PubMed · 14528983
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Karen McCaffery. 2003. Fluoride and dermatitis.. https://doi.org/10.14219/jada.archive.2003.0337
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After a caries decline of about 80% in children in Western Europe and other industrialized countries, there should be critical debate about the best way for future caries prevention. Multiple fluoride use played an important role in caries reductions achieved in the 1980s and 1990s, but it also resulted in a polarization of lesion distribution in young people: the majority consists of low-caries or even lesion-free individuals, while a minority is a so-called high caries risk group which seems not to be open to preventive programs. Recent studies indicate that frequent fluoride applications (>6 times/year) in conjunction with effective plaque removal can be a successful approach for effective future caries prevention in high caries risk groups. Health promotion programs that are merely educational and do not provide fluoride do not seem to be effective. Alternatively, preventive measures could be performed at home or in a private practice, but only minimal compliance is reached in high risk groups compared with out-reaching group programs. Thus, group programs are instrumental in providing effective and efficient caries-preventive measures in children. The more expensive time of a dental practice team should be limited to procedures where costly equipment is needed (professional tooth cleaning, sealants, etc.). For efficient caries prevention, measures formerly targeted specifically at either populations, groups, or individuals should be remodeled and aimed to interact in order to achieve optimal oral health in children at a reasonable cost.
OBJECTIVES: The aims of this study were to evaluate the effects of a novel 6% hydrogen peroxide containing tooth whitener, Xtra White (XW), on enamel and dentine microhardness in vitro. METHODS: Polished human enamel and dentine specimens were prepared and baseline microhardness determined. In study 1, enamel specimens were exposed to 20 min cycles of either water, XW or Sprite Light for up to 28 cycles. In studies 2 and 3, enamel specimens were treated with 20 min cycles of either XW or water and exposed to whole saliva at all other times. In study 3, an additional exposure to a fluoride containing toothpaste was conducted. In total, 28 treatments were conducted in order to simulate a 2 weeks product use. In study 4, dentine specimens were treated as per study 3. Final microhardness measurements were taken and for studies 3 and 4 colour measurements were additionally taken. RESULTS: XW and water gave no statistically significant (p>0.05) changes in enamel and dentine microhardness after 28 treatments. Sprite Light gave a significant (p<0.00002) reduction in enamel microhardness after one 20 min treatment. XW showed significant bleaching of enamel and dentine specimens as compared to the water control. CONCLUSIONS: XW does not have any significant effect on enamel and dentine microhardness.
BACKGROUND: Evidence-based dentistry, or EBD, is not a new concept for the dental profession in the United States. The American Dental Association has long relied on credible scientific evidence in setting policy and communicating with dentists and the general public. EBD provides an approach to oral health care that follows a process of systematically collecting and analyzing scientific evidence to answer a specific clinical question. OVERVIEW: The authors discuss applications of systematic review findings to everyday clinical practice and explore the implications of EBD for dental education, clinical research and the provision of care to patients. CONCLUSIONS AND PRACTICE IMPLICATIONS: In developing appropriate treatment plans, dentists should combine the patient's treatment needs and preferences with the best available scientific evidence, in conjunction with the dentist's clinical expertise. To keep pace with other health professions in building a strong evidence-based foundation, dentistry will require significant investments in clinical research and education to evaluate the best currently available evidence in dentistry and to identify new information needed to help dentists provide optimal care to patients.