Use Of Dentifrice Research Articles

Total fluoride intake in children aged 22–35 months in four Colombian cities

To obtain information on the level of total fluoride intake from food, beverages and toothpaste by children at the age of 22-25 months of low and high socioeconomic status (SES) in major Colombian cities. Daily fluoride intake was assessed by the duplicate plate method and by recovered toothpaste solution during a 3-day period and afterwards analysed by the microdiffusion method. Mean daily fluoride intake was 0.11 (+/-0.10), 0.14 (+/-0.12), 0.10 (+/-0.07) and 0.07 (+/-0.06) mg/kg body weight (bw)/day in Bogota, Medellin, Manizales and Cartagena, respectively. The total fluoride intake was higher in low-SES subjects in the cities of Medellin and Bogota. In the high-SES children of the four cities, the average intakes ranged from 0.06 to 0.09 mg F/kg bw, whereas, the low-SES children in three cities had intakes between 0.11 and 0.21 mg F/kg bw (Cartagena, 0.07). Toothpaste (containing 1000-1500 ppm F, with 1500 ppm F being more common) accounted for approximately 70% of total fluoride intake, followed by food (24%) and beverages (<6%). More than half the children had their teeth brushed by an adult, on average twice a day, using 0.22-0.65 g of toothpaste. Children from three Colombian cities have a mean total daily fluoride intake above the 'optimal range'. Health authorities should promote an appropriate use of fluoridated dentifrices discouraging the use of dentifrices containing 1500 ppm F in children younger than 6 years of age and promoting a campaign of education of parents and oral health professionals on adequate toothbrushing practices.

Editorial

To compare the abrasive wear on human dentine in an in situ model associated with use of an experimental low abrasivity anti-sensitivity dentifrice containing 1% alumina and 5% sodium tripolyphosphate (STP) with an experimental ultra-low abrasivity non-alumina 5% STP dentifrice, a higher abrasivity daily-use whitening dentifrice, and water as controls.This was a single-centre, single-blind, randomised, split-mouth, four-treatment, two-period, crossover in situ study in 29 healthy subjects. Subjects wore bilateral lower buccal appliances, each fitted with four dentine specimens. Study treatments were applied ex vivo (three times daily). Dentine loss was measured by non-contact profilometry after 5, 10 and 15 days’ treatment.All 29 subjects were included in the efficacy analysis. Significantly less dentine loss was associated with brushing with the low and ultra-low abrasivity dentifrices than with the higher abrasivity dentifrice at all timepoints (p < 0.01). Brushing with ultra-low abrasivity dentifrice or water resulted in statistically significantly less dentine loss compared with brushing with the low abrasivity dentifrice at all timepoints (p < 0.05). Dentine loss after brushing with ultra-low abrasivity dentifrice was not significantly different from brushing with water.The degree of dentine loss observed in this in situ model reflected the abrasivity of the study dentifrices. Brushing with low or ultra-low abrasivity STP-containing anti-sensitivity dentifrices resulted in significantly less dentine loss (equating to dentine wear) than with a higher abrasivity daily-use whitening dentifrice.

The importance of fluoride dentifrices to the current dental caries prevalence in Brazil

Similar to that which occurred in most developed countries, dental caries have shown a significant decline in Brazil over the last two decades. Water fluoridation, expansion of preventive programs at schools, and especially, the widespread use of fluoride dentifrice are discussed as factors related to this reduction in caries. Data from epidemiological surveys and historical facts are presented to support the importance of fluoride dentifrices to the current caries prevalence in Brazil.

The effectiveness of a toothpaste containing Triclosan and polyvinyl‐methyl ether maleic acid copolymer in improving plaque control and gingival health

To compare the effectiveness of triclosan/copolymer and fluoride dentifrices in improving plaque control and gingival health. We searched the Cochrane Controlled Trials Register, MEDLINE (1986 to March 2003) and EMBASE (1986 to March 2003). Personal files and the reference lists of all articles were checked for further studies. Trials were selected if they met the following criteria: random allocation of participants; participants were adults with plaque and gingivitis; unsupervised use of dentifrices for at least 6 months; and primary outcomes - plaque and gingivitis after 6 months. Two reviewers independently extracted information. For each plaque and gingivitis index, the mean differences for each study were pooled as weighted mean differences (WMDs) with the appropriate 95% confidence intervals (CIs) using the random effect models. Sixteen trials provided data for the meta-analysis. The triclosan/copolymer dentifrice significantly improved plaque control compared with a fluoride dentifrice, with a WMD of -0.48 (95% CI: -0.64 to -0.32) for the Quigley-Hein index and WMD of -0.15 (95% CI: -0.20 to -0.09) for the plaque severity index. When compared with a fluoride dentifrice, the triclosan/copolymer dentifrice significantly reduced gingivitis with WMDs -0.26 (95% CI: -0.34 to -0.18) and -0.12 (95% CI: -0.17 to -0.08) for the Loe and Silness index and gingivitis severity index, respectively.

Sustained oral health improvement and use of toothbrushes and dentifrice by previous users of traditional materials in a rural population in Andhra Pradesh, India

To follow-up, one year later, a double-blind, randomised study, which investigated the effect of regular brushing with dentifrices on the oral health of an economically disadvantaged rural population in Andhra Pradesh, India who were primarily users of traditional materials. 150 of the original study population. Examination to determine whether the improvements in oral health status and oral health behaviour (use of toothbrush and dentifrice), being unsupported, had been sustained since completion of the original study. Data analysis showed sustained, statistically significant improvements in gingival health as measured by gingival bleeding and plaque indices (GBI and PI) comparing users and non-users of toothbrushes and dentifrice in the original study (PI: p = 0.04; GBI: p = 0.03) and sustained use of toothbrushes and dentifrice by 60% of the subjects at follow-up one year later. This study shows a beneficial effect on oral hygiene indices following the introduction of toothbrushes and dentifrices to a community using traditional oral hygiene materials and sustainability of use of these materials with motivation and support. It may therefore be concluded that it is feasible to achieve significant use of conventional toothbrushes and toothpastes, with consequent major and sustained improvements in plaque control and gingival health in a disadvantaged population hitherto often considered as not amenable to conventional oral hygiene for cultural or economic reasons.

The Effects of Different Application Techniques and Orifices on the Amount of Dentifrice Dispensed

The purpose of this study was to evaluate three different methods (ST: Standard technique; PS: Pea-size; TT: Transverse technique) for dentifrice use in children between 5-7 years of age, as well as to compare the amount of dentifrice dispensed by using tubes with different orifices (cresent or round shaped). One hundred children who dispensed the dentifrice themselves were asked to apply the quantity of dentifrice they usually used (ST or TT) (Phase-I). In Phase-II they were instructed to apply a PS amount, and in Phase III the TT was demonstrated. Statistical analysis was obtained by using Anova and t-test. Most of the children (82 patients) preferred to use the ST rather than the TT (18 patients). A decrease in the dentifrice amount was obtained with both of the shaped orifices after the instruction of PS or demonstration of the TT (p< 0.05). It was observed the amount of dentifrice dispended decreased when a cresent-shaped orifice was used. Children usually preferred to use the ST rather than the TT before the instruction or demonstration by the operator. The amount of dentifrice dispensed generally decreased when a dentifrice tube with a crescent-shaped orifice was used.

The effect of a 2% zinc citrate, 0.3% Triclosan dentifrice on plaque acid production following consumption of a snackfood

A) To assess plaque lactate production following consumption of three foods (cake, chocolate/caramel bar, sweetened coffee), and B) To measure the effect of a fluoride dentifrice containing 2% zinc citrate and 0.3% Triclosan on plaque lactate and pH drop following consumption of cake. A) 10 subjects completed the first study. Plaque samples taken before and at 8,15 and 30 minutes after eating. Samples were analysed for lactate via Capillary Electrophoresis. B) 30 subjects completed the second study. Plaque samples were taken before and after cake and use of test dentifrice or no treatment control. Plaque pH and lactate content were assessed. A) Plaque lactate levels increased after all three foods; peak lactate levels occurred 8 minutes after eating. B) Plaque lactate concentrations after eating cake were 39.2mM for the control treatment and a significantly lower value, 23.6mM, for the test 2% zinc citrate, 0.3% Triclosan dentifrice. After food challenge, pH values were 5.53 for the no treatment group and a significantly higher value of 5.79 for the test dentifrice group. A toothpaste containing 2% zinc citrate, 0.3% Triclosan can significantly reduce plaque lactate generation and pH drop induced by cake, compared to no treatment control.

Daily use of dentifrice with and without xylitol and fluoride: effect on glucose retention in humans in vivo

The effect of daily use of three different dentifrices on glucose retention after glucose mouth rinsing was tested in this study regarding xylitol and fluoride. Six experimental groups used three different dentifrices produced by two different companies: xylitol- and fluoride-containing dentifrice (XF), non-xylitol- and fluoride-containing dentifrice (F), and non-xylitol- and non-fluoride-containing dentifrice (NonX–NonF). Subjects were divided at random and rinsed their mouths for 15 s with 20 ml of 0.5 M glucose solution. Glucose and lactate retention were determined by collecting samples of saliva from the approximal areas of the maxillary and mandibular anterior teeth and using the enzyme membrane test. Samples were collected 0, 1 and 2 months after the start of regular dentifrice use. There were significant differences in glucose retention in relation to the dentifrice used, month of sampling, site of sampling, and time since start of rinsing. Their contribution ratios were 2.0, 4.4, 11.7 and 7.4%, respectively ( P<0.01). There were significant differences observed between the XF and NonX–NonF groups, with the XF group presenting lower glucose retention than the NonX–NonF group. The XF group presented lower glucose retention than the F group. The F group showed lower glucose retention than the NonX–NonF group. There were significant differences in lactate retention in relation to the month and site of sampling, and their contribution ratios were 3.3 and 2.8%, respectively ( P<0.01). There were, however, no significant differences in glucose and lactate retention in relation to the dentifrice manufacturer. It was concluded that the XF dentifrice was the most effective, and the F dentifrice was more effective in reducing glucose retention than the NonX–NonF dentifrice.

A Survey on the Use of Fluoride Dentifrice among Kindergarten Children and Their Guardians Primary School Childen and Their Guardians, and Junior High School Students in 2000

A Survey on the Use of Fluoride Dentifrice among Kindergarten Children and Their Guardians Primary School Childen and Their Guardians, and Junior High School Students in 2000

Tissue structure, and IL-1beta, IL-8, and TNF-alpha secretions after contact by engineered human oral mucosa with dentifrices.

The use of dentifrice is part of an oral prophylaxis that aims at keeping bacteria in check within the dental plaque. When introduced into the oral cavity, dentifrice also comes in close contact with the oral epithelium. Our goal was to evaluate the effects of dentifrices on tissue structure and pro-inflammatory mediator release by epithelial cells. For this purpose, tri-dimensional engineered human oral mucosa (EHOM) was produced using normal human palatal fibroblasts and epithelial cells. EHOMs were either treated with Aquafresh(R) or Crest(R) for 1, 4, 8, and 24 h, or untreated, then used for cell viability assessment and structural analyses. Cultured supernatants were used to evaluate cytokine (interleukin (IL)-1beta, IL-8 and tumor necrosis factor (TNF)-alpha) secretion, and metalloproteinase (MMP)-2 and -9 activities. The present in vitro study using engineered oral mucosa confirms that dentifrices (Aquafresh and Crest) contribute to tissue desquamation. The desquamation was substantial at 24 h of contact but was limited to the upper layers of the treated tissues. Cell death in these tissues was not increased, suggesting that the dentifrice had accelerated desquamation of the layers containing differentiated cells. Measurement of cytokines revealed that dentifrices up-regulated IL-1beta while down-regulating IL-8 and TNF-alpha secretion, thus indicating an impaired cascade of inflammatory responses. These dentifrices may also impair normal repair mechanisms as suggested by an up-regulation of gelatinase activities. In conclusion, this study suggested that, via cytokines, dentifrice contributes to the modulation of the inflammatory (pro-inflammatory/anti-inflammatory responses) process.

Plaque Fluoride Concentrations Are Dependent on Plaque Calcium Concentrations

Despite the 1,000-fold difference between the fluoride concentrations ([F]) in dentifrices and fluoridated drinking water, clinical and epidemiological studies have shown that they have similar cariostatic effects. This double-blind, crossover study was done to determine whether the [F] in dental plaque is related more to the [F] of the dentifrice used or to the plaque concentrations of calcium and magnesium. The subjects (n = 13) were adults and residents of a city served with fluoridated drinking water. After 1 week of using a fluoridated dentifrice (940 ppm) or a placebo dentifrice, whole saliva and plaque were collected 1.0 h and approximately 12 h after the last use of the dentifrices. The average salivary [F] after brushing with the F dentifrice was higher than after using the placebo. The average plaque [F] 1.0 h after brushing with the F dentifrice was higher than after using the placebo (p < 0.01), but the difference at 12 h was not significant. Plaque [Ca] and [F] were directly related under all experimental conditions (p = 0.0001). The relationships between plaque [Mg] and [F] were weaker and inconsistent. Based on these findings and reports in the literature it is concluded that, for persons whose drinking water is fluoridated, plaque [F] throughout much of the day is not significantly increased by the use of a fluoridated dentifrice. Instead they are directly related to plaque [Ca]. These findings offer at least a partial explanation for why fluoridated dentifrices and drinking water have similar cariostatic effects.

Socioeconomic Status and Selected Behavioral Determinants as Risk Factors for Dental Caries

The purpose of this review is to summarize a systematic review evaluating the evidence regarding the association between the incidence and prevalence of dental caries and: 1) socioeconomic status; 2) tooth-brushing; and 3) the use of the baby bottle. Literature was drawn from two databases, Medline and EmBase. Because of limited resources, we did not conduct hand-searching or search unpublished studies. Three thousand one hundred thirty-eight abstracts were identified, 358 reviewed, and 272 papers included in the systematic review. There is fairly strong evidence for an inverse relationship between SES and the prevalence of caries among children less than twelve years of age. The evidence for this relationship is weaker for older children and for adults because of the relatively small number of studies and methodological limitations. There is weak evidence that tooth-brushing prevents dental caries, but it is uncertain whether the effects of tooth-brushing are due to use of a fluoride dentifrice or from mechanical removal of plaque. Finally, the evidence for the relationship between prolonged use of the baby bottle and dental caries is weak. More studies directly aimed at analyzing the relationship between SES and dental caries are needed to identify factors associated with SES that contribute to dental caries risk. Tooth-brushing should continue to be recommended as a measure to prevent dental caries, particularly using a fluoride dentifrice. Recommendations regarding bottle use should continue until clear evidence about the relationship between prolonged bottle use and dental caries can be obtained.

Prevalence of Dental Fluorosis in the Primary Dentition

This paper presents data on the prevalence of primary tooth fluorosis among children residing in Iowa, and the relationships between fluorosis prevalence and selected measures of fluoride exposures. Children in the study cohort were followed prospectively during the first year of life. This study assessed their home water fluoride concentrations and use of fluoride dentifrice or dietary fluoride supplements. A total of 637 children (320 females and 317 males) were examined for fluorosis using a modification of the TSIF index at age 4 1/2 to 5 years, with 90.4 percent having intact primary dentitions. 74 children (11.6%) had fluorosis present on one or more of their primary teeth, and 71 children (11.1%) had two or more teeth affected. Nearly all fluorosis was mild, with the primary second molar teeth most commonly affected. Fluorosis was significantly associated with higher water fluoride concentration, but not with the use of dentifrice or fluoride supplements. The results of this study show that primary tooth fluorosis is relatively uncommon, but is most frequently seen on the posterior teeth, particularly the primary second molars, which form at later stages of development. This finding suggests that primary tooth fluorosis is mostly a postnatal phenomenon, and is associated with higher water fluoride levels.

Patterns of fluoride intake from birth to 36 months.

Dental fluorosis prevalence has increased in the United States, Canada, and other nations due to the widespread availability of fluoride in many forms, with fluoride ingestion during the first three years of life appearing most critical in fluorosis etiology. With few contemporary studies of fluoride ingestion in this age group, the purpose of this paper is to describe patterns of estimated fluoride ingestion from birth to 36 months of age from water, dentifrice, and dietary fluoride supplements and combined. Repeated responses to separate series of questions about water intake, use of fluoride dentifrice, and use of fluoride supplements were collected by questionnaire as part of the longitudinal Iowa Fluoride Study and used to estimate fluoride intake. Estimated intake is reported by source and combined at different ages. Effects of subject age and other covariates on fluoride intake were assessed using regression methods appropriate for the analysis of correlated data. For most children, water fluoride intake was the predominant source, especially through age 12 months. Combined daily fluoride intake increased through 9 months, was lower at 12 and 16 months, and increased again thereafter. Mean intake per unit body weight (bw) was about 0.075 mg F/kg bw through 3 months of age, 0.06 mg F/kg bw at 6 and 9 months, 0.035 mg F/kg bw at 12 and 16 months, and 0.043 mg F/kg bw from 20-36 months. Depending on the threshold chosen (e.g., 0.05 or 0.07 mg F/kg bw), variable percentages of the children exceeded the levels, with percentages greatest during the first 9 months. Regression analyses showed fluoride intake (mg F/kg bw) from 1.5-9 months to decrease with increasing child's age, mother's age, and mother's education, with a complex three-way interaction among these factors. From 12-20 months, fluoride intake increased with increasing child age and decreased with increasing mother's age. No statistically significant relationships were found for fluoride intake from 24-36 months. There is considerable variation in fluoride intake across ages and among individuals. Longitudinal studies may be necessary to fully understand the relationships between fluoride ingestion over time and development of fluorosis.

Effect of sucrose-containing gum and fluoridated dentifrice on in situ remineralization of artificial caries

The aim of this study was to evaluate the remineralization of incipient carious lesions in bovine enamel in situ. Artificial carious lesions were produced and fixed in removable lower appliances in the region of the lingual surfaces of first molars, in six volunteers with ages between 18 and 22 years, who were subjected to 3 distinct experimental periods of 1 week each. In the first period (control group), patients brushed their teeth with a non-fluoridated dentifrice 4 times a day (after meals), and, in the second period (group I), patients used a dentifrice containing 1,500 ppm of fluorine (in the form of MFP). In the third period (group II) volunteers brushed their teeth with non-fluoridated dentifrice and used chewing gum containing 60% of sucrose during 20 minutes, 4 times a day (after meals). Before and after each treatment, the specimens underwent Vicker's hardness test (200 g of load), and the remineralization percentage (alpha) was calculated. The control group showed 2.78% of demineralization, and groups I and II showed 3.36 and 5.21% of remineralization, respectively. Statistical analysis (with Kruskal-Wallis and Miller's tests) showed significant difference (p < 0.05) between the control and experimental groups (I and II). Group II showed greater alpha than group I, but this difference was not significant. These results suggest that the use of sucrose-containing chewing gum and fluoridated dentifrice has a considerable effect on the remineralization of incipient carious lesions and may be a valuable alternative for their prevention.

The Influence of Different Fluoride Compounds and Treatment Conditions on Dental Enamel: A Descriptive in vitro Study of the CaF2 Precipitation and Microstructure

Electron and atomic force microscopy techniques have been applied to characterize both the in vitro deposition intensity and the microstructure of the KOH-soluble fluoride precipitates on human dental enamel. The study was focused on the effects of amine fluoride, sodium fluoride and sodium monofluorophosphate having a fluoride concentration of 0.1% F in acidulated and aqueous solutions. Under certain conditions, fluoride globules were formed within an initiation time of less than 20 s. This result supports the potential significance of this process for the cariostatic action of fluorides during dentifrice use. The deposition intensity seems to be dependent on the availability of Ca and F ions on the dental surface. A nanocrystalline calcium fluoride-like microstructure was revealed, with an additional phosphorus and oxygen incorporation as a function of the treatment time.

Fluoride and magnesium concentrations in human dental calculus obtained from Japanese and Chinese patients

Calculus deposited on a total of 68 permanent teeth from patients 30–60 years old from Nagoya in Japan and Beijing in China was investigated. An abrasive microsampling method was used to examine the fluoride (F) and magnesium (Mg) distribution, using a fluoride ion-specific electrode and atomic absorption spectrophotometry, respectively. F concentrations decreased from the surface towards the interior of the calculus. Mg concentrations, however, gradually rose towards the innermost surface adjacent to the tooth. In all parts of the depth profiles, the average concentrations of both magnesium and fluoride were higher in the Japanese than in the Chinese calculus. Towards the inner surface of the calculus, F and Mg concentrations were also much higher in the Japanese than in the Chinese group. A greater intake of sea foods and greater use of fluoride dentifrices are possible reasons for the higher F and Mg concentrations in the Japanese individuals.

Fluoride intake from foods, beverages and dentifrice by young children in communities with negligibly and optimally fluoridated water: a pilot study

Abstract– While the level of fluoride intake that affords optimal cariostatic efficacy without causing dental fluorosis is not precisely known, it has been suggested that the threshold of fluoride exposure above which fluorosis may occur is between 0.05 and 0.07 mg/kg/day. Objective: To monitor and compare fluoride intake from diet and dentifrice use (theoretical F: 0.10–0.11%) by three groups of 16‐ to 40‐month‐old children: two groups living in the negligibly water‐fluoridated communities of San Juan, Puerto Rico, and Connersville, Indiana, and the third group residing in the optimally water‐fluoridated region of Indianapolis, Indiana. Methods: Fluoride intake from diet was monitored by the “duplicate plate” method, and fluoride ingested from dentifrice was determined by subtracting the amount of fluoride recovered after brushing from the amount originally placed on the child's toothbrush. Results: The mean combined amount of fluoride ingested daily by children living in the negligibly fluoridated communities was not significantly different from that ingested by children in the fluoridated community. The major component of fluoride ingested by children in the negligibly fluoridated communities came from fluoridated dentifrice, and in the fluoridated area children ingested as much fluoride from toothpaste as they did from beverages. In San Juan mean daily fluoride intake was within the estimated range for safe fluoride expo‐sure; however, in the “halo” community of Connersville and in Indianapolis, daily fluoride ingested by many of the children may have exceeded this level. Conclusion: Attention needs to be given, in negligibly water‐fluoridated as well as in optimally water‐fluoridated communities, to reducing the daily intake of fluoride by young children in order to avoid putting them at risk of developing dental fluorosis.

In situ de- and remineralisation of enamel in response to sucrose chewing gum with fluoride or non-fluoride dentifrices

Objectives: Enhancement of the remineralisation of artificial enamel lesions has been observed in an intraoral model whether subjects chewed gum sweetened with a non-cariogenic sweetener such as sorbitol [1–3]or sucrose [4]after meals or snacks, and with use of a conventional (1500 ppm F) fluoride dentifrice. Since most of the clinical surveys which have shown the potential cariogenicity of sucrose chewing gum [5]were conducted before use of fluoridated dentifrices became widespread, the effect of fluoride dentifrice on de- and remineralisation of artificial lesions in enamel in response to chewing sucrose-sweetened gum has been examined with the aim of attempting to resolve this apparent discrepancy. Methods: Subjects wore an intraoral device bearing an enamel lesion and chewed one piece of sucrose gum for 20 min after each of three meals and two snacks daily for two 3-week periods, during which they used a dentifrice containing either 0 or 1500 ppm F in a double-blind, cross-over design. Measurement of the mineral content of the lesions was determined by microradiography or polarised light microscopy. Results: It was found that remineralisation tended to occur with 1500 ppm F dentifrice, but demineralisation with non-F dentifrice; the difference in enamel mineral content between the two periods was significant ( P<0.05). Conclusions: The results indicate that the potential cariogenicity of sucrose-containing chewing gum may indeed be negated by the use of a conventional fluoride dentifrice.

Caries prevention

It is apparent that the use of fluoride in multiple measures has a significant impact upon the prevention of dental caries. These measures involve public health benefits of water fluoridation, professional fluoride treatments in the dental office, and the home use of effective fluoridated dentifrices, with the use of fluoride rinses and gels as adjuncts when needed. In many clinical situations, professional judgment is required to identify the most appropriate treatment measures to address the needs of individual patients.