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

Vilhena, Fabiano Vieira; Olympio, Kelly Polido Kaneshiro; Lauris, José Roberto Pereira; Delbem, Alberto Carlos Botazzo; Buzalaf, M. A. R.

doi:10.1159/000320364

Cited by 26 publications

(19 citation statements)

References 37 publications

(18 reference statements)

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“…Since dental caries has become a polarized disease and conventional fluoride therapy seems to have little effect for highrisk groups [Pessan et al, 2008], alternatives have been proposed to increase the effectiveness of fluoridated vehicles Buzalaf et al, 2009;Takeshita et al, 2009;Vilhena et al, 2010;Amaral et al, 2013]. All fluoride varnishes tested in the present study were shown to significantly increase remineralization of enamel carious lesions, following a dose-response relationship.…”

Section: Discussionmentioning

confidence: 65%

In vitro Remineralizing Effect of Fluoride Varnishes Containing Sodium Trimetaphosphate

et al. 2014

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This study analyzed the effects of fluoride varnishes supplemented with sodium trimetaphosphate (TMP) on the remineralization of caries-like lesions in vitro. Bovine enamel discs were selected through surface hardness (SH) and caries-like lesions were induced. SH was again determined and the blocks were divided into 7 experimental groups (n = 24/group): placebo (no fluoride or TMP), 5% TMP, 2.5% NaF, 2.5% NaF/5% TMP, 5% NaF, 5% NaF/5% TMP and commercial formulation (Duraphat™, 5% NaF), following a blind protocol. Discs were treated with the varnishes and kept in a remineralizing solution for 4 h and a demineralizing solution for 2 h. Varnishes were then removed and half of the discs were used for analysis of loosely (CaF₂) and firmly bound fluoride. The remaining discs were submitted to a pH-cycling regimen for 6 days. The percentage of surface hardness recovery (%SHR), cross-sectional hardness (ΔKHN) and enamel CaF₂ and fluoride were determined. Data were analyzed by ANOVA and by Student-Newman-Keuls' test (p < 0.05). A dose-response relationship was observed between fluoride concentrations in the varnishes and %SHR. The 5% TMP varnish led to %SHR similar to that obtained for the placebo. When TMP was used in association with fluoride, however, significantly higher %SHR were observed in comparison with their counterparts without TMP. Moreover, ΔKHN obtained for the 5% NaF/5% TMP was significantly lower among all groups tested. Higher concentrations of CaF₂ and fluoride were observed for Duraphat and 5% NaF, followed by 5% NaF/5% TMP, 2.5% NaF and 2.5% NaF/5% TMP (p < 0.05). It was concluded that the supplementation of fluoride varnishes with TMP leads to enhanced remineralizing effect of artificial caries lesions in vitro.

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Section: Discussionmentioning

confidence: 65%

In vitro Remineralizing Effect of Fluoride Varnishes Containing Sodium Trimetaphosphate

et al. 2014

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“…The preventative effect of low-fluoride dentifrice is still a concern in the literature. Winter et al 12 and Vilhena et al 9 demonstrated good performance in preventing new caries lesions in clinical trials using 550 ppm F and 500 ppm F toothpaste, respectively. However, Lima et al 13 showed that in active caries in children, the 1100 ppm F performed better than the 500 ppm F. The low anticaries efficacy of 500 ppm F dentifrice compared with 1000-1100 ppm F dentifrice has been shown experimentally, 14 and it has also been supported by evidence.…”

Section: Discussionmentioning

confidence: 99%

“…9 Therefore, it is necessary to assess if dentifrices with lower fluoride concentrations (500 ppm F) that are targeted to children younger than six years old are effective against demineralization, and if this preventive effect is the same as those for 1100 ppm F dentifrices.…”

Section: Introductionmentioning

confidence: 99%

Combination effect of fluoride dentifrices and varnish on deciduous enamel demineralization

et al. 2011

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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.

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“…Tables 2 and 3 show the studies that reported caries incidence at surface level [Gerdin, 1974;Winter et al, 1989;Sonju-Clasen et al, 1995;Vilhena et al, 2010] and tooth level [Gerdin, 1974;Winter et al, 1989;SonjuClasen et al, 1995;Davies et al, 2002], respectively. All the means were smaller than twice the SD, suggesting that data were highly skewed, which prevented the calculation of a pooled weighted mean difference [Altman and Bland, 1996].…”

Section: Resultsmentioning

confidence: 99%

“…Secondly, it was not possible to evaluate the baseline balance regarding caries levels, age, gender and socioeconomic status. Thirdly, two studies lasted less than 2 years [Sonju-Clasen et al, 1995;Vilhena et al, 2010], despite the recommendation that trials should last at least 2 years in order to allow a significant number of lesions to develop at the cavitation level [Chesters et al, 2004]. Finally, one trial was quasi-randomized as the interventions were allocated according to the children's month of birth [Gerdin, 1974].…”

Section: Discussionmentioning

confidence: 99%

Effects of Low and Standard Fluoride Toothpastes on Caries and Fluorosis: Systematic Review and Meta-Analysis

2013

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Although the anti-caries effects of standard fluoride (F) toothpastes are well established, their use by preschoolers (2- to 5-year-olds) has given rise to concerns regarding the development of dental fluorosis. Thus, a widespread support of low F toothpastes has been observed. The aim of this study was to assess the effects of low (<600 ppm) and standard (1,000-1,500 ppm) F toothpastes on the prevention of caries in the primary dentition and aesthetically objectionable (moderate to severe) fluorosis in the permanent dentition. A systematic review of clinical trials and meta-analyses were carried out. Two examiners independently screened 1,932 records and read 159 potentially eligible full-text articles. Data regarding characteristics of participants, interventions, outcomes, length of follow-up and potential of bias were independently extracted by two examiners and disagreements were solved by consensus after consulting a third examiner. In order to assess the effects of low and standard F toothpastes on the proportion of children developing caries and fluorosis, pooled relative risks (RR) and associated 95% confidence intervals were estimated using a fixed and a random-effects model, respectively. Five clinical trials fulfilled the inclusion criteria. Low F toothpastes significantly increased the risk of caries in primary teeth [RR = 1.13 (1.07-1.20); 4,634 participants in three studies] and did not significantly decrease the risk of aesthetically objectionable fluorosis in the upper anterior permanent teeth [RR = 0.32 (0.03-2.97); 1,968 participants in two studies]. There is no evidence to support the use of low F toothpastes by preschoolers regarding caries and fluorosis prevention.

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

Cited by 26 publications

References 37 publications

In vitro Remineralizing Effect of Fluoride Varnishes Containing Sodium Trimetaphosphate

In vitro Remineralizing Effect of Fluoride Varnishes Containing Sodium Trimetaphosphate

Combination effect of fluoride dentifrices and varnish on deciduous enamel demineralization

Effects of Low and Standard Fluoride Toothpastes on Caries and Fluorosis: Systematic Review and Meta-Analysis

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