Evaluation of Topical Fluoride Preparations

Abstract

For practical reasons, evaluation of topical fluoride products must depend upon clinical and laboratory assessments. While not always a good predictor of clinical efficacy by itself, fluoride uptake is the most commonly used laboratory test. A consideration of the relationship between possible anticaries mechanisms of fluoride, different product types, and the meaning of various kinds of fluoride uptake data suggests that both the amount of fluoride taken up by early lesions and the amount of ambient fluoride present at a cariogenic site may play key roles in determining the efficacy of a product. While formulations applied annually or semi-annually probably depend on fluoride deposition, those used daily might not. There are no clear data supporting the superiority of one fluoride compound over another, even for infrequently used products, although there are significant differences among them in fluoride uptake by enamel. This suggests that fluoride uptake in vivo at a cariogenic site might actually be different from that suggested by in vitro data, or that larger differences are required for a clinical effect to be observable. Clinical data support the conclusion that a large increase in the fluoride concentration of a product will somewhat increase its anticaries effectiveness, although the increase will not be linearly related to concentration. There also are no obvious differences in clinical effectiveness caused by the addition of gelling agents to topical solutions. Fluoride varnishes are clinically effective but have not been shown to be superior to topical solutions or gels.(ABSTRACT TRUNCATED AT 250 WORDS)

Caries-Preventive Effect of Two Different Topical Fluoride Concentrations with Two Different Frequencies of Application in Preschool Children

“…Fluoride uptake data have shown that amine fluoride (and APF) deposits more fluoride in enamel than NaF or SnF2 [Gron, 1977;Kirkegaard, 1977;Mellberg, 1990], ten Cate [1990] concluded that fluoride from depots in porous parts of the dentition and plaque may gradually redis solve . The results of this present study suggest that month ly applications of amine fluoride, even with a lower fluo ride concentration, ensure that enough fluoride is present for the direct or indirect interaction with the de-or remin eralization components of the caries process and thereby reduce its progression in the deciduous dentition.…”

Fluoride Mouthrinses and Fluoride Varnishes

“…The posssibility that higher fluoride concentrations used at the same frequency might provide greater benefits should not be discounted. The additional benefits of daily rinsing as compared with weekly rinsing have not been demonstrat ed in controlled clinical studies, supporting the theory that the predominant action of fluoride is the remineralization of initial carious lesions [Arends and ten Cate, 1981;Mellberg. 1990].…”

Caries and fluoride processes

“…[19][20][21] Further, high fluoride uptakes did not necessarily show such a correlation, either. [21][22][23] Moreno et al 24 studied the solubility behaviour of hydroxyapatite at various levels of fluoride substitution. The maximum effect was obtained when only 50% of the hydroxyl groups had been replaced corresponding to the greatest lattice stability and reflecting a low lattice free energy (G).…”