High-fluoride dentifrice for older adult root caries lesions

Abstract This parallel, triple-blind RCT evaluated the restorative performance of a resin-modified glass-ionomer-cement (RMGIC) in irradiated patients and the prevention of root caries lesions adjacent to restoration, comparing the effect of conventional (control) concentration, high-fluoride (F) containing fTCP and arginine-based toothpastes. A total of 63 lesions was screened and 60 were included into randomized distribution into three groups (N- participants in baseline/n- root caries lesions): G1 = 1,450 ppm F (N = 10/n = 17); G2 = 5,000 ppm F + fTCP (N = 7/n = 18) and G3 = 1,450 ppm F + arginine + CaCO3 (N = 6/n = 25). Based on eligibility criteria, all patients were mandatory enrolled after completed 3-month of radiotherapy of head-and-neck. Two calibrated operators performed the restorative procedures (RMGIC - Vitremer) and two calibrated examiners (Kappa = 0.94) evaluated the restorations based on modified USPHS criteria at baseline, 1, 3 and 6-month follow-up. Data was collected and statistically assessed with Kruskal-Wallis test (p < 0.05). There were no statistically significance differences among the performance of the restoration among the three groups regarding the criteria retention, marginal adaptation, marginal staining, post-operative sensitivity, adjacent caries, color alteration, anatomic form and surface texture (p > 0.05). Even with oral complications caused by radiation-therapy, if the restorations are properly performed and patients are under professional supervision, high-F presented similar efficacy of arginine and conventional-containing toothpastes to prevent secondary caries. Clinical relevance: This clinical trial brings new evidences about the regular use of high-F, arginine-based and conventional-F containing toothpastes in irradiated patients under supervision of a multidisciplinary team and the encouragement of self-cooperation.

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Assessment of oral health-related quality of life as a function of non-invasive treatment with high-fluoride toothpastes for root caries lesions in community-dwelling elderly

International Dental Journal ◽

10.1111/idj.12415 ◽

2019 ◽

Vol 69 (1) ◽

pp. 58-66 ◽

Cited By ~ 1

Author(s):

Soraya León ◽

Miguel Rivera ◽

Sebastián Payero ◽

Gloria Correa-Beltrán ◽

Fernando N. Hugo ◽

...

Keyword(s):

Community Dwelling ◽

Root Caries ◽

Health Related Quality ◽

Invasive Treatment ◽

Non Invasive ◽

Related Quality ◽

Health Related ◽

High Fluoride ◽

Caries Lesions

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High Fluoride Dentifrices for Elderly and Vulnerable Adults: Does It Work and if So, Then Why?

Caries Research ◽

10.1159/000443021 ◽

2016 ◽

Vol 50 (Suppl. 1) ◽

pp. 15-21 ◽

Cited By ~ 15

Author(s):

Kim Rud Ekstrand

Keyword(s):

Calcium Fluoride ◽

Fluoride Concentration ◽

Mutans Streptococci ◽

Root Caries ◽

Preventive Effect ◽

Reasonable Evidence ◽

High Fluoride ◽

Vulnerable Adults ◽

Caries Lesions ◽

Better Than

The primary aim of this work is to present the available evidence that toothpastes containing >1,500 ppm fluoride (2,500-2,800 and 5,000 ppm F) provide an additional caries preventive effect on root caries lesions in elderly patients compared to traditional dentifrices (1,000-1,450 ppm F). The secondary aim of this paper is to discuss why high fluoride dentifrices in general should perform better than traditional F-containing toothpaste. When examining the few studies that have considered the preventive benefits of high fluoride products on root caries the relative risk appears to be around 0.5, and the risk can thus be halved by exchanging traditional F-containing toothpaste for toothpaste containing 5,000 ppm F. There is reasonable evidence that high fluoride dentifrices significantly increase the fluoride concentration in saliva during the day and the fluoride concentration in plaque compared to traditional F toothpaste. Furthermore, the use of toothpaste with 5,000 ppm F significantly reduces the amount of plaque accumulated, decreases the number of mutans streptococci and lactobacilli and possibly promotes calcium fluoride deposits to a higher degree than after the use of traditional F-containing toothpaste.

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Effect of 5,000 ppm Fluoride Dentifrice or 1,100 ppm Fluoride Dentifrice Combined with Acidulated Phosphate Fluoride on Caries Lesion Inhibition and Repair

Caries Research ◽

10.1159/000453624 ◽

2017 ◽

Vol 51 (3) ◽

pp. 179-187 ◽

Cited By ~ 10

Author(s):

Constanza E. Fernández ◽

Livia Maria Andaló Tenuta ◽

Altair Antoninha Del Bel Cury ◽

Diego Figueiredo Nóbrega ◽

Jaime Aparecido Cury

Keyword(s):

Fluoride Concentration ◽

Negative Control ◽

Double Blind ◽

Cross Sectional ◽

Caries Lesion ◽

Risk Patients ◽

High Fluoride ◽

Fluoride Dentifrice ◽

The Difference ◽

Caries Lesions

High fluoride dentifrice (FD; 5,000 ppm F) has been recommended to arrest root dentine lesions and to control enamel caries in high-risk patients. Also, standard FD (1,100 ppm F) in combination with professional fluoride application has been recommended to control dentine caries, but the effect of this combination on enamel has been considered modest. Considering the lack of evaluation comparing the use of 5,000 ppm FD (5,000-FD) versus acidulated phosphate fluoride (APF) application combined with 1,100 ppm FD (1,100-FD) on the inhibition and repair of caries lesions in both enamel and dentine, we conducted this in situ, double-blind, crossover study of 3 phases of 14 days. In each phase, 18 volunteers wore palatal appliances containing enamel and root dentine specimens, either sound or carious, to evaluate the effect of the treatments on the inhibition or repair of caries lesions, respectively. The treatments were non-FD (negative control), 5,000-FD, or 1 APF gel application on dental specimens combined with 1,100-FD used twice per day (APF + 1,100-FD). The reduction of demineralization and enhancement of remineralization were assessed by surface and cross-sectional hardness. Fluoride concentration was determined on dental specimens and on the formed biofilm. For enamel, APF + 1,100-FD and 5,000-FD did not differ regarding the inhibition of demineralization and repair of caries lesions. However, for dentine the difference between these treatments was inconclusive because while APF + 1,100-FD was more effective than 5,000-FD in caries lesion reduction and repair, 5,000-FD was more effective than APF + 1,100-FD in the reduction of surface demineralization. Therefore, the findings show that the combination of APF + 1,100-FD is as effective as 5,000-FD in enamel inhibition of demineralization and enhancement of remineralization.

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