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(1/124) The effect of triclosan toothpaste on enamel demineralization in a bacterial demineralization model.

Triclosan has been incorporated into toothpaste to enhance inhibitory effects on bacterial metabolism in dental plaque. Many studies have confirmed these effects by showing a reduction of accumulation of dental plaque, gingivitis and calculus. However, there is no evidence for triclosan having an inhibitory effect on the dental plaque-induced demineralization of the dental hard tissues. Therefore, the effect of 0.3% triclosan added to non-fluoride and fluoride toothpaste was tested in an in vitro model, in which bovine enamel specimens were to be demineralized by acids produced in overlaying Streptococcus mutans suspensions. In a first set of experiments the toothpastes were added to the S. mutans suspensions at 1:100, 1:1000 and 1:10,000 (w/v) dilutions. After 22 h incubation at 37 degrees C the suspensions were removed and assessed for calcium and lactate content, and pH. In this set of experiments, triclosan had no additive protective effect to the non-fluoride or fluoride toothpaste. In a second set of experiments, the enamel specimens were immersed daily for 3 min in 30% (w/v) slurries of the toothpastes before the 22 h incubation with the S. mutans suspensions. Under these conditions, triclosan showed an additional protective effect compared with non-fluoride toothpaste at a low concentration of S. mutans cells (0.07 mg cells dry weight per 600 microL suspension). It is concluded that the enamel surface may act as a reservoir for triclosan, which may protect the enamel surface against a mild acid attack. In combination with fluoride, however, as in toothpaste, triclosan has no additional protective effect against demineralization.  (+info)

(2/124) A retentive system for intra-oral fluoride release during orthodontic treatment.

The aim of this study was to test a particular type of intra-oral fluoride releasing device (IFRD), designed to release 0.04 mg/day of fluoride over a period of 6 months, using customized holders, in patients receiving orthodontic treatment. Discomfort, holder detachment, plaque accumulation near the device, and the presence of gingivitis, bleeding, white spot lesions, and/or decay was recorded in 76 orthodontic patients (53 experimental and 23 controls) before and after wearing the device for 12 months. The system proved to be easy and quick to use, and did not cause discomfort. There were no significant differences between the treated and the control groups for plaque index, bleeding, or the presence of gingivitis. In addition, no carious and/or white spot lesions occurred during the duration of this study in the test group.  (+info)

(3/124) Recommendations for using fluoride to prevent and control dental caries in the United States. Centers for Disease Control and Prevention.

Widespread use of fluoride has been a major factor in the decline in the prevalence and severity of dental caries (i.e., tooth decay) in the United States and other economically developed countries. When used appropriately, fluoride is both safe and effective in preventing and controlling dental caries. All U.S. residents are likely exposed to some degree to fluoride, which is available from multiple sources. Both health-care professionals and the public have sought guidance on selecting the best way to provide and receive fluoride. During the late 1990s, CDC convened a work group to develop recommendations for using fluoride to prevent and control dental caries in the United States. This report includes these recommendations, as well as a) critical analysis of the scientific evidence regarding the efficacy and effectiveness of fluoride modalities in preventing and controlling dental caries, b) ordinal grading of the quality of the evidence, and c) assessment of the strength of each recommendation. Because frequent exposure to small amounts of fluoride each day will best reduce the risk for dental caries in all age groups, the work group recommends that all persons drink water with an optimal fluoride concentration and brush their teeth twice daily with fluoride toothpaste. For persons at high risk for dental caries, additional fluoride measures might be needed. Measured use of fluoride modalities is particularly appropriate during the time of anterior tooth enamel development (i.e., age <6 years). The recommendations in this report guide dental and other health-care providers, public health officials, policy makers, and the public in the use of fluoride to achieve maximum protection against dental caries while using resources efficiently and reducing the likelihood of enamel fluorosis. The recommendations address public health and professional practice, self-care, consumer product industries and health agencies, and further research. Adoption of these recommendations could further reduce dental caries in the United States and save public and private resources.  (+info)

(4/124) Effectiveness of methods used by dental professionals for the primary prevention of dental caries.

This paper summarizes and rates the evidence for the effectiveness of methods available to dental professionals for their use in the primary prevention of dental caries. It reviews operator-applied therapeutic agents or materials and patient counseling. Evidence of effectiveness is extracted from published systematic reviews. A search for articles since publication of these reviews was done to provide updates, and a systematic review of the caries-inhibiting effects of fluoride varnish in primary teeth is provided. Good evidence is available for the effectiveness of fluoride gel and varnish, chlorhexidine gel, and sealant when used to prevent caries in permanent teeth of children and adolescents. The evidence for effectiveness of fluoride varnish use in primary teeth, chlorhexidine varnish, and patient counseling is judged to be insufficient. Use of fluoride, chlorhexidine and sealant according to tested protocols and for the populations in which evidence of effect is available can be recommended. However, they may need to be used selectively. Estimates for the number of patients or tooth surfaces needed to treat to prevent a carious event suggest that the effects of these professional treatments are low in patients who are at reduced risk for dental caries. The literature on use of these preventive methods in individuals other than school-aged children needs expansion.  (+info)

(5/124) Topical fluorides in caries prevention and management: a North American perspective.

A review of evidence-based literature indicates incomplete evidence for the efficacy of most measures currently used for caries prevention, with the exception of fluoride varnishes and the use of fluoride-based interventions for patients with hyposalivation. Not all fluoride agents and treatments are equal. Different fluoride compounds, different vehicles, and vastly different concentrations have been used with different frequencies and durations of application. These variables can influence the clinical outcome with respect to caries prevention and management. The efficacy of topical fluoride in caries prevention depends on a) the concentration of fluoride used, b) the frequency and duration of application, and to a certain extent, c) the specific fluoride compound used. The more concentrated the fluoride and the greater the frequency of application, the greater the caries reduction. Factors besides efficacy, such as practicality, cost, and compliance, influence the clinician's choice of preventive therapy. For noncavitated smooth surface carious lesions in a moderate caries-risk patient, the appropriate fluoride regimen would be semiannual professional topical application of a fluoride varnish containing 5 percent NaF (22,600 ppm of fluoride). In addition, the patient should use twice or thrice daily for at least one minute a fluoridated dentifrice containing NaF, MFP, or SnF2 (1,000-1,500 ppm of fluoride), and once daily for one minute a fluoride mouthrinse containing .05 percent NaF (230 ppm of fluoride). If the noncavitated carious lesion involves a pit or fissure, the application of an occlusal sealant would be the most appropriate preventive therapy. The management of the high caries-risk patient requires the use of several preventive interventions and behavioral modification, besides the use of topical fluorides. For children over six years of age and adults, both office and self-applied topical fluoride treatments are recommended. For office fluoride therapy at the initial visit, a high-concentration agent, either a 1.23 percent F APF gel (12,300 ppm of fluoride) for four minutes in a tray or a 5 percent NaF varnish (22,600 ppm of fluoride), should be applied directly to the teeth four times per year. Self-applied fluoride therapy should consist of the daily five-minute application of 1.1 percent NaF or APF gel (5,000 ppm of fluoride) in a custom-fitted tray. For those who cannot tolerate a tray delivery owing to gagging or nausea, a daily 0.05 percent NaF rinse (230 ppm of fluoride) for 1 minute is a less effective alternative. In addition, the patient should use twice or thrice daily for at least 1 minute a fluoridated dentifrice as described above for treatment of noncavitated carious lesions. In order to avoid unintentional ingestion and the risk of fluorosis in children under six years of age, fluoride rinses and gels should not be used at home. Furthermore, when using a fluoride dentifrice, such children should apply only a pea-size portion on the brush, should be instructed not to eat or swallow the paste, and should expectorate thoroughly after brushing. Toothbrushing should be done under parental supervision. To avoid etching of porcelain crowns and facings, neutral NaF is indicated in preference to APF gels for those patients who have such restorations and are applying the gel daily. The rationale for these recommendations is discussed. Important deficiencies in our knowledge that require further research on topical fluoride therapy in populations with specific needs are identified.  (+info)

(6/124) The use of combinations of caries preventive procedures.

There are now a number of different approaches to preventing dental caries available to the clinician. Caries preventive methods are frequently used in combination. This paper reviews the potential effectiveness of combinations of preventive methods. Three groups of studies are reviewed; combinations of fluoride procedures; fluoride and fissure sealants; chlorhexidine and other agents. The review indicates that there is considerable benefit to be derived from using more than one fluoride procedure. Further research is required in the effectiveness of combining chlorhexidine with other agents. The most promising combination programme currently appears to be the use of fluoride with fissure sealing. The relevance of combination therapy for adults needs to be investigated.  (+info)

(7/124) Varnish or polymeric coating for the prevention of demineralization? An ex vivo study.

OBJECTIVE: The ability of an experimental coating, Odyssey, to prevent demineralisation ex vivo was compared with that of a fluoride varnish, Duraphat and a chlorhexidine-containing varnish, Cervitec. DESIGN: an ex vivo single-blind study. SETTING: Hard tissue research laboratory. MATERIALS AND METHODS: thirty bovine enamel blocks 0.5 cm x 1.5 cm were divided into 6 groups of 5 specimens. The enamel blocks were then allocated to one of 6 surface treatments. INTERVENTIONS: (1) surface left unprepared (control), (2) Duraphat application, (3) Cervitec application, (4) experimental polymer coating, (5) enamel conditioned with 10% citric acid and coated with the experimental polymer coating Odyssey (O + C), (6) enamel etched for 30 sec with 37% phosphoric acid and coated with the experimental coating (O + E). All specimens were cycled for 7 days through a daily procedure of demineralisation for 4 hours and remineralisation for 20 hours, and exposed to an equivalent of 2 months toothbrushing. A single operator blinded to the treatment allocation of each specimen carried artificial lesion depth assessment out using computer-assisted transverse microradiography. RESULTS: The control group had the greatest mean lesion depth (97.16 + 29.8 microm) with the Duraphat group exhibiting the lowest mean lesion depth (24.53 + 15.44 microm). The Duraphat, Odyssey, O + C and O + E groups all had significantly less lesion depth when compared with no surface preparation (p < 0.05 for all comparisons). There were no significant differences between any of the Odyssey groups. CONCLUSIONS: The efficacy of Duraphat application in preventing demineralisation ex vivo has been demonstrated in the present study, but clinical trials are required to assess its usefulness in orthodontic practice.  (+info)

(8/124) Effect of experimental fluoride-releasing tooth separator on acid resistance of human enamel in vitro.

This study aimed to investigate the fluoride-releasing ability of an experimental tooth separator consisting of polyurethane elastomer with tin fluoride and its effect on the acid resistance of human enamel. The tooth separator was set around an enamel slab and stored in de-ionized water for 10 days. The daily concentration of fluoride in the de-ionized water was measured. Then the enamel surface was artificially decalcified by a lactic acid buffer solution (pH 4.5) for 96 hours. The mineral density at the surface layer of the enamel was measured to evaluate the acid resistance. The fluoride release increased with the amount of fluoride in the separator, but decreased with the immersion time. Both the enamel area contacting with the separator and its surrounding area showed lower mineral loss and lesion depth compared with the controls (P < 0.05). It is suggested that the experimental tooth separator would release enough fluoride and improve the acid resistance of the enamel surface layer.  (+info)