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PubMed1983

Fluoride absorption: a comparative study of 1 and 2% fluoride gels.

The systemic fluoride absorption following topical fluoride gel application has been monitored in two groups of 6 healthy volunteers. Plasma F- levels and urinary fluoride excretion were measured after the use of a 1% and of a 2% gel preparation (commercial products). The resorption of these gels seems lower than reported previously for other preparations. Creatinine clearance remained unaffected after a single application of the gels in healthy subjects.

Absorption↗
PubMed2001

Association of caries experience in 12-year-old children in Heidelberg, Germany, and Montpellier, France, with different caries preventive measures.

UNLABELLED: In Germany and France, different approaches to oral health promotion have been chosen. OBJECTIVES: It was the aim of the present study to assess whether different preventive measures were positively or negatively associated with caries experience in 12-year-old children in Heidelberg, Germany, and in Montpellier, France. METHODS: In the school year 1998/99, 12-year-old children were examined in Heidelberg (n=864) and in Montpellier (n =828). D3+4MFT, D3+4MFS (D3+4=dentinal caries), prevalence of fissure sealants and use of fluorides were recorded. RESULTS: The mean D3+4MFT scores of the pupils in Heidelberg and Montpellier were 1.56 and 1.42, the proportion of caries-free children being 43.5% and 46.9%, respectively. In 63.2% of the children in Heidelberg and in 6.8% of the children in Montpellier, at least one fissure sealed tooth was found. Fluoridated salt was used by 38.8% of families of the 12-year-olds from Heidelberg and the corresponding value was 73.3% in Montpellier. Topical fluorides were applied by 39.9% of the children in Heidelberg, but only by 5.4% of pupils in Montpellier. Multiple regression analysis revealed that, in Heidelberg, fissure sealants and the combination of topical fluorides and fluoridated salt were negatively associated with the D3+4MFT values, while in Montpellier the frequency of dental visits was positively associated with the D3+4MFT scores. CONCLUSION: A further decrease in the caries experience of 12-year-old children may well be obtainable by enlarging the share of marketed fluoridated salt in Heidelberg, by increasing the application of fissure sealants in Montpellier, and by extending the use of topical fluorides in both cities.

Chi-Square Distribution↗
PubMed1983

Fortnightly fluoride rinsing combined with topical paintings with a fluoride solution containing Fe- and Al-ions.

In clinical trials conducted for three and five years respectively the combined effect of fortnightly sodium fluoride rinsing and topical painting every fourth month with a ferric aluminum fluoride solution was found to be significantly more caries preventing than the combined effect of fortnightly sodium fluoride rinsing and topical painting every fourth month with a neutral 0.2% sodium fluoride solution.

Aluminum↗
PubMed1995

Periodic health examination, 1995 update: 2. Prevention of dental caries. The Canadian Task Force on the Periodic Health Examination.

OBJECTIVE: To make recommendations, based on current evidence, for practising physicians and dentists on interventions for the prevention of dental caries in their patients. OPTIONS: Systemic fluoride administration, professionally administered fluoride, use of fluoride mouth rinses, fissure sealants, oral-hygiene practices, dietary practices, identification of groups at a high risk of dental caries, and early diagnosis and treatment. OUTCOMES: Reduced prevalence of dental caries and fluorosis, longer retention of teeth and lower treatment costs. EVIDENCE: Several MEDLINE searches were conducted for articles published from January 1980 to December 1992, including relevant review articles. VALUES: Relevant clinical findings were evaluated and categorized with the use of the evidence-based methods and values of the Canadian Task Force on the Periodic Health Examination. Recommendations were developed for each method of caries prevention, with reduced incidence of dental caries and improved prevalence of caries-free teeth given high values. BENEFITS, HARMS AND COSTS: The potential benefits of these measures in the long-term are a lower incidence of tooth decay, longer retention of teeth and prevention of fluorosis. The cost saving can be considerable for patients and insurers; however, implementation of some recommendations will be difficult, since the traditional preventive practices of dentists and dental hygienists are not easily changed. RECOMMENDATIONS: There is good evidence that the following manoeuvres are effective in preventing dental caries: use of dentifrices containing fluoride, fluoridation of drinking water, fluoride supplements for patients in areas where there is a low level (0.3 ppm or less) of fluoride in the drinking water, professionally applied topical fluoride and the use of fluoride mouth rinses for patients with very active decay or at a high risk of dental caries and selective use of professionally applied fissure sealants on permanent molar teeth. There is poor evidence that the following manoeuvres are effective in preventing dental caries: professionally applied topical fluoride and the use of fluoride mouth rinses for patients with a low risk of caries, toothbrushing (without a dentifrice containing fluoride) and flossing, cleaning of teeth by a dentist or dental hygienist before topical application of fluoride or at a dental visit and dietary counselling for the general population. There is good evidence to recommend against the use of over-the-counter fluoride mouth rinses by the general population. VALIDATION: These guidelines are compatible with those of the US Preventive Services Task Force. SPONSOR: These guidelines were developed and endorsed by the task force, which is funded by Health Canada. Major funding was provided by the Faculty of Dentistry of the University of Toronto, Toronto and the Faculty of Dentistry of Dalhousie University, Halifax.

Canada↗
PubMed1988

Adoption of fluoride-based caries preventive innovations in a public dental service.

In dentistry comparative studies of diffusion of disease preventive innovations are rare and usually atheoretical. For these reasons the present study was designed 1) to determine whether or not normal distribution assumptions applied to decisions to adopt caries preventive fluoride programs in a public dental service; 2) to compare rates of adoption of two school-based and one clinic-based fluoride program, and 3) to look for evidence indicating which type of decision-making may have been involved. The programs studied were school-based fluoride brushing 4-5 times per year, fluoride mouthrinsing at least once a month, and professional topical fluoride applications at least once a year. Data were collected by postal questionnaires from public dental officers in Norway in 1972, 1977 and 1982. To determine the length of time which had elapsed from the time of innovation of the technologies to adoption, the dental literature was reviewed. The adoption curves for school-based fluoride brushing and rinsing, as well as for clinic-based topical fluoride application did not comply with the normal distribution assumption. The time lapse from innovation to adoption was in excess of 10 yr and the rates of adoption differed between programs. Decision-making would appear to have been primarily individual or collective. It was concluded that generalization beyond the innovations studied and the social and organizational setting of this particular investigation is inadmissible. Consequently, there is a need for more and larger scale comparative analytical studies to increase our understanding of diffusion and adoption of innovations in dentistry.

Adolescent↗
PubMed2003

Irradiation of dental enamel with Q-switched lambda = 355-nm laser pulses: surface morphology, fluoride adsorption, and adhesion to composite resin.

BACKGROUND AND OBJECTIVES: Lasers can be used to modify the chemical composition of dental enamel to increase the bond strength to restorative materials and to render the mineral phase more resistant to acid dissolution. Previous studies have suggested a synergistic relationship between CO(2) laser irradiation and fluoride treatment on increased resistance to acid dissolution. In this study a near-UV laser operating with lambda = 355-nm laser pulses of 3-5 nanoseconds duration was used to modify the surface morphology of dental enamel to increase the bond strength to restorative materials and increase the uptake of topical fluoride to render the surface more resistant to acid dissolution. We hypothesize that the short UV laser pulses are primarily absorbed by protein and lipid localized between the enamel prisms resulting in removal of intact mineral effectively etching the surface without thermal modification of the mineral phase. Such modification is likely to increase the permeability of the enamel surface and the subsequent absorption of fluoride. In addition, there is an increase in surface roughness without the formation of a layer of loosely adherent, thermally modified enamel that increases the bond strength to composite restorative materials. STUDY DESIGN/MATERIALS AND METHODS: The surfaces of blocks of bovine enamel, 5 x 5 mm(2), were uniformly irradiated by 355-nm laser pulses and subsequently bonded to composite. The shear bond test was used to assess the bond strength of non-irradiated blocks (negative control), acid etched blocks (positive control), and laser irradiated blocks. The resistance to acid dissolution was evaluated using controlled surface dissolution experiments on irradiated samples, irradiated samples exposed to topical fluoride, and non-irradiated control samples with and without fluoride. RESULTS: The laser surface treatments significantly increased the shear-bond strength of enamel to composite, to a level exceeding 20 MPa which was significantly more than the non-irradiated control samples and significantly less than the acid etch. Laser irradiation alone and topical fluoride application alone did not significantly increase the resistance to acid dissolution. The laser treatment followed by topical application of fluoride significantly increased the resistance to acid dissolution to a level of over 50% versus the control samples. CONCLUSIONS: We present a novel method for increasing bond strength to restorative materials and enhancing fluoride delivery to enamel surfaces and shed some light on the underlying mechanisms of caries inhibition via laser treatment and topical application of fluoride.

Animals↗
PubMed1989

Enamel fluoride and caries in Icelandic children and a comparison of enamel fluoride in Swedish and Icelandic children.

The fluoride content in surface enamel and its relationship to caries experience was studied in a group of Icelandic schoolchildren living in a low-fluoride area. Fluoride content was assessed by means of in vivo enamel biopsies sampled from 248 subjects aged 11 and 12 years. Dental examinations were performed in conjunction with the biopsy sampling and by the same examiner 1 year later. The prevalence and incidence of initial (DSI) and manifest (DFS) caries lesions were recorded separately. A median fluoride concentration of 610 ppm at a median biopsy depth of 4.2 microns was observed. A significant positive correlation was found between DSI and enamel fluoride content in girls and all older children. Additionally, surface enamel fluoride was measured in 72 Swedish children from a low-fluoride area but exposed to regular topical fluoride treatments. The difference in mean fluoride concentrations between the Icelandic and Swedish study populations was highly significant. From the measured fluoride concentrations the enamel fluoride profiles for both study populations were constructed. The differences in fluoride content were most pronounced in the outermost layer, apparently reflecting the higher exposure to and acquisition of topical fluoride in the Swedish children.

Age Factors↗
PubMed1997

Arrest of root surface caries in situ.

This study tests the hypothesis that daily oral hygiene combined with topical fluoride arrests active root-surface caries lesions without changing the mineral content of the lesions. Therefore, changes in mineral content and distribution were studied in root surfaces during caries lesion development and subsequent arrest of lesion progression in situ. In 18 subjects, lesions were developed during 3 months in sound root-surface specimens inserted into lower partial dentures. After 3 months, ground sections were prepared from each lesion prior to re-insertion of the specimens into the dentures. In addition, one sound root specimen was added per subject. During the following 3 months, half of the subjects cleaned both sound and carious specimens once a day with an 1100-ppm fluoride toothpaste, and the specimens were treated twice with 2% NaF for 2 min in situ. The other half of the subjects continued the experiment without cleaning. During the initial three-month period, all specimens developed subsurface lesions extending 187 to 583 microm into the dentin. Lesion depth increased somewhat in both experimental groups during the following 3 months (P > or = 0.1). There was a non-significant increase in mineral loss in the plaque-covered specimens (P = 0.08). However, the total mineral content of specimens subjected to plaque removal and topical fluoride did not change. This treatment resulted in an increased mineral content in the surface layer (P < 0.01) and formation of a zone of higher mineral content within the body of the lesion. The sound root surfaces which had been cleaned for a three-month period showed mineral uptake in the surface layer, occasionally associated with subsurface demineralization extending 20 to 70 microm into the tissue. The mineral loss of these specimens was significantly smaller than that of plaque-covered surfaces (P < 0.001). It is concluded that daily plaque removal and topical fluoride use influence the distribution of mineral in sound and carious root surfaces and may arrest lesion progression without affecting the total mineral content.

Aged↗
PubMed2004

Effect of diode laser and fluoride varnish on initial surface demineralization of primary dentition enamel: an in vitro study.

INTRODUCTION: Previous investigations have demonstrated improved enamel caries resistance after laser irradiation. The purpose of this in vitro study was to assess the caries-preventive potential of 809 nm diode laser treatment of the enamel of primary teeth compared to topical fluoride application. METHODS: Eighty samples of sound primary teeth were embedded in plastic and stored in saline solution. The enamel surface of 80 samples was polished in an area of 2 x 2 mm. These tooth specimens were randomly assigned to one control and three test groups: (1) no treatment/control; (2) application of 0.1 mg of fluoride varnish (Duraphat) for 6 h; (3) diode laser application (809 nm, 140 mJ, 50 Hz, Ø 600 micro m fibre, contact mode, absorber, 1 min; ORA-LASER01 I.S.T.); and (4) combined application - laser/fluoride varnish. Caries-like lesions were created by pH-cycling. After lesion formation, longitudinal sections were taken and examined by polarized light microscopy. RESULTS: In the control group, all samples showed lesions up to 30 micro m in depth. After laser application, lesions could be identified in 15 out of 20 samples. Topical fluoride treatment in groups 2 (varnish) and 4 (laser/varnish) completely inhibited the development of caries-like lesions in all samples. CONCLUSION: In this in vitro investigation, topical fluoride treatment enhances the resistance of sound enamel of primary teeth more effectively than diode laser application.

Chi-Square Distribution↗
PubMed2005

The effectiveness of two antibacterial regimens on salivary mutans streptococci and lactobacilli in children.

This study aimed to evaluate the long-term effect of the topical use of an iodine agent on the salivary mutans streptococci (MS) and lactobacilli (LB) and compare it with the professionally applied topical fluoride. The study included 54 children with high caries activity. Children received one application of topical fluoride gel (APF) then they were divided into two groups. In group I, twenty seven patients received topical application of fluoride gel weekly for 4 weeks followed by one application of fluoride gel every 3 months for one year. For group II, 10% povidone iodine was carried out weekly for 4 weeks for 27 patients followed by alternative applications of fluoride gel or povidone iodine every 3 months for one year. Bacteriological evaluation was done at base line, after 1, 3, 6 and 12 months. Saliva samples were grown on selective culture media. The differences between the two groups were evaluated at the end of the study. Drop out of patients was reported throughout the different evaluation periods. The results were evaluated statistically and showed no statistical significant difference between the two groups. It is concluded that iodine solution reduced the number of caries related microorganisms as compared to the base line. Antimicrobial approaches need more studies to confirm the findings and optimize the regimens.

Acidulated Phosphate Fluoride↗
PubMedDate not supplied

Prediction of caries in pre-school children in relation to fluoride exposure.

The levels of salivary mutans streptococci and caries experience were used as predictors for caries incidence in 3 groups of pre-school children from areas with different levels of natural and topical fluoride exposure. Altogether 1022 children, 4-5 years of age at baseline, were examined according to the WHO-criteria and followed for 2 years. The low fluoride group (n = 374) had a low fluoride level in the piped water and no topical fluoride applications; the F-varnish group (n = 442) had low water fluoride but semiannual topical applications of a fluoride varnish; the optimal fluoride group (n = 206) had an optimal level of fluoride in the drinking water and semiannual F-varnish applications. The number of salivary mutans streptococci was estimated and scored at baseline with the Strip mutans chair-side method. The sampling procedure was repeated in 337 children of the low fluoride group 3 weeks after baseline. In comparison with the low fluoride group, caries incidence was 30% and 60% lower in the F-varnish and the optimal fluoride group respectively. The caries predictive ability decreased with increasing fluoride exposure. The sum of sensitivity and specificity decreased from 151% (65% + 86%) in the low fluoride group to 131% (40% + 91%) in the optimal fluoride group. The positive predictive value was highest (62%) in the low fluoride group. Repeated salivary samplings at baseline did not improve the caries predictive power. The results suggest that the overall fluoride exposure should be taken into account when caries risk assessment strategies for preschool children are developed and implemented.

Child, Preschool↗