Effects of Regular and Low-fluoride Dentifrices on Plaque Fluoride

Previous studies have indicated that the use of low-fluoride dentifrices could lead to proportionally higher plaque fluoride levels when compared with conventional dentifrices. This double-blind, randomized, crossover study determined the effects of placebo, low-fluoride, and conventional dentifrices on plaque fluoride concentrations ([F]) in children living in communities with 0.04, 0.72, and 3.36 ppm F in the drinking water. Children used the toothpastes twice daily, for 1 wk. Samples were collected 1 and 12 hrs after the last use of dentifrices and were analyzed for fluoride and calcium. Similar increases were found 1 hr after the children brushed with low-fluoride (ca. 1.9 mmol F/kg) and conventional (ca. 2.4 mmol F/kg) dentifrices in the 0.04- and 0.72-ppm-F communities. Despite the fact that the increases were less pronounced in the 3.36-ppm-F community, our results indicate that the use of a low-fluoride dentifrice promotes a proportionally higher increase in plaque [F] when compared with that achieved with a conventional dentifrice, based on dose-response considerations.

Effects of Regular and Low-fluoride Dentifrices on Plaque Fluoride

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Fluoride intake from regular and low fluoride dentifrices by 2-3-year-old children: Influence of the dentifrice flavor

This study evaluated the fluoride intake from dentifrices with different fluoride concentrations ([F]) by children aged 24-36 months, as well as the influence of the dentifrice flavor in the amount of fluoride ingested during toothbrushing. Thirty-three children were randomly divided into 3 groups, according to the [F] in the dentifrices: G-A (523 μgF/g), G-B (1,062 μgF/g) and G-C (1,373 μgF/g). Dentifrices A and B are marketed for children, while dentifrice C is a regular product. The amount of F ingested was indirectly obtained, subtracting the amount expelled and the amount left on the toothbrush from the amount initially loaded onto the brush. The results were analyzed by ANOVA, Tukey's test and linear regression analysis (p < 0.05). Children ingested around 60% of the dentifrice loaded onto the brush, but no significant differences were seen among the groups (p > 0.05). Mean daily fluoride intake from dentifrice for G-A, G-B and G-C was 0.022 a, 0.032 a and 0.061 b mg F/kg body weight, respectively (p < 0.01). There was a strong positive correlation (r = 0.86, p < 0.0001) between the amount of dentifrice used and the amount of fluoride ingested during toothbrushing. The results indicate the need for instructing children's parents and care givers to use a small amount of dentifrice (< 0.3 g) to avoid excessive ingestion of fluoride. The use of low-[F] dentifrices by children younger than 6 years also seems to be a good alternative to minimize fluoride intake. Dentifrice flavor did not influence the percentage of fluoride intake.

Effect of low-fluoride dentifrices supplemented with calcium glycerophosphate on enamel demineralization in situ

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

In situ protocol for the detemination of dose-response effect of low-fluoride dentifrices on enamel remineralization

No in situ protocol has assessed the dose-response effects of fluoride dentifrices involving low-fluoride formulations. Objective: To assess the ability of an in situ remineralization model in determining dose-response effects of dentifrices containing low fluoride concentrations ([F]) on bovine enamel. Material and Methods: Volunteers wore palatal appliances containing demineralized enamel blocks and brushed their teeth and devices with the dentifrices supplied (double-blind, crossover protocol) separately for 3 and 7 days. Surface hardness (SH), integrated subsurface hardness (AKHN) and [F] in enamel were determined. Data were analyzed by ANOVA, Tukey's test and Pearson's correlation (p<0.05). Results: Dose-response relationships were verified between [F] in dentifrices and SH, AKHN and enamel [F]. Higher correlation coefficients between enamel [F] and SH and AKHN were obtained for the 3-day period. Significant differences in SH and AKHN were observed among all groups for the 3-day period, but not between 0-275, 275-550, and 550-1,100 mu g F/g dentifrices for the 7-day period, nor between 3- and 7-day periods for the 1,100 mu g F/g groups. Conclusions: Considering that the peak remineralization capacity of the conventional dentifrice (1,100 mu g F/g) was achieved in 3 days, this experimental period could be used in future studies assessing new dentifrice formulations, especially at low-fluoride concentrations.

Distribution of fluoride and calcium in plaque biofilms after the use of conventional and low-fluoride dentifrices

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Plaque fluoride concentrations associated to the use of conventional and low-fluoride dentifrices

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Low-Fluoride Acidic Dentifrice: A Randomized Clinical Trial in a Fluoridated Area

Background: Low-fluoride dentifrices have been suggested as alternatives to reduce dental fluorosis risk, but there is no consensus regarding their clinical effectiveness, which has been suggested to be increased when their pH is acidic. Aims: This single-blind randomized clinical trial evaluated the caries increment during the use of a low-fluoride acidic liquid dentifrice. Methods: Four-year-old schoolchildren (n = 1,402) living in a fluoridated area (0.6-0.8 ppm F) were randomly allocated to 4 groups differing according to the type of dentifrice used over a 20-month period. Group 1 (n = 345): liquid dentifrice, 1,100 ppm F, pH 4.5. Group 2 (n = 343): liquid dentifrice, 1,100 ppm F, pH 7.0. Group 3 (n = 354): liquid dentifrice, 550 ppm F, pH 4.5. Group 4 (n = 360): toothpaste, 1,100 ppm F, pH 7.0. At baseline and after 20 months, clinical examinations were conducted (dmfs index) and caries increment was calculated. Data were analysed by GLM procedure using classrooms (cluster) as unit of analysis (p < 0.05). Results: The mean +/- SD (95% CI) net increments found were as follows. Group 1: 2.06 +/- 2.38 (1.8-2.3); group 2: 2.08 +/- 2.87 (1.7-2.4); group 3: 2.05 +/- 2.79 (1.7-2.4), and group 4: 2.08 +/- 2.34 (1.8-2.4). No significant differences were detected among the groups. Conclusion: In a population with high caries risk living in a fluoridated area, as the selected sample, and according to the present protocol, the low-fluoride acidic liquid dentifrice seems to lead to similar caries progression rates as conventional 1,100 ppm F toothpaste. Copyright (C) 2010 S. Karger AG, Basel

Low-Fluoride Acidic Dentifrice: A Randomized Clinical Trial in a Fluoridated Area

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

In vitro evaluation of the effectiveness of acidic fluoride dentifrices

This study evaluated the effectiveness of acidic low-fluoride dentifrices compared to conventional neutral dentifrices. Enamel blocks were submitted to pH cycling and treatment with slurries of dentifrices containing 0, 275, 412, 550 and 1,100 mu g F/g (pH 4.5 or 7.0), and also a commercial dentifrice (1,100 mu g F/g) and a commercial children's dentifrice (500 mu g F/ g). Variations in surface microhardness and in the mineral content in enamel after pH cycling were calculated. Enamel blocks treated with acidic dentifrices exhibited less mineral loss compared to neutral dentifrices (ANOVA; p < 0.05). The acidic dentifrices with 412 and 550 mu g F/g had the same effectiveness as the neutral 1,100-mu g F/g dentifrice and commercial 1,100-mu g F/g dentifrice. Copyright (c) 2007 S. Karger AG, Basel

Effect of low fluoride acidic dentifrices on dental remineralization

This study evaluated the capacity of fluoride acidic dentifrices (pH 4.5) to promote enamel remineralization using a pH cycling model, comparing them with a standard dentifrice (1,100 μgF/g). Enamel blocks had their surface polished and surface hardness determined (SH). Next, they were submitted to subsurface enamel demineralization and to postdemineralization surface hardness analysis. The blocks were divided into 6 experimental groups (n=10): placebo (without F, pH 4.5, negative control), 275, 412, 550, 1,100 μgF/g and a standard dentifrice (positive control). The blocks were submitted to pH cycling for 6 days and treatment with dentifrice slurries twice a day. After pH cycling, surface and crosssectional hardness were assessed to obtain the percentage of surface hardness recovery (%SHR) and the integrated loss of subsurface hardness (δKHN). The results showed that %SHR was similar among acidic dentifrices with 412, 550, 1,100 μgF/g and to the positive control (Tukey's test; p>0.05). For ΔKHN, the acidic dentifrice with 550 μg F/g showed a better performance when compared with the positive control. It can be concluded that acidic dentifrice 550 μgF/g had similar remineralization capacity to that of positive control.

Effect of low fluoride acidic dentifrices on dental remineralization

This study evaluated the capacity of fluoride acidic dentifrices (pH 4.5) to promote enamel remineralization using a pH cycling model, comparing them with a standard dentifrice (1,100 µgF/g). Enamel blocks had their surface polished and surface hardness determined (SH). Next, they were submitted to subsurface enamel demineralization and to post-demineralization surface hardness analysis. The blocks were divided into 6 experimental groups (n=10): placebo (without F, pH 4.5, negative control), 275, 412, 550, 1,100 µgF/g and a standard dentifrice (positive control). The blocks were submitted to pH cycling for 6 days and treatment with dentifrice slurries twice a day. After pH cycling, surface and cross-sectional hardness were assessed to obtain the percentage of surface hardness recovery (%SHR) and the integrated loss of subsurface hardness (ΔKHN). The results showed that %SHR was similar among acidic dentifrices with 412, 550, 1,100 µgF/g and to the positive control (Tukey's test; p>0.05). For ΔKHN, the acidic dentifrice with 550 µg F/g showed a better performance when compared with the positive control. It can be concluded that acidic dentifrice 550 µgF/g had similar remineralization capacity to that of positive control.

Combination effect of fluoride dentifrices and varnish on deciduous enamel demineralization

The aim of this study was to evaluate the anticaries potential of 500 or 1100 ppm F dentifrices combined with fluoride varnish using a pH-cycling regimen. Seventy primary canines were covered with nail polish, leaving a 4×4 mm window on their buccal surface, and randomly assigned into 7 groups (n = 10): S: sound enamel not submitted to the pH-cycling regimen or treatment; N: negative control, submitted to the pH-cycling regimen without any treatment; D1 and D2: subjected to the pH-cycling regimen and treated twice daily with 1100 or 500 ppm F dentifrice, respectively; VF: fluoride varnish (subjected to F-varnish before and in the middle of the pH-cycling regimen); and VF+D1 and VF+D2. After 10 days, the teeth were sectioned, and enamel demineralization was assessed by cross-sectional hardness at different distances from the dental surface. Data were analyzed using a two-way ANOVA followed by Tukey's test. Dentifrice with 1100 ppm F and the combination of F-varnish with the dentifrices significantly reduced enamel demineralization compared with the negative control (p < 0.05), but the isolated effects of F-varnish and dentifrice with low concentration were not significant (p > 0.05). The effect of combining F-varnish with the dentifrices was not greater than the effect of the dentifrices alone (p < 0.05). The data suggest that the combination of F-varnish with dentifrices containing 500 and 1100 ppm F is not more effective in reducing demineralization in primary teeth than the isolated effect of dentifrice containing 1100 ppm F.

In vitro enamel remineralization by low-fluoride toothpaste with calcium citrate and sodium trimetaphosphate

The objective of this study was to evaluate in vitro the effect of a low fluoride toothpaste (450 μgF/g, NaF) combined with calcium citrate (Cacit) and sodium trimetaphosphate (TMP) on enamel remineralization. Bovine enamel blocks had the enamel surface polished sequentially to determine the surface hardness. After production of artificial carious lesions, the blocks selected by their surface hardness were submitted to remineralization pH cycling and daily treatment with dentifrice suspensions (diluted in deionized water or artificial saliva): placebo, 275, 450, 550 and 1,100 μgF/g and commercial dentifrice (positive control, 1,100 μgF/g). Finally, the surface and cross-section hardness was determined for calculating the change of surface hardness (%SH) and mineral content (%ΔZ). Fluoride in enamel was also determined. The data from %SH, %ΔZ and fluoride were subjected to two-way analysis of variance followed by Student-Newman-Keuls's test (p<0.05). The mineral gain (%SH and %ΔZ) was higher for toothpastes diluted in saliva (p<0.05), except for the 450 mgF/g dentifrice with Cacit/TMP (p>0.05). The 450 Cacit/ TMP toothpaste and the positive control showed similar results (p>0.05) when diluted in water. A dose-response was observed between fluoride concentration in toothpastes and fluoride present in enamel, regardless of dilution. It was concluded that it is possible to enhance the remineralization capacity of low F concentration toothpaste by of organic (Cacit) and inorganic (TMP) compounds with affinity to hydroxyapatite.