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PubMed2001

Analysis of fluoride levels retained intraorally or ingested following routine clinical applications of topical fluoride products.

A variety of topical fluorides is now used clinically for the prevention and control of dental caries. It is essential for the dental profession to be fully aware of the relative retention rates of fluoride in saliva and thus its contact with the teeth. These may vary following the use of the different categories and concentrations of agents available and with different methods of use. It is also important to be aware of the amounts of fluoride ion ingested following use of the more concentrated forms and of the resultant elevation in total blood fluoride levels. These parameters were investigated in a series of experiments involving human volunteer subjects using a variety of topical fluoride materials commercially available in Australia. Fluoride mouthrinses appeared to provide the highest salivary retention rates per dose of all forms of topical fluoride. Ingestion rates from concentrated gels were acceptable when effective evacuation methods were applied. The use of custom-made trays resulted in a reduction in amounts of fluoride ion ingested, though simple self-application by toothbrush of smaller quantities proved to be an effective alternative in terms of amount of fluoride ion retained in saliva per amount applied and ingested. None of the concentrated gels used resulted in elevations in total blood fluoride levels which were of concern in adults. It is acknowledged that salivary retention rates of fluoride ion do not necessarily reflect the caries inhibitory effects of topical fluorides. However, these data provide some indication of possible advantages of some products and methods of application over others.

Adult↗
PubMed1993

Fluoride uptake by enamel in vitro following application of various topical fluoride preparations.

Two conventional topical fluoride preparations; APF and neutral 2% NaF gel and two fluoride varnishes; Duraphat and Fluor Protector, were applied to 60 permanent and 20 primary teeth. The teeth were halved to provide test and control groups, and the fluoride uptake was measured using a micro acid etch technique, after 30 seconds and 60 seconds etching periods. All topical fluoride preparations in our study caused some fluoride uptake in permanent and primary tooth enamel compared to the control groups. Duraphat and APF were found to be more effective than the other agents.

Acidulated Phosphate Fluoride↗
PubMed1989

[Topical fluorides--possible side effects].

The use of topical fluoride products is established as an effective method in caries prevention and might be a considerable extra source of fluoride. Following the use of topical fluoride products variable amounts of fluoride are swallowed and adsorbed into the systemic circulation, amounts which may be sufficient to produce some effects on physiologic and biochemical processes like dental fluorosis, changes in the structure and function of the gastric mucosa, kidney function and plasma and tissue cAMP levels. These possible side effects are all, except that of dental fluorosis, transient and reversible. For the purpose of enhancing the safety of topical fluoride application, several recommendations are mentioned all of which are designed to reduce the ingestion and absorption of fluoride.

Fluorides, Topical↗
PubMed1981

In vivo enamel fluoride uptake from and caries inhibition by topical fluoride agents.

Acidulated phosphate fluoride (APF), Duraphat or Fluor Protector, was applied to the molar teeth of rats fed a cariogenic diet. The first maxillary molar teeth were subjected to a microbiopsy procedure for fluoride analysis and the mandibular molars scored for caries. All three topical fluoride agents produced a significant increase in the fluoride content of the outermost 5.0 micron of enamel. Only APF produced a significant reduction in caries incidence at all sites.

Acidulated Phosphate Fluoride↗
PubMed1997

Effect of topical fluoride agents on the morphologic characteristics and composition of resin composite restorative materials.

STATEMENT OF PROBLEM: The high reactivity of fluoride agents used in topical fluoride treatments have raised important questions on their potential adverse effects on restorative materials. PURPOSE: The purpose of this study was to evaluate the effect of topical fluoride agents used for office or home treatments on the surface morphologic characteristics and composition of composite restoratives. MATERIAL AND METHODS: The fluorides used were Act, Phosflur, Gel II, Prevident, Stop, Butler APE, Nupro, and Omni Gel & Rinse. The composites tested were Brilliant DI, Heliomolar Ro, Herculite XRV, and P-50. The pH of the fluorides was measured as received and after dilution with water at a 1:3 volume ratio. The composites were subjected to the fluoride treatments until the total number of applications simulated the equivalent of 4 years under treatment. The changes induced on the surface morphologic features and composition of the restoratives were assessed by multiple internal reflectance Fourier transform infrared spectroscopy, scanning electron microscopy, and x-ray microanalysis. RESULTS: All fluorides showed an acidic pH that was not significantly changed after dilution, except Stop, which exhibited a significant pH reduction. All fluorides increased the amount of loosely bound water in the composite matrix. Butler APF gel was the most aggressive for Brilliant DI and Herculite XRV, leading to excessive surface degradation, porosity, destruction of the filler-matrix interface, filler dissolution, and debonding. A reduction in the extent of remaining C = C bonds was observed in Herculite XRV after Butler APF treatment; Phosflur, Gel II, and Prevident had a milder effect. Treatment of Brilliant Dl and Herculite XRV with Omni Gel & Rinse resulted in the formation of a stable precipitation layer rich in barium, phosphorus, tin, oxygen, and fluoride. P-50 was severely affected at the resin-matrix interface after Stop treatment, whereas Omni Gel & Rinse induced fewer surface changes. Heliomolar Ro was the least affected restorative regardless of the type of fluoride used.

Acidulated Phosphate Fluoride↗
PubMed1983

Fluoride uptake and retention in vitro following topical fluoride applications.

Fluoride uptake and retention on maxillary and mandibular incisors were compared using a conventional APF gel, a thixotropic gel, and a new pluronic-based fluoride gel. Based on the results of in vivo acid-etch biopsies, significant fluoride uptake was obtained with each of the three agents. The highly viscous pluronic gel may provide an alternative to conventional topical fluoride gels for subjects--e.g., handicapped persons--with whom a tray system is not feasible.

Adolescent↗
PubMed1997

In vitro evaluation of topical fluorides for overdenture abutments.

STATEMENT OF PROBLEM: Topical fluorides are effective, yet none have been developed specifically for root or dentin surfaces. PURPOSE: This study evaluated the ability of several commercial topical fluorides to protect overdenture abutments from in vitro acid demineralization. MATERIAL AND METHODS: Twenty extracted teeth from persons aged 50 to 70 years were prepared for overdenture abutments. The teeth were sectioned to provide 40 buccal and lingual halves, covered with nail varnish except for windows on the occlusal and root surfaces, and randomly divided into 4 groups of 10 specimens, which were cycled for 6 hours in acid demineralization, washed, and then held 17 hours in a remineralizing solution for 18 days. Before each cycle, the specimens were treated with either Karigel, Karigel-N, or a NaF solution. The control group was treated with fluoride-free solution. RESULTS: The depth of the artificial lesions on the root surfaces showed a statistically significant dose response. On the occlusal, there were no differences in lesion depth between the various topical fluorides and the control group. But there was a dose response when the remineralized band was subtracted from the lesion depth. Remineralization bands in the occlusal lesions were not evident in the control group, but were present in the fluoride groups. CONCLUSION: This study suggests that higher concentrations of NaF are more protective for overdenture abutments.

Aged↗
PubMed1983

Morphology of enamel surfaces treated with topical fluoride agents: SEM considerations.

Three topical fluoride agents deposited surface coatings of different morphology and thickness on intact human enamel surfaces. The agents studied were an acidic silane fluoride lacquer, a neutral NaF lacquer, and an APF gel. Each agent reacted with the enamel surface differently, producing its own distinctive etching pattern. The smallest particles observed in the surface coatings were from 20 to 30 nm in diameter and appeared to have indistinct morphologies. They often agglomerated into spherical globules ranging from 1-3 micron in diameter.

Acidulated Phosphate Fluoride↗
PubMed1990

Physicochemical perspectives on the cariostatic mechanisms of systemic and topical fluorides.

The cariostatic mechanisms of systemic and topical fluoride agents are considered in light of a previously proposed model for the caries process. It is noted that fluoride, in principle, can induce a cariostatic effect: by (1) reducing enamel solubility when incorporated into the mineral structure; (2) by fostering the remineralization of incipient enamel lesions and the deposition of fluoridated phases (within dental plaque) which provide a source of mineral ions (Ca, P, F) under acidic conditions; and (3) by reducing the net rate of transport of matter out of the enamel surface, under acidic conditions, by inducing the reprecipitation of fluoridated hydroxyapatite phases within enamel. It is also noted that relatively high (approximately 12,000 ppm) concentrations of professionally applied topical fluorides significantly reduce the rate of acid production of cariogenic organisms (e.g., S. mutans). Based on an analysis of available clinical and laboratory data, it is concluded that the benefits provided by water fluoridation result, to a large degree, from a topical effect. It is suggested that clinical procedures be developed to establish and maintain low levels of free fluoride in plaque fluid. It appears that this will require frequent exposure to topical fluorides.

Cariostatic Agents↗
PubMedDate not supplied

The use of topical fluoride to prevent or reverse dental caries.

Topical fluoride has been the main stay of caries prevention for many decades. There are several mechanisms which make it beneficial including inhibiting demineralization, enhancing remineralization, and inhibiting bacterial growth. Topical fluoride is available in many different forms. The concentrations of various fluoride preparations range from 225 parts per million (ppm) fluoride in over-the-counter oral rinses to 22,600 ppm in the fluoride varnishes. The clinician must decide which type of topical preparation is best suited for their patient. Patients with high caries risk may benefit from prescription strength fluorides (along with the other chemical and dietary therapies described in this issue of Special Care in Dentistry). The application of fluoride varnish is an excellent topical form for those patients who have access to dental care and for whom it is difficult to comply with the use of other topical forms.

Cariostatic Agents↗
PubMed2000

Professionally applied topical fluoride and restorative care in insured children.

OBJECTIVES: This study evaluates the association between use of professionally applied topical fluoride and use of interproximal restorations in primary and permanent teeth of children. METHODS: Insurance claims from 15,190 children, for treatment provided by 1,556 different dentists, were analyzed to look for associations between frequency of use of professionally applied topical fluoride and use of interproximal restorations. The average follow-up period for the children included in the analysis was 5.3 years, with the range from 3.0 to 7.9 years. RESULTS: Both tabular and regression results failed to demonstrate an association between frequency of use of professionally applied topical fluoride and use of interproximal restorations in either the primary or permanent dentition. The most powerful predictor of restorative care for these children was the overall propensity of the dentist to place restorations in children. CONCLUSIONS: In this group of insured children, we were unable to find an association between the frequency of use of professionally applied topical fluoride and restorative care. Further, despite numerous recommendations that professionally applied topical fluorides should be used only in moderate- and high-caries children, approximately two-thirds of these children received topical fluoride at every recall visit, nearly two times per year.

Adolescent↗