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PubMedDate not supplied

Demineralization inhibition at glass-ionomer cement and amalgam restoration margins in conjunction with additional fluoride regimens.

The purpose of this study was to evaluate demineralization inhibition at restoration gingival margins. The study compared the effectiveness of a fluoride-releasing restorative material and topical fluoride regimens utilized individually and in conjunction with fluoridated materials. Glass-ionomer restorations demonstrated significantly less dentin demineralization than amalgam restorations at restoration margins when the restorations were exposed to no external fluoride, when the restorations were brushed with a fluoridated dentifrice twice per day, and when the restorations were exposed to a fluoride rinse (p, 0.05). There was no significant difference in dentin demineralization adjacent to glass-ionomer and amalgam restorations when both a fluoride rinse and a fluoridated dentifrice were used on a daily basis over 30 days, in vitro.

Cariostatic Agents↗
PubMedDate not supplied

Views on oral health care strategies.

The Oral Health Programme (ORH) is a health promotion and disease prevention initiative. ORH should be integrated into primary health care programmes by building policies suited to each country and based on the common risk factor approach. Dental caries and periodontal diseases are highly prevalent in recommended. Although cost-effective, water and salt fluoridation are often unavailable and topical fluorides are recommended. Governments and industry must ensure availability of affordable fluoride toothpaste. Fluoride toothpaste should also be used to control periodontal diseases. The atraumatic restorative treatment approach should be used to treat dental caries. The Basic Package of Oral Care (BPOC) for deprived communities outlines this approach in detail. Continuous training and research are recommended for personnel to keep pace with changes in methods of prevention and treatment procedures.

Child↗
PubMed1990

Dietary fluoride supplements for Ohio children--the role of the physician.

1. All children should receive one form of systemic fluoride and appropriate forms of topical fluoride. 2. If a child is not receiving optimally fluoridated water, the physician or dentist should prescribe dietary fluoride supplements (tablets or drops). 3. The correct dosage must be determined based on patient age and fluoride content of the patient's main water source(s). 4. Special attention is necessary concerning fluoride intake for children breast-feeding or consuming infant formula. 5. To determine the correct fluoride dose, these steps should be followed: A. Always have a sample of the main drinking water source (usually home water) analyzed for the fluoride content before prescribing a fluoride supplement, if you do not have other specific knowledge of water fluoride content. The Ohio Department of Health, Division of Laboratories can provide water fluoride-testing services. B. When the fluoride content of the water has been determined, the fluoride level and the child's age should be compared to the Supplemental Fluoride Dosage Schedule to identify the correct supplement dose. 6. The Division of Dental Health, Ohio Department of Health can provide a list of communities that are optimally fluoridated. Please contact: Ohio Department of Health Division of Dental Health 246 N. High Street Columbus, Ohio 43266-0588 (614) 466-4180

Administration, Oral↗
PubMed1989

Dietary fluoride supplements for children--the role of the physician.

1. All children should receive one form of systemic fluoride and appropriate forms of topical fluoride. 2. If a child is not receiving optimally fluoridated water, the dentist or physician should prescribe dietary fluoride supplements (tablets or drops). 3. The correct dosage must be determined based on patient age and fluoride content of the patient's main water source(s). 4. Special attention is necessary concerning fluoride intake for children breast feeding or consuming infant formula. 5. To arrive at the correct fluoride dose, these steps should be followed: A. Always have a sample of the main drinking water source (usually home water) analyzed for the fluoride content before prescribing a fluoride supplement, if you do not have other specific knowledge of water fluoride content. The Medical College of Georgia (Department of Oral Biology - Dr. Whitford) provides water fluoride assay services. B. When the fluoride content of the water has been determined, the fluoride level and the child's age should be matched on Table 1 to arrive at the correct supplement dose. 6. Dr. Alderman, Director of the Office of Dental Health, Division of Public Health, Georgia Department of Human Resources, can provide lists of communities in Georgia that are optimally fluoridated.

Adolescent↗
PubMed2003

Fluoride release by restorative materials before and after a topical application of fluoride gel.

The release of fluoride from restorative materials (Vitremer, Ketac-Fil, Fuji II LC and Freedom) was evaluated during two 15-day periods, before and after a topical application of acidulated phosphate fluoride gel (APF). For each material, 6 specimens were made, which were immersed in 2 ml of deionized water. The fluoride concentration dosages in the solutions were read at intervals of 24 hours for 15 days. After this period, the specimens of each material received treatment with APF gel for 4 minutes and the fluoride released was analyzed at 24-hour intervals during the following 15 days. The analysis of variance and the Tukey test (p < 0.05) showed that the total mean fluoride released during the initial 15 days was greater for Vitremer and Ketac-Fil and lower for Fuji II LC and Freedom; and in the final 15 days there was a difference in release readings, with the greatest value for Vitremer, followed by Fuji II LC, Ketac-Fil and Freedom. The comparison of the results between the 1st day and the 16th day (after gel application) showed a greater fluoride release on the 16th day for Vitremer, Fuji II LC and Freedom and was equal for Ketac-Fil. Although all the materials evaluated gained fluoride with the application of APF, the data suggest that the resin-modified ionomers are more efficient in releasing fluoride to the medium than the other materials.

Acidulated Phosphate Fluoride↗
PubMed1988

Intra-oral retention of fluoride by bovine enamel from amine fluoride toothpaste and 0.4% amine fluoride liquid application.

The purpose of this study was to compare in vivo fluoride accumulation in enamel and in enamel lesions from a single topical fluoride application and daily toothbrushing with a fluoride dentifrice. Amine fluoride preparations were used for both products. Intra-oral appliances with bovine enamel specimens were worn by volunteers during a period of seven weeks. After this period, the specimens were analyzed for fluoride uptake and change in demineralization susceptibility. The results demonstrated that lesions had a high fluoride uptake capacity. Fluoride content values increased by 25-30 micrograms/cm2 during a single topical application, as compared with 10-15 micrograms/cm2 during seven weeks of toothbrushing. About half the fluoride acquired as a result of topical treatment was lost during subsequent exposure to the oral fluids when no further fluoride supplementation was given. The uptake of fluoride by sound enamel was comparatively small, regardless of the use of fluoride dentifrice or application. The presence of mature plaque at the time of fluoride application did not affect the amounts of fluoride delivered. Acid susceptibility tests showed that the enamel solubility exhibited a negative correlation with fluoride content of the specimens.

Amines↗
PubMed1991

Studies of fluoride varnishes in Finland.

Despite the artificial fluoridation of drinking water in Kuopio, part of the children have high caries incidence. We therefore started our studies on fluoride varnishes in 1977 in an attempt to find a feasible means of applying fluoride topically in children at high risk of caries. In our first trial, the sodium fluoride varnish Duraphat was found to be effective in preventing caries, but the effectiveness of the silane fluoride varnish Fluor Protector could not be unequivocally established, despite the fact that Fluor Protector deposited markedly more fluoride in enamel than Duraphat. In a second study in children in a low-fluoride area, use of Duraphat was found to be more effective than fortnightly fluoride rinses or Fluor Protector. Increasing the frequency of application from two to four times a year did not increase the effectiveness of Duraphat even in highly caries-prone children in a 2-year trial. On the basis of peak values of fluoride in parotid saliva after application, use of either fluoride varnishes was considered safe. Although the fluoride content of the enamel remained elevated for at least two years after discontinuation of treatment with both varnishes, the caries preventive effect did not continue after the applications were stopped. This shows that increasing the fluoride content of enamel is not the main mechanism by which fluoride varnishes prevent caries, and that the applications need to be continued as long as caries is a problem.

Adolescent↗
PubMed1990

[In vitro uptake of fluoride from South African fluoride gel dentifrices].

An increasingly difficult situation in obtaining imported products has led to the development of a locally-manufactured topical fluoride gel. In order to evaluate the anticariogenic potential of the gel an in vitro study was conducted to compare the fluoride (F) uptake into the enamel from the locally-manufactured gel with that of two overseas products. Sound, unerupted third molar teeth were used in the study. One half of the buccal surface of each tooth was used as a control and the remaining half for conducting the experiment. Enamel biopsies (0.5 N HCLO4 3,143 mm2; 15 sec) were conducted prior to the F treatment (control halves) as well as 24 hours after F treatment (experimental halves). The fluoride concentrations ([F]) of the etching solutions were analyzed according to the potentiometric analytical method. The calcium concentrations were determined by means of a flame spectrophotometer. The [F] of the control halves of the teeth were used as a reference to determine the actual F uptake in the experimental halves after F treatment. The results obtained from the study showed that the teeth treated with the locally-manufactured F gel, revealed a significant uptake of fluoride in the enamel as well as an increased resistance to acid dissolution. Only one of the imported products showed a statistically significant higher fluoride uptake than the acidulated South African manufactured phosphate fluoride gel. There was a favourable overall comparison of the locally manufactured F gel with that of the overseas products.

Dentifrices↗
PubMed2000

Caries preventive knowledge and practices among dental hygienists.

PURPOSE: The aim of this study was to determine the knowledge, opinions, and practices of dental hygienists in the areas of dental caries etiology and prevention. METHODS: A pretested, validated 35-question survey instrument was mailed to a one percent national, stratified random sample of dental hygienists in the United States (n = 960) in October 1996. Four complete mailings of the instrument resulted in a 67% response rate, of which 77% were useable (n = 498). Respondents were asked if they agreed or disagreed with statements on caries etiology and preventive procedures, and also asked to rate the effectiveness of procedures for preventing dental caries in children and adults. Data were analyzed using descriptive statistics, t-tests, and ANOVA. RESULTS: Overall level of knowledge of caries etiology and preventive procedures was low. More than 40% of subjects did not recognize that remineralization is the most important mechanism of action of fluoride, and fewer than 50% recognized that dental caries is a chronic infectious disease. Analysis of four factors thought to be related to knowledge and practice showed that younger graduates, more recent graduates, and ADHA members were more knowledgeable about the effectiveness of caries preventive procedures for children (p < .01). Although an overwhelming majority correctly agreed that adults benefit from fluoride and that root caries is an emerging problem, this knowledge was inconsistent with practice (p = .02). Fewer than 35% reported that they provide fluoride to adults of any age, or they wait until the disease is present. For children and adults who did receive fluoride treatments, a one-minute application of an APF gel or foam was most often provided. CONCLUSIONS: Correct information about the etiology and prevention of dental caries is a predisposing factor to making informed decisions. Overall, respondents overrated the effectiveness of flossing and toothbrushing while underrating the effectiveness of fluorides. In the majority of cases, efficiency rather than efficacy was given priority when providing a topical fluoride treatment. An improved understanding of dental caries etiology and the scientific evidence for appropriate caries preventive procedures will allow dental hygienists to prevent and manage this disease better.

Acidulated Phosphate Fluoride↗
PubMedDate not supplied

Current understanding of the epidemiology mechanisms, and prevention of dental caries in preschool children.

The seriousness and societal costs of dental caries in preschool children are enormous. National data shows that caries is highly prevalent in poor and near poor US preschool children, yet this disease is infrequently treated. The etiology includes elevated colonization levels of mutans streptococci, high frequency sugar consumption, and developmental defects on primary teeth. A necessary first step in preventing dental caries in preschool children is evaluating the child's caries risk factors that include socioeconomic status, previous carious experience, presence of white spot lesions, presence of visible plaque, perceived risk by dental professionals, and microbiologic testing for the presence or quantity of mutans streptococci. Based on this knowledge, different preventive strategies, as well as different intensities of preventive therapies, can be employed. Caries preventive strategies in preschool children include diet modifications to reduce high frequency sugar consumption, supervised tooth brushing with fluoridated dentifrice, systemic fluoride supplements to children living in a nonfluoridated area that are at risk for caries, professional topical fluoride with fluoride varnish, and sealants for primary molars.

Cariostatic Agents↗
PubMedDate not supplied

Remineralisation of enamel lesions with daily applications of a high-concentration fluoride gel and a fluoridated toothpaste: an in situ study.

The inhibition of enamel demineralisation and the enhancement of remineralisation are positively but not linearly related to the concentration of fluoride, especially when high fluoride concentrations are used. The aim of this in situ experiment was to determine the maximum amount of enamel remineralisation that can be achieved with daily applications of very high concentrations of fluoride. For this purpose we compared the efficacy of a daily application of fluoridated topical gel (12500 ppm F, partly as NaF, Olafluor and Dectafluor, pH 4.5) in combination with a fluoridated toothpaste (1450 ppm F as NaF), with fluoridated toothpaste alone. Participants (n = 26, with partial dentures) were fitted with a demineralised enamel specimen (mean mineral loss of 1674 vol%.micro m) and were instructed to use one of the two fluoride treatments. After 4 weeks of treatment, the specimens were retrieved, a section was cut and analysed with microradiography. The remainder of each of the specimens was used for analysis of the 'loosely bound' and 'bound' fluoride. Fluoride was measured with gas-liquid chromatography. After 4 weeks in the mouth, the original lesion was reduced in size by 54% in the toothpaste + gel group (n = 14) and by 44% in the toothpaste-only group (n = 12), but the difference between the groups was not statistically significant. The mineral content profiles showed remineralisation of the lesions throughout the depth of the lesion. The enhancement of remineralisation by the high amounts of fluoride was most pronounced in the surface layer. For both the 'loosely bound' and 'bound' fluoride, a statistically significant increase in fluoride concentration could be found in the toothpaste + gel group. In the 4-week in situ period the use of high amounts of fluoride resulted in a maximum remineralisation rate. This is illustrated by an increase in remineralisation and higher fluoride concentrations in the toothpaste + gel group compared to the toothpaste-only group.

Dental Enamel↗
PubMed1992

Uptake of KOH-soluble and KOH-insoluble fluoride in sound human enamel after topical application of a fluoride varnish (Duraphat) or a neutral 2% NaF solution in vitro.

The uptake of alkali-soluble fluoride (calcium fluoride-like material and adsorbed fluoride) and alkali-insoluble fluoride (apatitically bound fluoride) on sound human enamel from treatment with Duraphat or a neutral 2% NaF solution was investigated in vitro. Blocks from impacted third molars were used. More fluoride was deposited on the enamel from the neutral 2% NaF solution than from the Duraphat treatment. All the fluoride could be dissolved in alkali. Globules of calcium fluoride-like material were demonstrated by scanning electron microscopy. Chemical analysis showed no measurable increase in the apatitically bound fluoride (alkali-insoluble fluoride) after brief exposures. Duraphat-treated samples submerged in water after the exposure lost only about 50% of the deposited fluoride, whereas samples treated with 2% NaF are known to lose all their fluoride under similar circumstances, a condition which may be related to the favorable clinical effect of Duraphat.

Acid Etching, Dental↗
PubMed2002

Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children.

Untreated dental caries in Chinese pre-school children is common. This prospective controlled clinical trial investigated the effectiveness of topical fluoride applications in arresting dentin caries. Three hundred seventy-five children, aged 3-5 years, with carious upper anterior teeth were divided into five groups. Children in the first and second groups received annual applications of silver diamine fluoride solution (44,800 ppm F). Sodium fluoride varnish (22,600 ppm F) was applied every three months to the lesions of children in the third and fourth groups. For children in the first and third groups, soft carious tissues were removed prior to fluoride application. The fifth group was the control. Three hundred eight children were followed for 30 months. The respective mean numbers of arrested carious tooth surfaces in the five groups were 2.5, 2.8, 1.5, 1.5, and 1.3 (p < 0.001). Silver diamine fluoride was found to be effective in arresting dentin caries in primary anterior teeth in pre-school children.

Analysis of Variance↗
PubMed2001

Caries-preventive effects of fluoride products when used in conjunction with fluoride dentifrice.

Toothbrushing with fluoride dentifrice has become an important public health measure in preventing caries and gingivitis. Since the fluoride concentration in dentifrices does not provide absolute protection for everyone and is limited by legal regulations, the question about the efficacy of additional use of topical fluoride products arises. In children aged 9-15 years, the biannual application of Duraphat varnish in school-based programmes provides a caries inhibition of 38%. A caries inhibition of up to 40% can also be achieved by gels containing 1.25% fluoride, if applied 30 times per year. In subjects with a risk of root caries, the daily use of a 250-500 ppm fluoride solution seems to be advisable.

Adolescent↗
PubMed1997

Paediatric dentistry discussion paper and case report. Management of small carious lesions in primary teeth: caries removal versus fluoride application and periodic 'observation' until exfoliation.

Differences in treatment rationale exist between dental practitioners with respect to the management of small carious lesions in primary teeth. Some do not consider it necessary to use a conventional restorative approach, preferring to apply topical fluoride and/or 'monitor' the lesion(s). This paper advocates the alternative approach which entails complete caries removal by mechanical means, the rationale being to eliminate the pool of cariogenic microorganisms and thereby protect sound teeth from succumbing to carious attack. A case is presented to illustrate the extent to which caries can progress and also involve other teeth if small cavitated lesions are simply treated by 'spot' application of fluoride. Clinical treatment of caries must be based on scientific knowledge of the microorganisms involved and an understanding of its transmissible and infectious nature.

Child, Preschool↗
PubMedDate not supplied

Observations on dental caries in primary teeth after frequent fluoride toplications in a program involving other preventives.

The anticaries effect of repeated toplications with APF gel was assessed in the primary dentition of 2-6-year-olds after 8, 18 and 28 months. Frequent, but less than daily, topical fluoride therapy appeared to have little effect in pre-school children consuming water-borne fluoride and receiving other traditionally recommended modalities of prevention.

Acidulated Phosphate Fluoride↗
PubMedDate not supplied

Dental visits and professional fluoride applications for children ages 3 to 6 in Iowa.

PURPOSE: The purpose of this study was to report the occurrence of having a dental visit and/or a topical fluoride treatment from age 36 months to 72 months among a cohort of children followed longitudinally since birth. METHODS: Families of children enrolled in a study of fluoride ingestion were asked about their children's dental appointments and office fluoride treatments occurring during the time interval since the previous mailed questionnaire. Percentages of children who had at least 1 dental visit and at least 1 fluoride treatment during each 6-month period, each year of life, and cumulatively from birth were calculated separately. Factors related to dental visits were assessed using generalized linear models. RESULTS: Among those with complete data, 71% reported a visit cumulatively from birth to 48 months, 89% from birth to 60 months, and 96% by age 72 months. Similarly, 27% reported a professional fluoride treatment by 48 months, 44% by 60 months, and 66% by 72 months. CONCLUSIONS: Among children who had not been seen by a dentist by age 3, almost all were seen by age 6. Similarly, among those who had no professional fluoride treatment by age 3, almost two-thirds received one by age 6.

Adult↗