Accumulation and clearance of fluoride in human mixed saliva after different topical fluoride treatments.
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Adult↗
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Results for “FLUORIDES, TOPICAL”
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The effect of topical fluorides, after acid etching of enamel, on the bond strength of directly bonded orthodontic brackets.
This study tests the hypothesis that the beneficial effects of topical fluoride can be realized without reducing the bond strength of the resin adhesive. Twenty-eight groups of four teeth (third molars and premolars) were extracted from twenty-eight patients and stored in distilled water. Twin brackets on Ormesh pads were bonded to all teeth with Endur adhesive. One tooth from each group was bonded according to the manufacturer's instructions. These teeth, Subgroup I, served as controls. Subgroup II teeth were etched for 4 minutes with 50% phosphoric acid containing 2 percent sodium fluoride. Subgroup III teeth received a 3-minute application of a basic phosphate fluoride solution (10(-2)M NA3PO4, 10(3) ppm F) after 1 minute of etching with 50 percent phosphoric acid. Subgroup IV teeth received a 4-minute application of 8 percent stannous fluoride solution after 1 minute of etching with 50 percent phosphoric acid. Each tooth was mounted in a block of improved dental stone; guide wires were used to reproduce bracket orientation. The M.T.S. materials-testing apparatus was used to generate a torsional moment on the bracket at a rate of 1 degree per second. Fluoride uptake by enamel has been shown to be greater in an acid medium or after acid etching. The application of directly bonded orthodontic brackets and pit-and-fissure sealants requires acid etching of the enamel surface. This study supports the use of topical fluoride after acid etching, a procedure that achieves the benefits of increased fluoride uptake without changing the bond strength of the resin adhesive.
Acid Etching, Dental↗
Topical fluoride in orthodontic bonding.
Neutral and acidified sodium fluoride solutions were topically applied to enamel etched in a manner typical for orthodontic bonding procedures. Enamel fluoride levels were greater with the acidified solutions.
Acid Etching, Dental↗
Topical fluoride therapy: discussion of some aspects of toxicology, safety, and efficacy.
Although ingestion of an acute toxic dose of fluoride is extremely rare in dental treatments, practitioners should be familiar with the signs and symptoms and with emergency measures of treating accidental overdosage. The amount of fluoride ingested chronically from the use of self-applied topical fluoride can be reduced to safe limits by instructing parents to dispense small amounts of toothpaste for their young children and to ensure that fluoride dentifrices and mouthrinses are fully expectorated. Similarly, when custom-fitted trays are used, only minimal amounts of fluoride gels are necessary. The minimal amount of such gels that can be dispensed appears to be influenced by their viscosity. Clinical efficacy does not support a reduction in the concentration of fluoride in commercial dentifrices.
Diet↗
Effect of topical fluoride application before and after amalgam restoration placement on recurrent caries inhibition.
PURPOSE: To evaluate the in vitro caries inhibition effects of 1.23% APF foam topical fluoride treatment of cavity preparations, prior to restoration placement and after restoration placement. MATERIALS AND METHODS: Sixty standardized Class V preparations were placed in molars. Randomly, 40 teeth received an amalgam restoration: Twenty other teeth had 1cc 1.23% APF foam applied to preparation surfaces for 1 minute, then an amalgam restoration was placed. The APF was not rinsed away prior to restoration, it was displaced by the pressure of the amalgam being condensed into the preparation. Twenty of the initial 40 amalgam restorations had 1 cc 1.23% APF foam applied to the external tooth/restoration margins for 4 minutes, the remaining 20 amalgam restorations acted as the controls. Acid-resistant varnish was placed, leaving 1 mm of tooth adjacent to restoration margins exposed. All specimens were subjected to an artificial caries challenge (pH 4.4) for 5 days. Sections of 100 microns were cut longitudinally through the restored margins, photographed under polarized light microscopy, then demineralized areas adjacent to restoration margins were quantitated. RESULTS: Results demonstrated the mean (+/- S.D.) area (microns 2) of demineralization 100 microns from the restoration margins to be: amalgam 10,221 +/- 524, amalgam with 1-minute APF over preparation 529 +/- 557, amalgam with 4-minute APF over external surface 736 +/- 359. ANOVA and Duncan's (P < 0.05) indicated both 1.23% APF foam topical fluoride treatment regimens exhibited significantly less demineralization at restoration margins than the non-treated amalgam control. There was no significant difference between the two fluoride placement regimens examined in this study.
Acidulated Phosphate Fluoride↗
Effect of the routine professional application of topical fluoride on caries and treatment experience in adolescents of low socio-economic status in the Netherlands.
The purpose of this study was to study the effect of professionally applied topical fluoride on oral health status at the population level in adolescents with low socio-economic status. Adolescents attending dental clinics where professional fluoride application was a routine procedure (high-fluoride group) were compared to adolescents from other clinics (low-fluoride group). The study consisted of a questionnaire, a clinical examination and two bitewing radiographs. X-rays showed no statistically significant differences in the number of DS, FS or DFS. Clinically, there were no statistically significant differences in the number of FS or in the number of DFS. The low-fluoride group had a statistically significant higher number of DS than the high-fluoride group. The results indicate that professionally applied fluoride has no effect on caries and treatment experience in a population. These results justify a randomized clinical trial on a population level to study the effectiveness of professionally applied topical fluorides.
Adolescent↗
Comparison of three topical fluorides using computer imaging.
The purpose of this in vitro study was to evaluate the short and long-term effectiveness of fluoride varnish and compare it with the two most commonly used topical fluorides, i.e., fluoride gel and foam. A second purpose of the study was to compare the effectiveness of these preparations on primary and permanent teeth. Enamel slabs with a thickness of 500 microns were obtained from caries free primary molars and premolars. They were divided into four groups: control, foam (F), gel (G) and varnish (V). Fluorides were applied to the enamel slabs according to the manufacturer's instructions and were placed in a 5.1 pH acidic gel for one week. The amount of demineralization from the enamel was measured by calculating the amount of light reflected from these surfaces. This was done by using a Charged Couple Device attached to a high resolution microscope with image processing software, Optima 5.22. The enamel slabs were placed in a freshly prepared acidic gel for a second week without application of fluorides. This was done to mimic a situation where fluoride is eventually brushed away from teeth. Reflective images were recorded under the previously described conditions. A two-way analysis of covariance was used to compare the treatments. The results showed no statistically significant difference (with Bonferroni correction) in the effectiveness of different fluoride preparations over the short-term (Week I comparison; p-values: F vs. G 0.079, F vs. V 0.030, G vs. V 0.44). However, the long-term protection provided by fluoride varnish was far more than fluoride gel and foam (Week II comparison; p-values: F vs. G 9X10-5, F vs. V 7X10-8, G vs. V 1X10-4). Fluorides were equally effective for both primary and permanent enamels (p-value 0.24). The results of this study suggest that fluoride varnish is beneficial for use with white spot lesions, newly erupted permanent teeth and early decalcification in primary dentition.
Acidulated Phosphate Fluoride↗
[Effect of topical fluoridation on post-radiation caries in patients with head and neck cancer].
Post-radiation caries, a rapidly progressing and highly destructive type of dental caries, is one of the most common post- radiation complications in patients with head and neck cancer. Topical fluoride application has been shown in clinical studies to reduce post-radiation caries in irradiated patients. This study reviewed 148 patients who had received radiation for head and neck cancer. All the subjects received pre-radiation dental care. After radiation, the first group consisted of 53 patients who were under regular 3 months dental recall and received topical fluoride applications. The second group consisted of 95 patients who did not return for regular dental recall. Result from clinical examination and bitewing radiographs revealed that the caries indexes were 7% and 31% for the first and second groups, respectively. Chi-Square test showed significant difference between the two groups (P value less than 0.005). Regular topical fluoride application is valuable in reducing dental caries after radiation for head and neck cancer.
Administration, Topical↗
Crystallographic structure of enamel surfaces treated with topical fluoride agents: TEM and XRD considerations.
The crystallographic structure of surface coatings produced by three topical fluoride agents deposited by a single application on intact human enamel surfaces was investigated by light- and dark-field transmission electron microscopy, as well as by electron and x-ray diffraction. The agents studied were an acidic silane fluoride lacquer, a neutral NaF lacquer, and an APF gel. The smallest coherently diffracting particles were CaF2 microcrystallites 4-15 nm in diameter. Large apatite-like crystals, approximately 1 micron in length, were also observed in the outer surface coating produced by the silane fluoride lacquer.
Animals↗
The comparative sensitivity of intra-oral, in vitro, and animal models in the 'profile' evaluation of topical fluorides.
The development of predictive and rapid methods for the assessment of the anticaries activity of topical fluorides has been a long-standing objective of caries researchers. These methods can provide useful benefits in a number of applications, ranging from the identification of novel agents to progress into clinical testing to the regulatory screening of commercial product variations. In the latter applications, combinations of test methods (so-called profiles) are used by manufacturers to prove that changes in formulations do not alter the efficacy of the products. Historically, combinations of in vitro and animal models have been used for basic research as well as for profile testing purposes; however, in recent years, the use of intra-oral or in situ models has increased. In this paper, in vitro, animal, and in situ methods are reviewed in terms of the historical basis for their development, protocols currently used in testing, and the primary advantages and limitations of each as applied to 'profile' applications. Recommendations are provided concerning circumstances for the appropriate use of modern test methods in formulation screening.
Animals↗
The effect of topical fluoride agents on saliva secretion.
The aim of this study was to assess the possible influence of various topical fluoride agents on the rate of saliva secretion. Fifteen healthy volunteers, both males and females, aged 20-60 years, participated in this study. Aminfluorides and monofluorophosphate products in gel, toothpaste and rinse states were used. Each subject brushed or rinsed the teeth and mouth for 2 minutes. Secreted saliva was collected for 5 minutes. Salivary secretion was significantly greater after toothbrushing with aminfluoride compounds as compared to toothbrushing with monofluorophosphate. There was a tendency for an increased saliva flow rate with higher fluoride concentration of the aminfluoride.
Adult↗
One topical fluoride (toothpastes, or mouthrinses, or gels, or varnishes) versus another for preventing dental caries in children and adolescents.
BACKGROUND: Topical fluorides in the form of toothpaste, mouthrinse, varnish and gel are effective caries preventive measures. However, there is uncertainty about the relative value of these interventions. OBJECTIVES: To compare the effectiveness of one form of topical fluoride intervention with another when used for the prevention of dental caries in children. SEARCH STRATEGY: We searched the Cochrane Oral Health Group's Trials Register (May 2000), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2000), MEDLINE (1966 to January 2000), plus several other databases. We handsearched journals, reference lists of articles and contacted selected authors and manufacturers. SELECTION CRITERIA: Randomized or quasi-randomized controlled trials with blind outcome assessment, comparing fluoride varnish, gel, mouthrinse, or toothpaste with each other in children up to 16 years during at least 1 year. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces (D(M)FS). DATA COLLECTION AND ANALYSIS: Inclusion decisions, quality assessment and data extraction were duplicated in a random sample of one third of studies, and consensus achieved by discussion or a third party. Authors were contacted for missing data. The primary measure of effect was the prevented fraction (PF) that is the difference in mean caries increments between the 'experimental' and 'control' groups expressed as a percentage of the mean increment in the control group. Random effects meta-analyses were performed where data could be pooled. MAIN RESULTS: There were 17 studies included, and 15 contributed data for the meta-analyses. Fluoride toothpaste was not significantly different from mouthrinse (pooled DMFS PF 0%; 95% CI, -18% to 19%; p = 0.94), or gel (pooled DMFS PF 0%; 95% CI, -21% to 21%; p = 1), or both gel and mouthrinse (pooled DMFS PF 1%; 95% CI, -13% to 14%; p = 0.94); heterogeneity was substantial. Results from the single trial comparing toothpaste with varnish (in deciduous teeth) were inconclusive (dfs PF 5%; CI not obtainable). The pooled results from the comparisons of fluoride varnish with mouthrinse was a non-significant difference favouring varnish (DMFS PF 10%; 95% CI, -12% to 32%; p = 0.40), but this result was not robust to sensitivity analysis performed, and heterogeneity was considerable. Results from the single trial comparing varnish with gel (14%, 95% CI, -12% to 40%; p = 0.30) and the single trial comparing gel with mouthrinse (-14% DMFS PF; 95% CI, -40% to 12%; p = 0.30) were inconclusive (favoured varnish and mouthrinse respectively). REVIEWER'S CONCLUSIONS: Fluoride toothpastes in comparison to mouthrinses or gels appear to have a similar degree of effectiveness for the prevention of dental caries in children. There is no clear suggestion that fluoride varnish is more effective than mouthrinses and the evidence for the comparative effectiveness of fluoride varnishes and gels, and mouthrinses and gels is inconclusive. No conclusions about adverse effects could be reached, because no data were reported on in the trials. Acceptance is likely to be greater for fluoride toothpaste.
Adolescent↗
[Topical fluoride in the reduction of dental caries in adolescents in Salvador, BA, 1996].
The aim of this paper was to investigate the experience of dental caries in a population of young adults from Salvador--BA, and to associate the prevalence of caries with the utilization of topical fluoride. A cross-sectional study was carried out with a sample of 493 persons aged 12-20 years, from Salvador--BA. Data were obtained from interviews and clinical examinations and they were analyzed through backward logistic regression. The DMFT was 4.44 (SD 3.71), and, for subjects aging 12-13 years, it was 2.72 (SD 2.75). A hundred and forty adolescents reported that they had participated in oral health programs (30%), and the majority felt that they were unable to maintain their own oral health. Topical fluoride was not a significant factor in the decrease of the prevalence of caries among these young adults (RP = 0.9). There was a decline in dental caries in this group. However, it is necessary to review the surgical-restorative model of dental practice in order to achieve better results in the promotion of oral health.
Adolescent↗
Effects of topical fluoride treatment on tensile bond strength of pit and fissure sealants.
Clinicians often do not place pit and fissure sealants immediately after topical fluoride treatment because fluoride treatment might reduce bonding to enamel. The effect of NaF, SnF2, and APF on the in-vitro bond strength of two sealants to enamel was determined. The fluoride treatments and control (artificial saliva) were applied to enamel surfaces for four minutes and rinsed. A filled sealant (FluoroShield) and an unfilled sealant (Concise) were bonded to the etched enamel and debonded in tension using a universal testing machine. NaF increased the bond strength of the unfilled sealant; SnF2 and APF had no significant effect. NaF and APF decreased the bond strength of filled sealant while SnF2 had no significant effect. The bond strength of the filled sealant was higher than or equal to that of the unfilled sealant. Exposure of enamel to NaF, SnF2, or APF prior to placement of unfilled or filled sealants has no effect on in vitro bond strength between the enamel and the sealants.
Acidulated Phosphate Fluoride↗
Critical evaluation of the composition and use of topical fluorides, with emphasis on the role of calcium fluoride in caries inhibition.
There is evidence that a major part of the fluoride which is retained on teeth during topical application is calcium fluoride or calcium fluoride-like, and that this material is relatively stable in the mouth. This is due to surface adsorption of phosphate (HPO4(2-)) ions onto the calcium fluoride surface. Calcium fluoride releases fluoride during caries challenges due to reduced concentration of HPO4(2-) at acid pH. Normally, the fluoride released from calcium fluoride during caries challenges is subsequently built into hydroxyfluorapatite through dissolution/re-precipitation reactions. It appears likely that the formation of calcium fluoride from topical application agents should be increased and not reduced, as believed in the past. Increased deposition of calcium fluoride can be achieved with increased reaction time between fluoride and enamel, reduced pH of the solution, increased concentration, or pre-treatment with calcium. A reduction in pH of the agents is probably the most practical approach to increase the deposition of calcium fluoride during topical application, and clinical data support this contention. Calcium fluorides with various dissolution rates are formed during different procedures of topical application with fluoride, presumably due to incorporation of phosphate into the calcium fluoride crystals.
Animals↗
Professionally applied topical fluoride: evidence-based clinical recommendations.
BACKGROUND: With the dramatic increase in the amount of scientific information available about oral health, an evidence-based approach to oral health care and the practice of dentistry is necessary. There is a need to summarize, critique and disseminate scientific evidence and to translate the evidence into a practical format that is used easily by dentists The evidence-based clinical recommendations in this report were developed by an expert panel established by the American Dental Association Council on Scientific Affairs that evaluated the collective body of scientific evidence on the effectiveness of professionally applied topical fluoride for caries prevention. The recommendations are intended to assist dentists in clinical decision making. TYPES OF STUDIES REVIEWED: MEDLINE and the Cochrane Library were searched for systematic reviews and clinical studies of professionally applied topical fluoride--including gel, foam and varnish--through October 2005. RESULTS: Panelists were selected on the basis of their expertise in the relevant subject matter. The recommendations are stratified by age groups and caries risk and indicate that periodic fluoride treatments should be considered for both children and adults who are at moderate or high risk of developing caries. Included in the clinical recommendations is a summary table that can be used as a chairside resource. CLINICAL IMPLICATIONS: The dentist, knowing the patient's health history and vulnerability to oral disease, is in the best position to make treatment decisions in the interest of each patient. These clinical recommendations must be balanced with the practitioner's professional expertise and the individual patient's preferences.
Adolescent↗
Fluoride retention in children using self-applied topical fluoride products.
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Adolescent↗
[In vitro effect of topical fluoride gels on the surface of composite resins].
This study was designed to compare the surface change in 6 brands of composite resins immersed in 4 topical fluoride gels of various pH. The result was evaluated by visual change in light reflectance and SEM. The findings were as follows: 1) five 4-minute immersions in acidic fluoride gels increased surface roughness and decreased the light reflectance of Prisma-Fil, Prisma APH, Brillant D and P-30, 2) Silux-Plus and Heliomolar were not affected by acidic fluoride gels, and 3) the surface texture of all resin samples was not changed when immersed in neutral fluoride gels. The findings suggested that a) neutral fluoride gels should be recommended for patients who have extensive composite restorations and require fluoride treatment, and b) when resin restoration is indicated, microfilled composite resin should be considered for patients who plan to use acidic fluoride gels.
Composite Resins↗