrice. No significant associations were found between caries experience and toothbrushing frequency, use of fluoride dentifrice or parents' education.

Commentary on and Recommendations for the Proper Uses of Fluoride

Fluorosis has been associated with the fluoride concentration of drinking water, use of dietary fluoride supplements, early use of dentifrices, and prolonged use of infant formula. The literature, however, does not show associations between fluorosis and use of fluoride mouthrinses, professionally applied fluorides, bottled waters, carbonated beverages, and juices. It is unwise to issue laundry lists of items that may be implicated as problem-causing when, in fact, they may not be. Although usually classified without fluorosis, children in Dean's "questionable" category would be classified with the condition if the TFI or TSIF were used. Accordingly, Dean, in 1942, really reported only 52.8 percent of children without fluorosis in Kewanee, a community with 0.9 ppm fluoride in drinking water. Because the morbidity and sequelae of dental caries have declined, undue emphasis has been placed recently on the risks of using fluoride rather than on its profound beneficial effects. Although of paramount importance, conclusions cannot be drawn on whether fluoride protects against, contributes to, or has no effect on bone fractures or is valuable in treating osteoporosis. Careful thought is required before making recommendations that may reduce health benefits because of unfounded concerns about perceived risks. There should be greater regulation of extraneous fluoride sources, rather than reliance on educational efforts or recommendations to eliminate use of highly effective preventive regimens.

Dental caries status of 12-year-old students in the state of Mexico.

A total of 2275 schoolchildren 12 yr of age from the four health regions of the State of Mexico were examined for the prevalence and severity of dental caries. The proportion of caries-free children was only 10%, and the DMFS index was 6.94. 78% of the index derived from decayed surfaces, and 19% from filled surfaces. Pits and fissures of the permanent first molars were the most frequently affected surfaces. Higher dental caries scores were found in rural areas compared with the urban centers. No significant relationship was found between use of dentifrice and dental caries. Several reasons for this lack of relationship are discussed. 10% of the children account for 23% of the DMFS index. Results indicate the need to aim preventive and restorative programs at the whole population as well as at specific high risk groups or individuals.

Studies on Plaque Fluoride After Use of F-Containing Dentifrices

Increased fluoride levels in plaque and saliva have been associated with improved protection against dental caries for dentifrices which contained sodium monofluorophosphate (Duckworth et al., 1992). The main aim of the present work was to test whether oral fluoride retention depended on F source after use of dentifrices containing either NaF or Na2FPO3. In study 1, plaque samples were collected from 474 subjects who had been using one of six test dentifrices for two years, and analyzed by F extraction with water. The dentifrices contained 1000 or 1500 micrograms F/g as either NaF or Na2FPO3. Significantly more fluoride was found in plaque from subjects who were using the NaF dentifrices than in plaque from subjects who were using Na2FPO3 dentifrices of the same F content. Subsets of plaque samples were large enough to divide into two parts for extraction by both acid and water. No significant difference was found between mean fluoride contents, indicating that the majority of fluoride retained in plaque from these conventional dentifrices appears to be relatively labile. The results of two small-scale human enamel studies showed that NaF dentifrices gave elevated F concentrations in plaque and saliva, respectively, compared with Na2FPO3 dentifrices of equivalent F content, consistent with the main plaque study 1. These findings demonstrate that oral F retention from dentifrices is dependent on the source of ionic fluoride and support the view that NaF dentifrices may be more clinically effective than dentifrices which contain the same amount of F as Na2FPO3.

Review of fluorosis risk of self-applied topical fluorides: dentifrices, mouthrinses and gels.

The literature on the risks of dental fluorosis and the benefits from the use of fluoride dentifrices, mouthrinses and self-applied gels has been briefly reviewed. While there are several studies that have investigated the impact of dentifrices on the development of dental fluorosis, results are mixed. Although there is far less research investigating the relationship between the use of mouthrinses and dental fluorosis, the available evidence generally fails to identify this technology as one of the major causes of dental fluorosis. Although there is little direct evidence to suggest that the use of self-applied fluoride gels contributes to the development of dental fluorosis, ingestion of fluoride from these systems is of genuine concern and their use by preschool age children is not recommended.

Review of fluoride exposures and ingestion.

The literature on fluoride intake/ingestion was reviewed critically to determine the current exposure to fluorides for children living in non-fluoridated and fluoridated areas in North America. Fluoride from all sources except mouthrinses and professionally applied topical fluorides was considered, including ingestion from foods and beverages, as well as intake from the use of fluoride dentifrice and dietary fluoride supplements. Data from all of these sources were used to produce estimates of mean daily ingestion. Studies consistently have identified substantial variation in ingestion among individuals. These analyses demonstrated that a substantial proportion of individuals had exposure or ingestion well beyond that of the mean for each source, and often 10-20% received up to several times as much exposure as the mean. Some children probably ingest sufficient fluoride from a single source to exceed the "optimal" fluoride intake recommended from all sources, and are therefore at increased risk of fluorosis. This review highlighted the substantial variation and complexity of fluoride ingestion. Appropriate consideration of these aspects is warranted in efforts to ensure a margin of safety favoring dental caries prevention while limiting objectionable fluorosis.

フッ化物配合歯磨剤の利用状況と親子による歯磨剤の共用

フッ化物配合歯磨剤の利用状況と親子による歯磨剤の共用

Factors Associated with the Use of Fluoride Supplements and Fluoride Dentifrice by Infants and Toddlers

Dental fluorosis may be associated with the inappropriate use of fluoride dentifrices and/or dietary fluoride supplements by young children, especially for those who consume optimally fluoridated water. Studies to date have used retrospective designs that rely on anamnestic responses of adults to determine fluoride exposures in their children. The 1986 National Health Interview Survey (NHIS) collected information on current use of fluoride-containing dental products (dentifrices, drops, tablets, and mouthrinses) by all household members during home interviews. This report contains information obtained from adults for 1,996 children younger than two years of age. Nearly half of the children used fluoride dentifrices or dietary fluoride supplements. Eleven percent of the children younger than one year of age and nearly 60 percent of children between one and two years of age reportedly used a fluoride toothpaste. Dietary fluoride supplements were used about equally in these age groups (about 16%). The use of a fluoride dentifrice was similar across racial-ethnic groups, but the use of dietary fluoride supplements was less among blacks and Hispanics. A significantly higher proportion of children whose respondent knew the purpose of water fluoridation used some type of fluoride product. Because young children tend to swallow dentifrices, the findings of this study suggest the need for educational programs targeted to parents and health care providers regarding the appropriate use of fluorides and the risk of fluorosis when they are used inappropriately.

異なったフッ素濃度入り歯磨剤使用と部位別エナメル質表層フッ素濃度

The present study was undertaken to examine fluoride concentrations at different sites on tooth surfaces of permanent premolars after use of dentifrices with different fluoride concentrations.A pair of extracted premolars from each subject was examined; one was used for a control, and the other was extracted for this experiment two weeks after the control. During the two weeks the subject used one of three kinds of dentifrices: 1, 000ppmF, 100ppmF, and 0ppmF.The fluoride and phosphorus concentrations of surface enamel were determined by Weatherell's micro-sampling with an electrode and by colorimetry, respectively. Three sites on the buccal, one site on the occlusal, and one site on the mesial surface were investigated. The results were as follows;Fluoride concentrations at the center and occlusal buccal sites were higher in the 1, 000ppm group than in the control groups. Significant differences were observed at 10 and 20μm depths in the enamel.Fluoride concentrations tended to be higher in the 100ppm group than in the control groups at the outermost surfaces of the bucco cervical and mesial surfaces. There were no significant differences in 0ppm dentifrice between the two groups.It was concluded that the use of 1, 000ppm dentifrices was the most effective for the uptake of fluoride on enamel surfaces in vivo.

岐阜県における小児のフッ化物配合歯磨剤の利用状況

岐阜県における小児のフッ化物配合歯磨剤の利用状況

Caries Prevalence amongst Schoolchildren in The Hague between 1969 and 1993

Since a first survey in 1969, juvenile caries prevalence in the second largest city of the Netherlands has attained a European minimum of DMFT = 0.8 in 11.9-year-old children. However, the curves of improvement have been flattening out since the mid-eighties. Incidental variations between 1984 and 1993, especially of caries prevalence in the deciduous teeth of 5- and 7-year-old children, do not indicate a turn to the secular downward trend. The stability of juvenile oral health does not seem to be due to changes in dietary habits, nor to public health measures, but is mainly due to good oral health and use of fluoride dentifrices by the children.

Caries experience in Icelandic 12-year-old urban children between 1984 and 1991.

In order to evaluate trends in caries experience, a 20% random sample of 12-yr-old residents of Reykjavik, Iceland (252 children) was examined clinically and radiographically in 1991 under conditions consistent with those of the survey conducted in 1984. In addition to caries data, frequency of toothbrushing and use of fluoride dentifrice were recorded. The mean DFT and DFS were 3.0 and 4.1, respectively. The decrease in caries experience reached 60% with an annual fall in DFS of nearly 10%. During the 7-yr period between examinations the decline in DFT and DFS scores averaged 5.2 and 8, respectively, the annual reduction amounting to 0.7 DF teeth or 1.1 DF surfaces per child. The ratio of approximal/occlusal caries and the proportion of approximal caries were similar in both surveys. Fourteen percent of the children were free from manifest caries in 1991, but only 2% in 1984. Polarization between low and high prevalence individuals had intensified. Ninety-five percent of the children brushed their teeth regularly and 97% reported using a fluoride dentifrice.

Should the drinking water of Truro, Nova Scotia, be fluoridated? Water fluoridation in the 1990s

An epidemiological assessment of differences in caries and fluorosis prevalences between children in Truro (< 0.1 ppm) and Kentville (fluoridated at 1.1 ppm in 1991), Nova Scotia, Canada, was completed in 1991. Out of a total of 429 children, in grades 5 and 6, in the two towns in 1991, 219 (51%) were examined. Parents answered a self-administered questionnaire investigating the sources of drinking water used by the children since birth, residence history, use of fluoride supplements, dentifrices, and other fluoride products during the first 6 yr of the life. The examination criteria differentiated between non-cavitated and cavitated carious lesions. Dental fluorosis was measured using the TSIF index. Examiner agreement was excellent. Of the children examined, 80 (36.5%) drank water (fluoridated or non-fluoridated) from municipal water systems during the first 6 yr of life. The children were assigned into five groups based upon residence history and exposure to fluoridated water during the first 6 yr of life. The percentage difference in mean DMFS scores between children in the fluoridated and non-fluoridated groups is 17% (delta DMFS1 = 0.7) when non-cavitated carious lesions are included and 39% (delta DMFS2 = 1.1) when they are excluded. The differences are not statistically significant. The significant risk factors associated with the DMFS1 and DMFS2 scores identified by a stepwise multiple regression analysis are: education level of the father, gender, and number of years of reported use of toothpaste during the first 6 yr of life. Dental fluorosis (mainly TSIF score of 1) was present in 41.5% and 69.2% of the children in the non-fluoridated and fluoridated groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Role of fluoride toothpastes in a caries-preventive strategy.

While the clinical relevance of fluoride toothpastes per se is firmly established, the multifactorial processes involved in causation and prevention of caries render it difficult to define their exact role in an overall caries-preventive strategy. Therefore, an indirect pragmatic approach was chosen: the interpretation of secular trends in caries prevalence and other parameters is used to estimate the relative importance of this method of topical fluoride administration and to compare it with the contributions by other methods of prevention. All methods of caries prevention, with the exception of population-administered measures such as fluoridation of drinking water or domestic salt, can only work when applied regularly and conscientiously. For this reason behavioural aspects such as compliance and the chances for widespread (if not universal) application have to be considered. There is indirect evidence that toothbrushing with fluoride toothpastes is a highly probable explanation for the decline of caries prevalence in developed countries since the 70s; moreover, toothbrushing, and the use of therapeutic dentifrices, is considered to meet spreading compliance because a 'healthy mouth' becomes more and more socially desirable in growing numbers of subpopulations.