High‐fluoride toothpaste: a multicenter randomized controlled trial in adults

Abstract

ObjectiveThe aim of this single – blind, multicenter, parallel, randomized controlled trial was to evaluate the effectiveness of the application of a high-fluoride toothpaste on root caries in adults.MethodsAdult patients (n = 130, ♂ = 74, ♀ = 56; mean age ± SD: 56.9 ± 12.9) from three participating centers, diagnosed with root caries, were randomly allocated into two groups: Test (n = 64, ♂ = 37, ♀ = 27; lesions = 144; mean age: 59.0 ± 12.1; intervention: high-fluoride toothpaste with 5000 ppm F), and Control (n = 66, ♂ = 37, ♀ = 29; lesions = 160; mean age: 54.8 ± 13.5; intervention: regular-fluoride toothpaste with 1350 ppm F) groups. Clinical examinations and surface hardness scoring of the carious lesions were performed for each subject at specified time intervals (T0 – at baseline before intervention, T1 – at 3 months and T2 – at 6 months after intervention). Mean surface hardness scores (HS) were calculated for each patient. Statistical analyses comprised of two-way analysis of variance and post hoc comparisons using the Bonferroni–Dunn correction.ResultsAt T0, there was no statistical difference between the two groups with regard to gender (P = 0.0682, unpaired t-test), or age (P = 0.9786, chi-squared test), and for the overall HS (Test group: HS = 3.4 ± 0.61; Control group: HS = 3.4 ± 0.66; P = 0.8757, unpaired t-test). The anova revealed significantly better HS for the test group than for the control groups (T1: Test group: HS = 2.9 ± 0.67; Control group: HS = 3.1 ± 0.75; T2: Test group: HS = 2.4 ± 0.81; Control group: HS = 2.8 ± 0.79; P < 0.0001). However, the interaction term time-point*group was not significant.ConclusionsThe application of a high-fluoride containing dentifrice (5000 ppm F) in adults, twice daily, significantly improves the surface hardness of otherwise untreated root caries lesions when compared with the use of regular fluoride containing (1350 ppm F) toothpastes.

Systematic Review on Noninvasive Treatment of Root Caries Lesions

“…The median (25th/75th percentiles) follow-up time was 15 (12/24) mo. Eleven studies investigated dentifrices (Jensen and Kohout 1988;Banoczy and Nemes 1991;Baysan et al 2001;Paraskevas et al 2004;Papas et al 2007;Papas et al 2008;Vered et al 2009;Ekstrand et al 2013;Hu et al 2013;Souza et al 2013;Srinivasan et al 2013), 10 rinses (Ripa et al 1987;Banoczy and Nemes 1991;Ravald and Birkhed 1992;Wallace et al 1993;Fure et al 1998;Powell et al 1999;Paraskevas et al 2004;Wyatt and MacEntee 2004;Petersson et al 2007;Wyatt et al 2007), 8 varnishes (Schaeken et al 1991;Ravald and Birkhed 1992;Powell et al 1999;Banting et al 2000;Baca et al 2009;Fure and Lingstrom 2009;Tan et al 2010;Zhang et al 2013), 3 (fluoride) solutions (Fure and Lingstrom 2009;Tan et al 2010;Zhang et al 2013), 3 gels (Ravald and Birkhed 1992;DePaola 1993;Wallace et al 1993), 2 ozone applications (Holmes 2003;Baysan and Lynch 2007), and 1 preventive dental regimes (Mojon et al 1998). Eleven studies investigated both initiation of RCLs and the change of RCLs, 11 analyzed the change of RCLs, and 8 studied initiation of RCLs ...…”

“…Therefore, no meta-analysis could be performed for fluoride varnish, CHX mouth rinse, and ozone application. Two studies-one analyzing both CHX (EC 40) and fluoride varnish (Duraphat; Schaeken et al 1991) the other analyzing highly concentrated fluoride dentifrice (Duraphat 5000; Srinivasan et al 2013)-had to be excluded from quantitative analyses. The gained evidence is additionally limited by the focus of the studies and the follow-up times.…”

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

“…The latter study contains the 3-month results of the study of Baysan et al [2001] already mentioned above. Yet another randomized clinical trial was identified [Srinivasan et al, 2014], but the RR could not be calculated from the study. However, at the end of the study period, ANOVA revealed significantly better surface hardness scores of the lesions in the test groups than in the control groups (p < 0.0001).…”

Caries Progression: How Can We Control this Disease?

“…Some clinical data [24][25][26] suggest that more fluoride would be needed to control root caries than that used for enamel caries. In addition, the difference in fluoride effect on dentin compared to enamel explains why the combination of professional application of fluoride with regular daily use of toothpaste with standard fluoride would be more effective to control caries in dentin [27], but not in enamel [28].…”